9 July 2018
By Simon Cross
(The campaign to #SaveSouthendNHS gathers before national demonstrations in London. ©Paul Stygal)
Last Friday, 6th July 2018 - just a day after the celebrations of the NHS's 70th birthday, the five Mid and South Essex CCG's met with the STP committee led by Mike Bewick to hand down the sentence in public to Orsett Hospital, the Southend University Hospital and the wellbeing of 1.5 million potential users of primary care services.
The premise of this meeting was to inform the public of the decisions made as a result of the recent 'Consultation' of the original document proposing the selling off of NHS assets, downgrading Southend Hospital, transporting acutely unwell patients on traffic-laden roads, and replacing Doctors and Nurses with Skype and Apps.
The 'Consultation' engaged with just 4,000 people out of an affected population of over 1.4 million people, making it simply a pointless focus group.
Even in this sample of 0.3% of the affected area, nobody supported this wholesale destruction of local health provision. It became quite clear within the process that the evidence to drive these proposed changes was long discredited, outdated or not representative of our population.
There seems to be a total denial of the very real issues which make the patient movements proposed, frankly, dangerous. The plans were simply put together to cut costs and deliver massively-reduced health services with no thought for the inconvenience of long-distance travel for care or the patient deaths this will cause. Not to mention that the proposals were initially predicated on an improved GP service which is now not even being discussed!
The decision makers simply passed the entire STP proposals with no amendments whatsoever and announced the almost immediate closure of Orsett Hospital.
They now plan, as part of the 'Care Closer to Home' scheme, to force Orsett patients (if physically capable) to travel in excess of 10 miles for care which was provided on their doorstep but weeks ago. Counterintuitive much! This will make people who have infirmities incapable of accessing their NHS services.
This is the full statement from the CCG Committee:
The five clinical commissioning groups (CCGs) in mid and south Essex have today <Friday 6 July> given the go-ahead for plans to secure the future of health and care services.
The plans are a result of two years of detailed work undertaken by clinical teams across health and care organisations to improve the services provided to the 1.2 million people living in mid and south Essex and follows the outcome of a 16-week public consultation.
The Joint Committee of the CCGs gave approval to implement proposals, which include:
These changes are alongside the plans launched last month to build up GP and community services with a £30 million increase in annual funding to extend the range of professionals and services available via GP practices. This will create more appointments and increase care closer to where people live.
The committee was asked to approve 19 recommendations, set out in a decision making a business case.
In particular, this included specific recommendations to address the main concerns raised during the public consultation, regarding the safe transfer of patients and support for carers and relatives to visit loved ones who may be at a different hospital.
The full decision-making business case can be found at http://www.nhsmidandsouthessex.co.uk/decision-making-business-case/
The assertion that there have been any changes to the original proposals is outright deception.
None of the issues raised was ever adequately addressed by the focus groups, and the proposal for cross-county patient transport is not costed, not safe, not properly planned, and the STP is still lying about the numbers around expected use.
The idea that against the backdrop of the 44 STP 'footprints' up and down the country being required to close 70% of A&E facilities by 2020, the likelihood of Southend and Chelmsford retaining an A&E is non-existent within the privatisation agenda.
Despite the STP and Conservative claims, the Government is providing NO additional money for GP services and has scrapped both the Primary Care and Social Care '5 Year Forward View' documents having found them totally unworkable.
The £30 million of funding claimed was clearly identified within the STP business case as being purely Capital Funding (buildings and equipment not Human Resource) and would be generated from alternative sources to the NHS budget.
So effectively, this will be PFI money and will cost more than the value it attempts to deliver.
The failure of a recent Judicial Review brought by Alysson Pollock, Peter Roderick and the late Stephen Hawking could still offer a lifeline.
Some of the reasons for the Judge ruling against the case, was to force the government to hold a full public consultation regarding ACO's (Accountable Care Organisations) and to bring forward Primary Parliamentary Legislation and a full vote.
In light of this information, if the STP's can be shown to be the vehicle for the transformation of the public NHS into US Insurance and Bank controlled ACO's then the decisions taken by STP's will also be unlawful!
I cannot personally understand why these people are still blithely selling off our NHS and that the Government has not halted all progress towards this when these actions can (and hopefully will) be considered an illegal act?
This is the statement regarding the Judicial Review:
Today the High Court handed down its judgement on the judicial review we brought against the Secretary of State for Health and Social Care and NHS England on their introduction of Accountable Care Organisations (ACOs). We had originally brought our claim on four grounds - two on the lack of proper consultation, one on the legality of the idea itself, and one on grounds of lack of clarity and transparency. We withdrew our claim on the consultation grounds when our opponents conceded that they would not proceed without a full national consultation, so this success was in the bag.
Unfortunately, the Court has found against us on the law on the other two grounds.
On legality - whilst making clear that he was not deciding on the merits of ACOs, and acknowledging that we raised “perfectly good and sensible questions…..about the ACO policy and the limitations of the terms and conditions in the draft ACO Contract” - Mr Justice Green decided that the ACO policy is lawful because the Health and Social Care Act 2012 gives very broad discretion to Clinical Commissioning Groups when commissioning services.
And on clarity and transparency – whilst resoundingly rejecting the government’s argument that the principle did not apply “in relation to what by common accord is intended to amount to radical and transformational changes in the way in which health and social care is delivered” - he decided that the principle was not yet engaged.
There is more about the judgment below on the Crowdjustice site:https://www.crowdjustice.com/case/jr4nhs-round3/
We have decided not to appeal against this decision for several reasons.
Apart from the extra costs involved, our opponents have already been forced to change their plans. In order to win the case, they had to argue that ACO contracts were just like other provider contracts, and not the fundamental change to the governance of the NHS that we know they intended. The judge recounts in detail how their position changed as they began to appreciate the power of our claim. The commissioning functions of CCGs were to be - illegally - delegated to ACOs - but instead are now reinforced, and if the government wishes to continue on the original path to creating ACOs, primary legislation will be needed and CCGs will have to retain sufficient staff and resources. The Health and Social Care Select Committee has called for legislation, and the Prime Minister included the possibility of new legislation for the NHS in her speech a couple of weeks ago. In addition, the promised consultation will have to be lawfully conducted, and any eventual ACO contract - in Dudley, Manchester or wherever – will have to be lawfully entered into. 999 Call for the NHS are still engaged in legal action, seeking leave to appeal the decision in their judicial review, but for us, the campaign moves out of the courtroom – at least for now – and continues in the local and political arenas, and on to the consultation.
We are extremely grateful to the thousands of people who have allowed us to bring this challenge. Thank you again from the bottom of our hearts for all your encouragement and financial support. We do not believe that this has been wasted, and we hope you agree. We deeply regret the judgment and we imagine you will share our disappointment. But we hope its effect will be to strengthen resolve to hold the government to account during the consultation, and raise public awareness of the issues at stake if contracts for billions of pounds of public money lasting ten or more years are awarded to new bodies not established by statute, which could be partly or wholly private companies, and which could outsource all their services if they wished.
This could be our final line of defence as the NHS is not actually in the hands of government anymore; It is clear that the Bankers, Insurers and Big Pharma have been controlling the NHS for several decades without us noticing.
We have possibly been looking the wrong way in our campaigns because while the NHS is highly political, it certainly is not a Party Political.
The battle we need to have is to prevent any private body taking a pecuniary advantage of healthcare provision.
The more Barclays and Virgin fail, the less attractive it becomes to other business interests circling overhead.
There has been a lot of nuanced and supposed cross-party debate on whether the public would pay a ringfenced tax.
This is a trojan horse and very much what happened in Spain and Holland, whose healthcare systems are now experiencing the problems of multipayer health systems. The idea of a ringfenced tax is that it can be easily converted into an insurance which means it can easily be transferred to the Private Sector. The most likely reason Politicians favour this is that it leads to a 'Bismarck' style Health Service.
The Bismarck System.
Named for the Prussian Chancellor Otto von Bismarck, who invented the welfare state as part of the unification of Germany in the 19th century.
Despite its European heritage, this system of providing health care would look fairly familiar to Americans. It uses an insurance system — the insurers are called “sickness funds” — usually financed jointly by employers and employees through payroll deduction.
Unlike the U.S. insurance industry, though, Bismarck-type health insurance plans have to cover everybody, and they don’t make a profit. Doctors and hospitals tend to be private in Bismarck countries; Japan has more private hospitals than the U.S. Although this is a multi-payer model — Germany has about 240 different funds — tight regulation gives government much of the cost-control clout that the single-payer Beveridge Model provides.
The Bismarck model is found in Germany, of course, and France, Belgium, the Netherlands, Japan, Switzerland, and, to a degree, in Latin America.