We need to look at the wider context of the hospital cuts & changes proposals

On 30.9.2016 the Joint Health Scrutiny Committee met to consider its response to the Right Care Right Time Right Place proposals for closing all the acute and emergency services at Huddersfield Royal Hospital, knocking down the hospital, replacing it with a new build 120 bed planned care clinic, sending all acute and emergency Huddersfield patients to an expanded Calderdale Royal Hospital and cutting a range of hospital services and move them into the “community”.

They came up with 19 recommendations about the proposals that they sent to the Clinical Commissioning Groups, who brushed them aside by saying they would be addressed in the Full Business Case for the Right Care Right Time Right Place

This is Jenny Shepherd’s deputation statement to this meeting.

My statement focuses on 4 aspects of JHSC response to Right Care Right Time Right Place proposals.

  • The Joint Health Scrutiny Committee Response ignores the policy framework and goals set up by the Health and Social Care Act 2012,
  • it fails to scrutinise the Sustainability and Transformation Plan
  • it overlooks the public health damage resulting from successive governments’ so-called austerity policies
  • it takes at face value the review of consultation findings that omitted from its 6 key areas of focus the fact that most consultation respondents rejected the proposals and said they would have a bad effect on them

1. In excluding consideration of the policy framework set up by the Health and Social Care Act 2012, the Joint Health Scrutiny Committee’s response to the case for change ignores the agenda of NHS privatisation that drove & shaped the Strategic Review, the National Clinical Advisory Team report, the Keogh Review, the Strategic Outline Case and the models of hospital and community care they proposed.

The Right Care Right Time Right Place proposals cannot meaningfully be scrutinised without taking this into account.

The cuts and privatisation agenda that underpins these proposals betrays the people of Calderdale and Greater Huddersfield. We stand to lose the NHS as a comprehensive health service that is free at the point of use and based on patients’ clinical need if the STP – the logical end point of this agenda – goes ahead

When the JHSC response talks about the proposed hospital clinical model following national guidelines, it means that it’s following national guidelines that are determined by the privatisation agenda of the Health and Social Care Act 2012 and the cuts agenda of the Coalition government’s so-called austerity policy.

But the urgent and emergency care proposals do not follow national guidelines from the Royal College of Emergency Medicine. This is a point campaigners have raised more than once, but the Joint Health Scrutiny Committee has ignored it.

2. The Joint Health Scrutiny Committee Response refers briefly to the Sustainability and Transformation Plan but doesn’t acknowledge its full impact. The cuts pressures it exerts are so intense that NHS Providers recently wrote to the House of Commons Health Select Committee urging them to set up an inquiry to look at, among other things, changing the NHS Policy framework to bring it into line with the reality of the NHS, which is that it no longer provides a comprehensive health service.

Both CHFT and SWPFT are members of NHS Providers and so are presumably signatories to the NHS Providers letter. This surely should be something the Joint Health Scrutiny Committee should scrutinise.

Privatisation is implicit in the Sustainability and Transformation Plans. The Autumn 2015 comprehensive spending review that authorised the sustainability and transformation funding made this conditional on increasing private sector involvement in the NHS. This has been seized on by the NHS Confederation, the organisation for private health companies working in the NHS. The NHS confederation’s STP aim is to embed them in the work of Local Economic Partnerships with the aim of  match funding the government’s 5 year forward view funding with private sector funding. That means bringing in over £100bn/year of private finance into the NHS for five years.

So it is really no surprise that Matthew Swindells recently told CCGs to abandon “old style” contracting. The Joint Health Scrutiny Committee should scrutinise this.

3. When talking about public health, the Joint Health Scrutiny Committee response  ignores the fact that successive governments’ so-called austerity economic policy is responsible for an epidemic of ill health. A study by South West Yorkshire Partnership Foundation Trust of the effects on mental health of the coalition government’s austerity policies found that people’s mental health has suffered. And a recent study by Ted Schrecker of Durham University describes the consequence of these policies as “neoliberal epidemics”: there is an abundant evidence base that connects economic inequality and insecurity with adverse health outcomes, of which obesity is one. The spread of such adverse health outcomes across time and space has been so rapid that it qualifies as an epidemic and this epidemic is the direct consequence of neoliberal economic and social policies.

So any attempt to improve public health without addressing this key determinant of health is like shifting the deckchairs on the Titanic.

4. The Joint Health Scrutiny Committee Response to the Commissioning Support Unit review of the consultation findings omits to mention that the review identifies 6 key areas of focus for the CCGs’ deliberations that exclude focusing on the fact that most consultation respondents rejected the proposals and said they would have a bad impact on them

I hope that the Joint Health Scrutiny Committee might discuss these issues in its meeting today.

Thank you

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