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Sunday 17th June 2018

KONP and HCT

  • Serious questions surround increased NHS funding – inadequate response for cash starved service

    Joint press release by Keep Our NHS Public, Health Campaigns Together and The People’s Assembly Against Austerity 17 June 2018

    Theresa May has announced today an increase in NHS funding by 3.4% a year for the next 5 years. The headline 3.4% increase only applies to the NHS England budget and not to the whole NHS budget. Importantly, it also excludes medical and nurse training and public health budgets – these are crucial to the delivery of NHS services. The overall increase promised is in fact only 3% a year.

    Even this is a reluctant response from the Government to the unrelenting pressure exerted by campaigners, health unions and the electorate – and even health think-tanks and NHS Providers – to provide desperately needed increased funding for the NHS, left in a critical condition after suffering 8 years of virtually flat funding per person.

    While any funding increase is to be welcomed, 3% will not be enough to repair the damage already done to the NHS from years of austerity. At least a 5% real uplift next year would be needed to begin to begin to repair the damage done and at least 4% per year is essential after that to ensure the NHS is fit for the future.

    As always with the Conservatives, the devil will be in the detail. We don’t know exactly how this money will be allocated and what strings will be attached. In 2016 the government announced a £10bn a year increase. However, due to some accounting tricks involving moving money around within the Department of Health budget, according to the Nuffield Trust it resulted in only £800m in real terms.

    This promised increase must be genuine new money and not a repeat of the ‘smoke and mirrors’ designed to appease the public without resulting in any significant benefits. Resurrection of the tarnished claim of a ‘Brexit dividend’ to fund the NHS is political gamesmanship, when most analysts predict a negative fiscal impact, at least in the short term.

    Whilst Theresa May talks of extra funding not being wasted, there are no policy measures to ensure that increased funding actually improves health care delivery rather than paying for the private market and wasteful bureaucracy the Government has created.

    There must be an end to the fragmentation of the NHS and the enforced contracting out of NHS services to the market. The NHS must be reinstated as a public service. Currently £billions are wasted on market transaction costs and outsourcing to the private sector. NHS efficiency, co-ordination of services and collaborative delivery of care is undermined by competition.

    With no promised increase in social care funding any funding increase for the NHS will have limited benefit. Social care has suffered from extremely damaging cuts over the past eight years and this has adversely impacted the NHS. Social care cuts have cause caused real suffering and an increased mortality rate in those who are directly affected. Any new funding settlement for the NHS requires increased funding for social care.

    Think-tank estimates argue for a 3.9% annual uplift in real terms for social care. There should be no pretence that “integration” of health and social care, without extra funds for both, will solve the problems of either service. True integration will require social care to be brought into the NHS as a public service and to be properly funded.

    Health Campaigns Together (1), Keep Our NHS Public (2) and People’s Assembly (3) join with NHS staff, other campaigners and concerned members of the public in continuing to apply pressure on this government to fund the NHS properly and reinstate it as a public service according to its founding principles as this is the most economical way to run the system and deliver high quality care for all. We will be calling for these demands on 30 June at the celebration and protest in defence of the NHS at its 70th Birthday. (3)

    Dr Louise Irvine is a GP in Lewisham, south London and co-chair of Health Campaigns Together says:

    "The Conservative government’s promised funding increase for the NHS is too little too late. It is in fact only 3% a year – they’ve done their usual smoke and mirrors to make it appear more by only counting the increase to the NHS England budget and not the overall Department of Health budget. 4% is the minimum increase needed.
    "3% won’t be enough to repair the untold damage the Tories have done to the NHS over the past eight years of austerity or secure its future as a high-quality service. I fear that patients will continue to suffer needlessly and staff will continue to leave the profession due to stress and burnout. We’ll see more rationing, cuts and closures and insufficient improvement, if any, in waiting times.
    "Any increase in funding is welcome but its a missed opportunity to put the NHS back on its feet. There’s so much more the Government could and should do. It could stop wasting precious NHS resources on the failed experiment of the market and outsourcing and reinstate the NHS as a public service – the only way to ensure effective and efficient joined up services.
    "And it needs to increase social care spending by at least 3.9% a year because without decent social care the NHS will continue to pick up the pieces for all the elderly and disabled who are not getting the care they need."

    Dr Tony O’Sullivan, retired paediatrician and co-chair of Keep Our NHS Public says:

    "The NHS and social care have been severely damaged by the last 8 years of wilful neglect. NHS workforce planning was abandoned leaving 100,000 vacancies and doctors and nurses working in extremes of pressure and ending up in tears of distress.
    "They do not need more mischievous statements, previously exposed as lies, about ‘Brexit dividends’ that smack more of electioneering than care for the NHS.
    "We need a commitment to respect NHS staff once again, reinstate the NHS student bursary, pay staff properly and to put the NHS back together again alongside a publicly funded social care system."

    References:

    1. Health Campaigns Together is an alliance of over 100 organisations including five national unions and Keep Our NHS Public, formed Autumn 2015 to campaign for a fully funded and fully public NHS: https://healthcampaignstogether.com/
    2. Keep Our NHS Public was formed in 2005 to campaign for a fully publicly funded, provided and managed universal and comprehensive NHS: https://keepournhspublic.com/
    3. The People’s Assembly Against Austerity
    4. Rally and demonstration supported by HCT, KONP, The People’s Assembly Against Austerity and the TUC and 13 health unions: Saturday 30 June 12midday, assembling Portland Place, London and proceeding to Whitehall


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Tuesday 12th June 2018

KONP website

  • KONP statement: PUBLICATION OF HEALTH AND SOCIAL CARE COMMITTEE REPORT ON INTEGRATED CARE: ORGANISATIONS, PARTNERSHIPS AND SYSTEMS

    The Health and Social Care Committee (HSCC) has published its report on Integrated Care: organisations, partnerships and systems today. Keep Our NHS Public (KONP) contributed written evidence , gave oral evidence 27 February (Dr Tony O’Sullivan, retired paediatrician and co-chair of KONP) and followed this up with supplementary evidence.

    KONP statement:

    While we welcome certain conclusions of the HSCC, the overall message defends NHS England (NHSE) and the Department of Health & Social Care (DHSC) in their policy direction of introducing accountable care organisations that are dangerous in bringing in models of care based on the deskilling of a workforce designed to give cheaper, underfunded care in the community.

    We suspect that the report does not convey a single coherent message but reflects the various different positions of committee members, who have reached a compromise to agree a published report.

    A key tenet put forward by KONP is that ACOs are illegal under the current legislation and are an unlawful ‘workaround’. The HSCC has accepted this:

    The legal barriers and fragmentation that arose out of the Health and Social Care Act 2012 will need to be addressed … ACOs, if introduced, should be NHS bodies and established in primary legislation.

    KONP believes that this is a vindication of one of the key bases for the current Judicial Review (JR) heard 23-24 May (ruling by Mr Justice Green expected in the next few weeks) taken against NHSE and Secretary of State Jeremy Hunt. Five individuals (one now deceased, Professor Stephen Hawking) challenged their attempt to introduce ACOs from April 2018 using secondary regulation, originally planned to be laid down in February 2018, and only delayed in the face of a defeat at JR. However, the HSCC gives a green light to further Government attempts to ‘workaround’ primary legislation:

    Where barriers are identified and can be removed with secondary legislation, this may represent a less complex way forward.

    We reject this concession to Government attempts to totally reconfigure and break up the NHS without the scrutiny that would accompany primary legislation.

    We believe that the HSCC, while denying that ACOs facilitate privatisation, has also responded to the public concern over the risk of that privatisation poses through ACOs. It is beyond dispute that the awarding of 10-15 year contracts to manage ACOs with multi-billion pound annual turnover constitutes a risk of privatisation of the NHS of unparalleled scale to date.

    Given the risks that would follow any collapse of a private organisation holding such a contract and the public’s preference for the principle of a public ownership model of the NHS, we recommend that ACOs, if introduced, should be NHS bodies and established in primary legislation.

    There is also recognition that the timescale of 5 years that Simon Stevens, CEO of NHSE laid down in his Five Year Forward View has been unrealistic within the context of unparalleled underfunding and in our view a total failure of workforce strategy since 2010:

    Countries that have made the move to more collaborative, integrated care have done so over 10–15 years and with dedicated upfront investment … A long-term funding settlement and effective workforce strategy are essential not only to alleviate immediate pressures on services, but to facilitate the transition to more integrated models of care.

    It is misleading to imply that NHSE and Jeremy Hunt have merely failed to communicate their intentions adequately – a conclusion unmistakeably drawn from the title of the press release: ‘Government and the NHS must improve how they communicate NHS reforms to the public, say MPs.’ There has been no misunderstanding: ACOs and associated policies embodied in the Five Year Forward View and subsequent documents clearly have been in the direction of:

    • Delivering healthcare at unprecedentedly lower funding levels (£22bn annual NHS funding below predicted requirement for the NHS to meet needs)
    • A break up of the national NHS into 44 or more geographically based non-NHS management bodies called ACOs covering the whole of England
    • New cheaper models of health and social care workforce to reduce the level of skills and professional experience and thereby reduce costs
    • An opening up of private control, or private-public partnership control of these huge contracts, whilst (unbelievably) denying the risk of privatisation.

    KONP and others gave evidence that successful efforts to deliver integrated clinical care have been in existence long before the Five Year Forward View and this Government. The National Audit Office concluded in February 2017 [3] that there is no evidence that organisationally imposed integration delivers better care. We need delivery of coordinated patient care, but formally integrated organisations are not proven to be valuable and require dramatic and damaging widescale reorganisation to achieve.

    Dr Tony O’Sullivan, Co-chair of Keep Our NHS Public says:

    We welcome that the Select Committee appear to agree with KONP and those who have taken NHSE and Jeremy Hunt to JR, when the HSCC states that ACOs must be subject to primary legislation and should be statutory NHS bodies. We also welcome the conclusions of the Select Committee that ACOs lack evidence that they will deliver better coordinated care; that they are being rushed through and are severely underfunded – massive challenges that are without precedent. We welcome the HSCC’s call for change to be evidence-based and that results of trial areas must be closely evaluated.
    We reject the HSCC assertion that competition can be a useful tool, when it has most clearly failed in numerous disasters, not least Carillion and Capita.
    We are disappointed that the HSCC paints the abject failures of the Five Year Forward View and NHSE policy as mere misunderstandings. We call for the following further conclusions to be drawn
    • privatisation of the NHS in all its forms must be stopped
    • safe levels of funding must be restored immediately and must fund a safe and effective workforce strategy
    • models of care must be based on clinical evidence and patient outcomes, not on financial restraint imperatives
    • the NHS must be restored to a fully public provision, fully funded publicly with restoration of the direct duty of the Secretary of State to provide universal and comprehensive health care to the population


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Thursday 24th May 2018

  • Make bankers and business foot bill for repairing NHS undermined by austerity cuts

    The NHS needs more money now and for years to come: but the bill for putting right 8 years of deliberate under-funding should not fall on working families, say campaigners.

    News media have picked up on one figure in the new report from the Institute of Fiscal Studies and the Health Foundation, claiming that the cost of maintaining and restoring the NHS could be a tax grab of “£2,000 per household” over 15 years.

    John Lister, Editor of Health Campaigns Together newspaper, said:

    “We agree that a big increase of 4% a year above inflation is needed to get our NHS back on track and improve services. But taxing ordinary families is the least fair way of raising the extra money: in fact even floating this suggestion seems designed undermine public affection and support for the NHS,”

    The virtual freeze on real terms NHS funding since 2010 has been part of austerity cuts to make working people carry the cost of the massive public sector bail out of the failing banks ten years ago: but while bankers are again coining in bonuses, pay increases are barely keeping pace with inflation, many families are struggling on low pay.

    “The tax bill for repairing the damage done to health services should fall on the banks, big business and the wealthy who have prospered, not the millions who have suffered. It’s time to look at a tax on financial transactions and speculation in the City of London, which could easily raise the money needed. Other countries already raise such taxes.

    “We also need to stop the haemorrhage of NHS funds to private companies cherry-picking services while NHS trusts face deficits and close beds. Almost 11% of the NHS budget is now going to private providers.

    “That’s why we are working with Peoples Assembly and trade unions to build a huge march through London on June 30 to both celebrate the 70th birthday of our NHS and demonstrate our demand for proper funding from progressive taxation to keep it free, for all, for ever.”

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Monday 14th May 2018

Hands Off HRI

  • Public Statement on behalf of Hands Off HRI - The Campaign to save Huddersfield Royal Infirmary

    Last Friday's announcement by Mr Jeremy Hunt, Secretary of State for Health in response to the referral made by Joint Health Scrutiny Committee last July 2016 to the Independent Reconfiguration Panel (IRP), has both delighted and surprised local campaigners fighting to save all hospital service in the Huddersfield area. Since the inception of the IRP , there has never been such a strong and unambiguous statement. Mr Hunt has said of the NHS bosses proposals that

    ·       there are a wide variety of failings in their business case

    ·       the proposals lack consistency

    ·       there is widespread scepticism about them being deliverable

    ·       there is no evidence of adequate out of hospital care

    ·       the loss of beds is unjustifiable

    ·       there is no evidence of capital finance being available for their project

    Mr Hunt correctly concludes that the proposal to downgrade HRI is 'not in the best interests of the people' of Kirklees and Calderdale and he has ordered the CCG to work with Joint Health Scrutiny alongside NHS Improvement and NHS England to develop new proposals which take into account these misgivings.

    This outcome has completely vindicated the long and relentless campaign waged by Hands Off HRI over the last two and a half years, and supports the findings of the courts that will result in the full Judicial Review in June. There is little doubt in campaigners’ minds that the decision at Leeds Crown Court two months ago to order a full Judicial Review into this proposal has concentrated minds in Whitehall. 

    The Judge has identified five counts of public law which must be tested in a full  hearing which  is set to go ahead on 12 - 14 June. With this decision by Mr Hunt now also hanging over the local CCG, it is very difficult to see how they can justify continuing with their disgraceful scheme.

    Hands Off HRI had commissioned three professional clinical, financial and building experts to scrutinise the proposal in preparation for the court hearing. Their findings completely bear out Mr Hunt's observations, namely that the financial case for closure is not justified; there is no clinical evidence of improved outcome for patients and that HRI has another 100 years life left in it. Faced with this huge weight of evidence, perhaps Mr Hunt has done the CCG a favour by vetoing their plans.

    Where does this leave the future of HRI?? Whilst delighted with this decision, Hands Off HRI recognises that this is not the end of the proposal to shut our hospital. It is the same CCG which is being asked to think again. 

    Whilst we welcome the departure of Mr Alan Brook as Governing Body Chair of NHS Calderdale CCG,  Hands off HRI is demanding that the whole board of both Calderdale and Greater Huddersfield CCGs resign and that new appointees take over to look at the genuine health needs of the population. 

    It has been clear from the outset that this proposal was driven by the disgraceful PFI scheme hanging over Calderdale Hospital in Halifax and that the CCG is attempting to balance the books by closing HRI.

    Mr Hunt has ordered the relevant authorities to develop a new plan over the next 3 months. Hands Off HRI will be engaging with this process by submitting further evidence to the IRP and local politicians. We will also be consulting with our legal team about the Judicial Review which is still scheduled to go ahead.

    However momentum is now with our campaign and the whole town is lifted by the decision. There is renewed confidence that we can see this through to the end. The Crowd Justice appeal to raise funds for the Judicial Review has already exceeded our target and funds continue to pour in as no stone is left unturned to ensure our war chest is full. The fight will go on and we will be rallying to our campaign themes:

    If you stand up and fight , you can win

    It's only a done deal, if you do nowt.

     

    For more information, contact Mike Forster 07887668740; Steve Slator 07854358479; Cristina George 07747446005

    To contact the campaign: find us on the following:

    info.handsoffhri@gmail.com    Facebook: HandsoffHRI  Twitter: @HoHRIltd      

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Friday 11th May 2018

Hands Off HRI Official Group

  • Hunt signals retreat from flawed plan to axe Huddersfield Royal Infirmary

    A 2-page letter from Jeremy Hunt to the joint Calderdale and Kirklees Health Oversight and Scrutiny Committee has slammed the brakes on plans to run down the 400-bed Huddersfield Royal Infirmary.

    Hunt's bluntly worded letter (see link below) admits that even the Tory-led Independent Reconfiguration Panel was unable to ignore "a wide variety of failings which call into question the benefits of this scheme and the way in which the process has been managed so far".

    Hands Off HRI, after a hard slog going back over 4 years, challenging the plan at every stage, was poised for court action in June, seeking a Judicial Review to challenge the deeply flawed plan.

    They had assembled evidence to demonstrate the spurious assumptions and assertions of the Full Business Case, which was neither full nor a genuine Business Case, its lack of concern to address equality issues, transport and access issues, the prospect of chronic capacity gaps, the lack of any clinical or other evidence to support the plan and the careless, slipshod drafting of misleading documents that failed to answer any of the key questions.

    Congratulations to all those who have fought so hard and all those who have contribute to the crowd-funding appeals for resources to finance the JR process, and congratulations too to the legal team Irwin Mitchell who had assembled such a strong case.

    This is just the most recent of a series of retreats that have been forced onto NHS England, local trusts CCGs and STPs by solid, relentless campainging, piling local pressure onto politicians and refusing to accept the bland assurances of managers and their cynical management consultants.

    Campaigning can work: if you fail to fight back you guarantee a defeat. That's a vital message as we fight to build the broadest, strongest, biggest, hardest alliance we can to defend the NHS we still have, stem the haemorrhage of money squandered on a destructive market system and contracting out, and bring the clinical and support services that have been privatised back in house.

    In six weeks we will stage a massive show of strength as we march through London on June 30 to celebrate the 70th birthday of the NHS and demonstrate demanding it be properly funded and restored as a publicly owned, publicly funded and publicly accountable service guaranteeing health care free for all, free forever.

    Join us in this, and join local campaigns in your area fighting this vital fight against irrational, ill-conceived and potentially disastrous schemes to cut costs at the expense of patient care. Leaflets can be downloaded or ordered FREE from us at Health Campaigns Together: see the front page of this website.


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