NHS Report No. 2 – September 2013

Each month Leeds North West Constituency Labour Party is reporting on the damage to the NHS being wreaked by Cameron, Osborne and Clegg’s health policies. The situation is dire and getting worse.

The picture the BBC didn't show you - 10s of 1000s march in Manchester to protect NHS.
The picture the BBC didn’t show you – 10s of 1000s march in Manchester to protect NHS.

At the point at which Labour lost the 2010 general election the British public‘s rating of the service provided by the NHS was at a record high level. During the election campaign, the Conservatives declared that the NHS was safe in their hands and David Cameron repeatedly promised “no more top down reorganisations”. Tory promises being what they are, there was no surprise when the coalition government said it was going to introduce a top-down reorganisation of the NHS!

And not just any old top-down restructuring of the NHS either, but the biggest since the National Health Insurance Act of 1946. This is enabling the Lib Dem and Tory government to give the NHS in England and Wales to the US dominated market – gift wrapped and tied up with a bow.

So how’s the privatisation of the NHS going? Well, if you are one of the ‘any healthcare providers’ then it is going very nicely, thank you, but badly if you happen to be a patient. The Labour North West Constituency Labour Party believes NHS backroom and frontline staff are working hard to provide a great service for the British public. However, after three years of coalition government, the problems piling up in the NHS are becoming as obvious as the trollies parked in hospital corridors.

NHS sale of the century
During Jeremy Hunt’s first year as Secretary of State for Health, 81 NHS contracts – with a total value of almost £4.5 billion – were put out to the market. This makes it the single biggest year for NHS privatisation. It included:

– £800 million contract for elderly care services in Cambridgeshire and Peterborough;
– £770 million for pathology services in the Midlands;
– £500 million for community health services in Gloucestershire;
– £240 million for care homes in the North West;
– £210 million for adult mental health services in Bristol.

The George Eliot hospital in Nuneaton may follow Hinchingbrooke into private hands following the Treasury go-ahead earlier this month, with an estimated contract value of £630 million.

Missed government targets in A & E
Early in September, Labour revealed that England’s major A&E departments had had their worst summer in a decade and missed government targets in 41 of the past 52 weeks. Hunt said a £500m winter pressures fund would be paid to 53 NHS trusts to pay for extra consultants, nurses and teams to support early discharge of elderly patients into the community. He denied that this was either emergency funding or a “bung for failure”.

Commenting on the crisis in A&E, Andy Burnham, the shadow health secretary, described Hunt’s plans as half-baked. “Jeremy Hunt tries to blame the 2004 GP contract but conveniently ignores the fact that A&E performance improved between 2004 and 2010. The truth is it is they who have let GP practices stop evening and weekend surgeries and ended the guarantee of appointments within 48 hours.”

Senior NHS spokesman reveal the looming crisis in the service
Throughout September a succession of very senior figures within the NHS infrastructure spoke of the looming in crisis in the NHS.

1. Professor Chris Ham, the chief executive of the Kings Fund, previously a member of Downing Street’s now-disbanded ‘kitchen cabinet’ of health experts, said that rising demand for healthcare and tight finances in the NHS meant it was likely to come under intolerable pressure. Ham particularly pointed at a deepening series of problems, including cancelled operations, rising waiting lists and worsening financial problems.
He said, “We could end up with patients on waiting lists having their operations cancelled because hospitals are forced to use their beds for patients coming in as emergencies, hospitals failing to meet the four-hour A&E target, difficulties treating patients within the required 18 weeks, ambulances waiting outside hospitals with patients inside them, and delayed transfers reaching such a level that hospital beds are full up and the whole system is under intolerable pressure.”

2. Stephen Thornton, the deputy chair of the NHS regulator Monitor, said the growing number of NHS trusts in financial trouble meant “we are heading for a disaster”, with a number of hospitals at risk of ending up deep in the red. Thornton expressed particular concern for small and medium-sized district general hospitals that will find it hard to deliver their share of the NHS’s £20bn efficiency drive next year.

3. Chris Hopson, chief executive of the Foundation Trust Network, also warned that there were “a number of clinically and financially unsustainable trusts” and some could go the same way as the South London Healthcare Trust, which collapsed in the summer of 2012 with debts of more than £150m. It was taken over by a special administrator and its hospitals have been taken over by other trusts.

NHS hospitals are losing their grip on finances and waiting times.
Late in September a survey of NHS leaders revealed that NHS organisations will not be able to make enough efficiency savings to contribute their share of the £20bn required by the NHS England chief executive, Sir David Nicholson, 2015.

NHS bodies have so far saved more than half of the required £20bn. However, the growing pressures on the NHS to provide good quality care while coping with none of the real-terms increases in their budgets they used to receive mean that 56% say there is a high or very high risk that they will fail to do so this year.

Professor John Appleby, chief economist at the King’s Fund health thinktank, identified the situation in very stark terms. “The reality for hospitals is that they face an uncomfortable choice between whether to prioritise the quality of services for patients or allow performance in some areas to slip in order to balance the books.”

Around one in seven health leaders who responded to the survey thought the financial situation had improved but, ominously, almost one in three said patient care in their area had worsened over the past year.

The survey revealed some dreadful situations:
1. The proportion of trolley waits – patients waiting more than four hours to be admitted after treatment in A&E – have risen to almost 4.5% in those three months, the highest figure since 2003-04.
2. While hospitals did treat the required 95% of A&E patients within four hours, the proportion not seen and admitted or discharged within that time – 4.3% (241,000 patients) – was the highest since the same quarter in 2004-05.

Andy Burnham, the shadow health secretary, said: “This survey makes clear that large parts of the NHS are losing their grip on finances and waiting times.”

Care Quality Commission Report on Kings Mill Hospital
At the end of September, the Care Quality Commission demanded action over “horrendous” understaffing at the Kings Mill Hospital in Sutton-in-Ashfield. The CQC revealed that frontline staff at Kings Mill Hospital, part of the Sherwood Forest Hospitals NHS Foundation Trust, told their inspectors that they were concerned that low numbers of nurses and poor senior doctor cover were harming patient safety.

1. Although many patients reported that they trusted staff and received good care, inspectors said that the hospital did not have “enough qualified, skilled and experienced staff to meet people’s needs.”
2. The hospital’s elderly care ward fell well below national guidelines on safe nurse to patient ratios.

The CQC report came as new figures revealed that 5,500 nursing posts have now been cut since the Coalition came into office, increasing pressure on the health secretary Jeremy Hunt to act on repeated warnings over under-staffing.
Job cuts and increasing workloads have plunged the nursing profession into one of its worst crises in recent times, with growing concerns over patient safety.

Andy Burnham’s views
Andy Burnham MP, Labour’s Shadow Health Secretary, spoke ahead of the pro-NHS march and rally in Manchester, timed to coincide with the Tory party conference, but disgracefully under-reported.

“David Cameron needs to be forcefully reminded that he has never been given the public’s permission to put the NHS up for sale. Thousands of people will today travel to Manchester to do just that.”

Commenting on the rapid privatisation now taking place, Burnham said, “These figures reveal the frightening scale and pace of NHS privatisation since Cameron’s Health Act came in. It has mandated market testing on the NHS and placed it on a fast-track to fragmentation and privatisation.

“If we carry on down this path, market forces will eventually devour everything precious about the NHS. That is why Labour will repeal the Health & Social Care Act in the first Queen’s Speech of the next Labour Government.”

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