Council Election – May 2nd, 2019


Member Voice: Papering over the cracks in NHS England

It has become a regular event that is becoming known as ‘Take out the trash day‘, and it refers to the now familiar process by which the government releases a whole lot of new information and data into the public domain on the last day of parliament, with the (intended) consequence that proper scrutiny by MPs or the media is prevented.

The event in July 2016 was no exception and you can check out this article for a sense of which reports, reviews and surveys they tried to bury on this ocassion.

Hidden in plain sight among this mountain of dense and inaccessible documentation was an innocuous sounding release from NHS England, ‘Strengthening Financial Performance and Accountability 2016/2017‘ (pdf).

The only significant coverage it received was from Chris Cook l on Newsnight on July 21st (37 minutes into the program which you can see here for a limited time) and since we have a great deal of NHS experise in the constituency, we ask one of our members Dr Martin Hime for his view. Here it is.

Disclaimer: Members’ Voice is an opportunity for North Somerset Labour Party Members to express their views on the issues which are important to them. The views expressed do not necessarily represent those of the membership and should not be interpreted in that way.

This Document is a reaction to the long term underfunding of the NHS. It outlines plans for both commissioning and provider organisations to become more financially responsible and accountable. It argues that the £1.8 billion to be injected into the NHS market system over the 2016-17 year will come with strings attached. The clinical commissioning groups will have to work within the financial limits set by central government or face being labelled as “in special measures”. North Somerset CCG has already been placed in this category. Provider Trusts will no longer be fined but will be given centrally defined “performance review trajectories” in the hope that their various politically sensitive targets will be met.

This is another attempt by the Government to deal with the problems created by the dysfunctional market orientated system. The £1.8 billion is not new money but will come out of other public health and social care budgets. Hunt remains wedded to the idea of a 7day NHS – an entirely unrealistic, uncosted concept whose rationale was based on the false interpretation of mortality evidence. The requirement for the NHS to make £22billion efficiency savings by 2020 remains in place and the byzantine management structure created by the Health and Social Care act continues to waste money that should be spent on patient care.

So what will this initiative do for commissioning? It will certainly create huge stresses and uncertainties in the commissioning groups. The chances that motivated GPs will be involved in commissioning in the future will diminish. The impossibility of the CCGs being able to buy the services that communities need within the budget restraints will become more obvious (maybe a good thing). CCGs will be motivated to further restrict the services that are provided by the NHS and the fiction that they are independent bodies will be further eroded.

Provider organisations will no longer be fined but will have to adhere to the extremely strict requirements dictated by the document in order to qualify for the “Sustainability and Transformation Fund”. This, in the context of a gross underfunding will further undermine the morale of NHS staff that are trying to maintain the service.

The document demonstrates the failure of the Government’s strategy on the NHS. Rather than dealing with the real reasons why the NHS is in crisis, it tries to force those that are attempting to manage it into doing the impossible.  An under-funded market driven NHS will not work. No amount of coercion will change that.

Martin Hime

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