Scrutiny Committee consultation on hospital cuts and changes isn’t fit for purpose

NHS campaigners are baffled by contradictory accounts of why the Full Business Case for the Calderdale and Huddersfield hospitals reconfiguration will not be handed over to the Councils’ health scrutiny committee, before it meets on Friday July 21st to see if the plans are up to scratch.

At the meeting,  Calderdale and Kirklees 999 Call for the NHS and Huddersfield Keep our NHS Public will tell Councillors that their only honest option is to report to the Secretary of State for Health that the NHS organisations have failed to provide adequate, timely information to the Committee’s consultation.

Calderdale and Kirklees Joint Health Scrutiny Committee have put out a statement that saying that although the Full Business Case was due to go to them at the end of June, the hospitals Trust has told them that it will not publish the Full Business Case, because it is a detailed case for capital funding that will include commercially sensitive information.

But the Calderdale and Huddersfield hospitals Trust has told campaigners that they will publish as much as possible of the Full Business Case as they can, although they don’t know when this will be.

The Full Business Case is only a draft

The Trust added that the current Full Business Case is a draft that the Board has commented on and is expected to sign off later this month. But the hospitals regulator, NHS Improvement, has not told the Trust when it will sign off the Full Business Case – which it must do before it submits it to the Treasury.

NHS campaigners want to know the reason for the delay in completing the Full Business Case. Paul Cooney of Huddersfield Keep Our NHS Public attended the Trust Board meeting last week and said

“The proposals and the Full Business Case were not even discussed in the public session of the meeting which lasted almost 3 hours. I spoke to Andrew Haigh, the Chair, and handed him a list of questions which we need answers to. I have had replies to some of them and these show many gaps in the Case.”

According to the hospital Trust Board papers, the reason for the Full Business Case delay is due to:

“insufficient capacity and capability across the organisation to manage the many schemes (Electronic Patient Records, Cost Improvement Programme, Care Quality Commission preparation and service reconfiguration) while keeping the base safe”.

In other words, the Trust seems overwhelmed by demands from the government’s NHS quangos while struggling to provide safe patient care and staff working conditions.

Campaigners will tell the 21st July Scrutiny Committee meeting that – as well as reporting to the Secretary of State that the NHS organisations have failed to provide adequate, timely information –  it also needs to scrutinise the effects of NHS quangos’ pressure on our Hospitals Trust; how this has affected the Trust’s ability to produce a Full Business Case that meets the Joint Health Scrutiny Committee’s recommendations and timeframe; and its ability to provide safe patient care and safe staff working conditions.

The Joint Health Scrutiny Committee has stated that they will use the information that the Trust is sending them to see if the Trust has satisfied the Committee’s recommendations made 10 months ago, following the public consultation which roundly rejected the proposed changes.

Councillors on the Committee haven’t acknowledged that the information they are to scrutinise at the July 21st meeting is only from the draft Full Business Case.

A half baked draft is just taking the p*ss

How can they decide if the hospitals reconfiguration plans meet the health care needs of local people on the basis of  a half baked draft that is subject to revision by NHS Improvement and the Treasury?

Without access to the proper documents,  the Committee can’t carry out its duty to scrutinise significant NHS and social care service changes and make sure they do not damage the health interests of the public in Calderdale and Kirklees.

This is why NHS campaigners say the Councillors must now report to the Secretary of State that the NHS organisations’ consultation with the Committee has been inadequate.

Recommendations that the Committee made to the Trust last September are for the Trust to produce:

  • A costed workforce strategy that shows how shortages of clinical and other staff will be addressed,
  • A financial plan that shows how the hospital’s deficit (ie government underfunding) will be addressed and identifies how local clinical services will be provided safely and sustainably.
  • Full assurance that full capital funding will be available that will not increase the hospital Trust’s deficit – and if this is not available, the Trust must produce information about how it is to go ahead with the reconfiguration.
  • Clear targets to reduce A&E attendance and actions and measures to make sure that NHS 111 sends patients to the right place, that patients have improved access to GPs and the Care Closer to Home scheme will reduce A&E attendance by patients with chronic health problems.
  • Evidence that the Halifax hospital building can be improved so that it can provide Emergency and Urgent Care services to more than 100K people/year without detriment to the quality of the service.

Campaigners are angry and perplexed that the Councillors on the Joint Health Scrutiny Committee have justified the Trust’s failure to provide the Full Business Case on the grounds that it is a commercially sensitive financial proposition.

Jenny Shepherd, Chair of Calderdale and Kirklees 999 Call for the NHS (CK999), said:

“It was clear when the Pre-Consultation Business Case was published early last year that the Full Business Case would be a detailed case for capital funding.

The Joint Health Scrutiny Committee can’t pretend that they didn’t know this was going to be the case. Throughout the public consultation, when people asked about the capital costs of the hospitals ‘reconfiguration’ and where the money was coming from, we were told repeatedly that this would be sorted in the Full Business Case.”

Private finance initiative will fund new buildings

According to the Trust’s report to the Joint Health Scrutiny Committee, which is now on the Kirklees Council website,

“the Trust has been advised that PFI is the the only capital finance source that meets Treasury requirements.”

The report also says that the Full Business Case financial projections, based on PFI funding, show that the Trust’s underlying deficit would be eliminated in year 8 (2024/25) and the Trust would have a financial surplus of around £6m/year after that.

In an email to staff,  the hospital Trust’s Chief Executive Owen Williams says that the cost of the new buildings, to be covered by a PFI loan, is around £298M.

Jenny Shepherd said,

“We all know from experience that the Private Finance Initiative is a rotten deal for the public.

At the public consultation meeting last July, Owen Williams said that the Calderdale Royal Hospital PFI contract was at the root of the hospitals Trust’s problems and the main reason for the proposed cuts and changes.

The PFI contract for Calderdale Royal Hospital is a total rip off. Service charges, interest and debt repayment take a significant proportion of Calderdale’s annual NHS budget. The PFI debt has changed hands at least ten times, sold on at massive profit by companies that mostly pay no tax in the UK.

Going down the PFI route a second time is either mad, bad or a combination of the two.”


One comment

  1. This isn’t good enough. I demand the JHSC reject this unsafe plan.
    Don’t they learn by experience that PFI debt is another hospital closure disaster waiting to happen? Or is this deliberate to end the NHS? This plan has failed to address the 19 flaws outlined:-
    No road improvement to ease traffic congestion and improve journey times.
    Plans to extend parking have been rejected.
    No increase on ambulances to support the increase of transfers from HEI to CRI
    No additional service to support patients in primary care . GP surgeries budgets have been cut.
    A reduction in beds from the original plan has not been met with any public consultation. 64 beds led by Advanced Practitioner lwith no iCU back up or any acute beds is downright irresponsible and dangerous. This could lead to an increase in poor patient outcomes and an increase in mortality rate.
    These plans will also impact on other public services such as the police . No mental health resources in Huddersfield will impact on the police service. police will be increasingly left to deal with mental health crisis by transferring them or keeping them in custody until appropriate care can be provided. This isn’t best patient practice. .


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