A Health Emergency Press Release Friday March 20th
As Foundations collapse, campaigners warn of more scandals to come:
The shocking revelations of managerial incompetence, under-staffing and appalling quality of care at two NHS Foundation Trusts, Mid Staffordshire and Birmingham Children’s Hospital have also highlighted the underlying systemic weakness of regulation and the “commissioning” model that is now being aggressively rolled out across the NHS.
Monitor, the body charged with regulating Foundation Trusts, has been found to be obsessed with the financial administration of Foundation Trusts as businesses, and to lack even the most basic overview of the quality of care delivered by the supposed “top-performing” Trusts. And the Primary Care Trusts, which “commission” (purchase) hospital and other NHS care on behalf of local patients, have also lamentably failed in both Birmingham and Mid Staffordshire to ensure that health services have been of adequate quality, or to challenge the failing hospital Trusts.
But there is worse to come, as more Trusts are press-ganged by ministers and Strategic Health Authority bureaucrats into becoming Foundation Trusts , often at the cost of massive cuts in spending to bring their budgets into balance. This was one factor in the collapse in standards of care at Mid Staffordshire. NW London Hospitals, for example is planning to cut 10% of its budget: St George’s in SW London faces a £30m-plus cutback, and many more are looking at cuts in the tens of millions – which must mean staffing cuts.
PCTs, having failed to carry out the relatively simple task of monitoring the quality of care delivered by NHS and Foundation Trusts, are now being driven by ministers to make the task even more complex by implementing so-called “World Class Commissioning”, which involves fragmenting existing local NHS services into new “markets” of competing providers.
To make matters worse, a new Department of Health “Cooperation and Competition Panel” is being set up, which will intervene on behalf of aggrieved private sector companies to force Primary Care Trusts to put services out to tender, and prevent NHS Trusts and Foundations from collaborating and cooperating to provide a comprehensive service for local people.
Chaired by former private health and nursing home boss Lord Carter of Coles, the new Panel will be quite openly biased in favour of “competition”, regardless of the consequences in terms of local access to services and the financial viability of NHS hospitals.
None of these far-reaching changes has been subject to any serious public debate: many will be rubber-stamped without even a pretence of consultation with local communities. Few proposals have been reported in the national or local press. The proposed policies of the Competition Panel have been out to “consultation” since January 30, with the consultation due to end on April 30, but this has barely been reported even in the health service press, and not mentioned at all by the national newspapers.
Warning that the new changes could trigger more scandals like Mid Staffordshire and Birmingham Children’s Hospital, Health Emergency director Dr John Lister said:
“There is a good reason why the PCTs have avoided public consultation on these changes: if the public knew how they were planning to break up and flog off local services, often for vulnerable people, and bring in grasping private sector providers, they would be furious. That’s why they are hiding the proposals behind the ridiculous mumbo-jumbo of “World Class Commissioning”
There is no evidence that the new market will benefit patients. All the evidence so far, including extensive reports by former Blair advisor Professor Chris Ham, is that the commissioning model does not work anywhere in the world – and that integration and collaboration are the best way to achieve quality care.
The Competition Panel is being set up precisely to outlaw integration and collaboration. It has not yet concluded its consultation, which runs to April 30 – so we have six weeks to raise the alarm and force a halt to these ill-conceived and damaging policies.
If the free market is no longer the way for even the banks to operate, it is definitely not the right road for our health care.”