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  • 30 years ago - the first moves to marketise the NHS

    Monday 5th February 2018

    As Tories, LibDems and some misguided academics back away from calls for proper funding of the NHS through general taxation and once more regurgitate the tired old call for a "hypothecated tax" to pay for the NHS - "perhaps replacing National Insurance" - it's time to remember some of the crazy formulae dreamt up by Backwoods Tory MPs back in 1988 as Margaret Thatcher commenced her "review" of the NHS.

    It was 30 years ago: but the right wing has neither learned anything or forgotten anything from those days of cash crisis, falling share of GDP on health, and searching for ways of maximising private profit from what till then had been a largely publicly provided and funded NHS.

    This is an extract from Chapter 4 of The NHS after 60; for Patients or Profits? - a 300 page book by John Lister (2008), Libri Press (pages 75-79)

    Chapter 4: The first steps into the marketplace

    "When the internal market begins to work and signals that there are winners and losers, it's going to be essential that we don't give in to lobbying and bale out the losers."

    (William Waldegrave, Health Secretary, Health Service Journal, April 1991.)

    "It seems to be part of the government's strategy not to provide all the cash needed for fees [for residential and nursing home care]. Ministers are implying that relatives are part of the income support package. It is a monstrous way of going on."

    (Lady Wagner, speaking to 1991 conference of British Association of Social Work)

    1988, the fortieth anniversary year of the NHS opened with a crisis and a strike - by Manchester nurses followed by a continuing rumble of industrial action (including strikes and "work to contract" action) by nurses furious at the arbitrary way their new grading structure was being implemented.

    There was also widespread anger among health workers and the wider public at moves to scrap free eye tests and dental check-ups (to save an estimated £170m), and to lift restrictions on NHS hospitals making profits from private patients and "income generation" schemes - which ministers claimed could net the NHS up to £70m a year within three years. A new "income generation unit" was set up in February, encouraging hospitals to seek cash from such varied activities as imposing car park charges, running jumble sales and raffles and franchising out space for new shopping malls (Mohan 1995:182-3).

    But events took shape in the shadow of the government's impending review, which had been announced in what appeared to be impromptu fashion by Margaret Thatcher in a January television interview, and which then proceeded behind firmly locked doors amid anxious speculation as to its outcome.

    The formal membership of the review team was the Prime Minister plus just four of her ministers - John Moore, returning from his spell of private treatment for pneumonia in the £195-a-night Parkside Hospital in Wimbledon; health minister Tony Newton, Treasury Secretary John Major and Chancellor Nigel Lawson. It took no formal evidence, invited no participation from the BMA or other professional bodies, ignored the health unions and the representatives of patients, and left MPs as ignorant of its debates as the wider public (Timmins 1995: 456).

    Behind the scenes a furtive cabal of advisors included Roy Griffiths, who was still waiting, impatiently, for the government's response to his report on community care, and a group of hand-picked individuals chosen by David Willetts, then employed at the Downing Street policy unit. One of these, Dr Clive Froggatt, was subsequently disgraced after admitting the use of and sale of heroin (Wise 1996).

    By February it was already becoming clear that the Thatcher review of the NHS was likely to include the introduction of a form of "internal market". But there was no shortage of outlandish ideas on offer from the backwoods fringes of the Tory Party. Leon Brittan, for example, a former trade and industry secretary, home secretary and chief secretary to the Treasury, let rip in February with a booklet advocating a "National Health Insurance Scheme", transparently designed to promote the growth of the private medical industry (Brittan 1988). The establishment of a separate "health stamp" might seem like a pointless organisational change, producing no extra cash for the NHS: but its effect would have been to reduce income tax contributions - especially for those who might feel rich enough to "opt out" of the state scheme and take out their own private policies - and to increase National Insurance contributions by over £9 billion. Critics pointed out that the impact of this would be felt by low-paid workers, who barely pay any income tax, but do pay National Insurance, while those at the top of the salary scale could pocket the difference, and the insurance companies would almost inevitably retain the right pick and choose those it would take on, leaving the NHS with the bill for the chronic sick, emergency services and mental health.

    David Willetts, who played a key orchestrating role in the secretive review proceedings, was also quick off the mark in publishing his views on the way the NHS should be reformed. He praised the model of the American "health maintenance organisations" which manage health care on behalf of their private subscribers. In a booklet for the Centre for Policy Studies in February 1988, Willetts and co-author Dr Michael Goldsmith of the Conservative Medical Society stress that "it is not possible simply to adopt an American model". What they advocated was the separation of the purchasing authority from the providers of health care - with hospitals being detached from health authority control (Willetts and Goldsmith 1988).

    Outside the ranks of Tory crackpots, the King's Fund, sometimes described as an independent think tank, published a collection of essays with a preface from chief executive Robert Maxwell suggesting that it might be necessary to recognise that the promise of comprehensive health care was "one on which we simply cannot deliver".

    "Some things are going to have to be excluded from the NHS, so that it can do well what it takes on, and so that the public and its staff can have confidence in it."

    Among the services to be dropped should be anything the private sector - possibly with elements of public funding - could do as well as the NHS. However Maxwell pulled short of advocating a fully market-led approach, warning of "real limitations of the market as an effective and equitable way of providing health care" (Maxwell 1988).

    No such reservations were expressed by a broadside in May from the Thatcherite Institute of Economic Affairs, which advocated a voucher system to ensure that "everyone, rich or poor, could become a private patient". The Institute's director Dr David Green proposed a complex procedure in which people could opt out of the health service - renouncing any claim to free services or NHS care even in emergencies - and use their voucher to buy private insurance. But they would not exchange the voucher directly with the private health insurer - instead a "health purchase union" would negotiate on their behalf to find a competitive deal with insurance firms. Health care for the poor would remain a government responsibility (Green 1988).

    John Redwood, later more prominent, began to fire off his arsenal of radical right wing ideas in various directions. In a May pamphlet for the Centre for Policy Studies, written with another rising star in the Conservative Party, Oliver Letwin, he advocated earmarking 50% of income tax as a "national health tax", and allowing individuals and companies rebates if they opted to "contract out" al or part of their risks to a private insurance scheme (Redwood and Letwin 1988). Redwood predicted that such a scheme could lead to 20 million people contracting out, leading to a quadrupling of the share of GDP flowing to private health care - from 0.6% to 2.5%. While this would clearly lighten the load on the Exchequer, it would still leave 30 million people, including the poorest, the oldest and the youngest - the most expensive in health terms - dependent upon the NHS. Nor did Redwood explain how, unless individuals paid more into the system through private insurance, the net result would be an increase in health care provision. In a separate line of argument, Redwood urged the government to combat the rising influence and militancy of the health unions COHSE and NUPE by building up the Royal College of Nursing.

    Two months later, Redwood was at it again, this time in a pamphlet jointly produced by the "No Turning Back" group of Conservative MPs, including such luminaries as Neil Hamilton, Edward Leigh, David Heathcoat-Amory, Eric Forth and Michael Fallon. It proposed steps to create competition within the NHS, allowing hospitals to compete against each other, alongside a substantial expansion of the private sector, fuelled by tax relief on private medical insurance. The proposals - which would of course have diverted money from the Exchequer and the NHS into the pockets of well-to-do individuals and private medical corporations - rested on the unsupported assumption that the private sector would be ready and willing to offer a full range of services, and would in this way "siphon at least some of the excess demand away from the NHS." The pamphlet also suggested the establishment of a "Patients Charter" setting out the rights of health consumers (No Turning Back Group, 1988).

    Cash pressures

    Meanwhile vocal lobby groups outside the Conservative right were demanding a very different way forward. As the NHS ground its way through one winter crisis, there were already fears for the one to come. NHS spending had been squeezed down as a share of GDP from 5.5% in 1981/82 - to just 5.1% in the four years1986-1990 (Rivett 1998: 485). Figures grudgingly released in February 1988 by Health Minister Tony Newton revealed that real terms spending on Hospital and Community Health service revenue had increased by just £66m since 1982, whereas ministers had previously admitted that spending needed to rise by 2% per year in real terms in order to keep pace with demographic pressures, new technology and the costs of community care programmes (Radical Statistics Health Group 1987: 46).

    Government capital allocations for NHS development, too, had actually reduced year by year, from £859m in 1984 to £812m in 1986-7: the apparent increase in capital was entirely due to cash receipts from asset-stripping sale of "surplus" NHS land - a source of cash which began to dry up with the collapse of property prices in the late 1980s. The dire shortage of capital for new projects, maintenance and refurbishment came at a time when, according to Health Minister Edwina Currie, 81% of hospitals were built before 1918, 5% before 1939 and only 8% had been built since 1964 (Currie 1988).

    With spending on primary care services still exempt from cash limits, and growing in real terms year by year, the sharpest problems were being felt in the revenue squeeze on hospitals and community services. Figures published by the Commons social services committee showed the rapid increases in productivity that were being forced onto hospital staff: numbers of inpatient cases per bed had risen by 40% between 1978 and 1986; in-patient and day case numbers were up by almost 26%, and the average length of stay was being steadily reduced (HSJ January 26 1988).

    The BMA in February 1988, warning of a new round of cash problems in the coming financial year, called for a £1.5 billion cash injection into the NHS - the equivalent of 1p on income tax- and for it to remain essentially tax-funded (Independent February 2 1988). The Labour Party mounted a campaign involving shadow chancellor John Smith and social services spokesman Robin Cook calling for an extra £2 billion (HSJ February 25 1988). This effort was reinforced by a Gallup poll in the Daily Telegraph is which over two thirds of those asked said they would be prepared to pay at least an extra £1 per week in taxes for the NHS. At local level, too, doctors and others were campaigning. In Redbridge, NE London, 140 GPs and 30 hospital consultants placed newspaper adverts warning that they were no longer able to treat patients to the best of their ability or within a reasonable time. One GP said:

    "Forty percent of our surgical beds are closed, half the operating theatres are closed, and even if we could recruit nurses we could not afford to pay them. My advice is that people should not come and live in this district." (HSJ February 25 1988)

    In Birmingham a pressure group of 150 consultants "for the rescue of the NHS" was formed after 250 doctors signed a protest letter to West Midlands regional health authority. The consultants called for an extra £13m to halt rising waiting lists in England's second city, and complained that only one of the four new operating theatres had opened at Sutton Coldfield's Good Hope Hospital. Their stand inspired the formation of a similar organisation in Manchester (Independent April 22, HSJ February 18).

    The anxiety over funding grew as the year went on. In August the National Association of Health Authorities warned that many HAs were heading towards a fresh winter crisis with many beds still closed from 1987, and a new projected overspend totalling over £500 million. More bed closures were also being triggered by growing shortages of nursing staff. The squeeze on beds and services was having a predictable impact on waiting lists, which rose throughout 1988. By early 1989 the combined total for in-patients and day cases was rising by 6,000 a month, and had reached the dizzy heights of 928,000, with growing numbers waiting over a year for treatment (Health Emergency 23 1989).

    In early July 1988 the massive Department of Health and Social Security was split into two separate departments, with Kenneth Clarke taking over as Health Secretary. Within weeks even more alarming figures were to be revealed, as an internal memo was leaked, showing that the government was not fully funding the apparently generous 15.3% pay award to nurses, linked to the introduction of the new clinical grading structure. Ministers were forced to agree to pay the full £803m cost of this, but refused to underwrite the cost of pay awards to other staff including admin and clerical, ancillaries and laboratory technicians, none of whom had settled for less than 5.5%: the government had only allocated an extra 4.5% to cover NHS inflation (Independent April 22 1988). To make matters worse, NHS managers dragged their feet in implementing the regrading exercise, while others attempted to cut costs by allocating nursing staff to lower grades. It became increasingly obvious that Kenneth Clarke's pledge to have the money in nurses' pay packets by Christmas was a hollow one. Frustrated at this new setback, nursing staff at the Maudsley psychiatric hospital walked out in September on a 12-day strike (Health Emergency 20 1988).

    Militancy was again growing into a "hot autumn" across the country, as angry down-graded nursing staff protested by the effective tactic of "working-to-contract", exposing the holes in the management case. All 19 health districts in the North West were affected: in Burnley health chiefs agreed to reconsider 800 gradings after the health authority meeting was besieged by 1,000 angry nurses. In Yorkshire there was action in Leeds, Bradford, Hull and Rotherham, while Wakefield saw a 95% vote for work to grade action by COHSE members. 50 hospitals in the West Midlands were affected by the industrial action, including Walsall, where 300 out of 340 nurses lodged appeals against their grading. In London, NUPE nurses at St George's hospital staged a 3-day strike, and both NUPE and COHSE found strong support for days of action (Health Emergency 21 1988).

    […] (the chapter goes on to discuss the White Paper, "Working for Patients" and the resultant "internal market" up to 1997).

  • Hawking joins Judicial Review v Jeremy Hunt

    Saturday 9th December 2017

    Latest news in battle against ‘Accountable Care’ threat to NHS

    Urgent: Help fund Round 2

    Professor Stephen Hawking has joined Dr Colin Hutchinson, Professor Allyson Pollock (co -author of the NHS Reinstatement Bill), Professor Sue Richards and Dr Graham Winyard in their joint intention to take Jeremy Hunt, secretary of State for Health in England, to judicial review.

    This is a critical challenge to the government’s attempt to circumvent Parliament and democratic scrutiny and to allow Accountable Care Organisations to operate in the NHS in England.

    Support the five complainants in this important action by donating to Round 2 of their funding appeal at CrowdJustice

    With your help they will cover the potential legal costs.

    Since Round 1, lawyers for the Secretary of State for Health, and for NHS England (NHSE), have written to their solicitors, rejecting their arguments and stating that they will robustly defend any judicial review.

    The four (now five) complainants’ lawyers have studied these replies and have sent a further letter before action to both Hunt and NHSE.

    They expect to file proceedings in the court very shortly.

    Why Hawking has joined the JR application

    “I have been lucky to receive first-rate care from the NHS. It is a national institution, cherished by me and millions of others, and which belongs to all of us.

    "I am joining this legal action because the NHS is being taken in a direction which I oppose, as I stated in August, without proper public and parliamentary scrutiny, consultation and debate.

    “I am concerned that accountable care organisations are an attack on the fundamental principles of the NHS. They have not been established by statute, and they appear to be being used for reducing public expenditure, for cutting services and for allowing private companies to receive and benefit from significant sums of public money for organising and providing services.

    “I want the attention of the people of England to be drawn to what is happening and for those who are entrusted with responsibility for the NHS to account openly for themselves in public, and to be judged accordingly.”

    `What are we seeking and why?’ – team’s motivation for legal challenge

    We are seeking a judicial review to stop Secretary of State for Health Jeremy Hunt and NHS England from introducing new commercial, non-NHS bodies to run health and social serviceswithout proper public consultation and without full Parliamentary scrutiny.

    These non-NHS bodies would be called “Accountable Care Organisations” (ACOs). They would be governed by company and contract law and can be given “full responsibility” for NHS and adult social services.

    ACOs were conceived in the US about twelve years ago. ACOs are being imported into England although they are not recognised in any Act of Parliament.

    ACOs would be able to decide on the boundary of what care is free and what has to be paid for. They will be paid more if they save money. They can include private companies (e.g. Virgin in Frimley, Circle in Nottinghamshire), including private insurance and property companies, which can make money from charging.

    They could also include GP practices, in which case people on their lists would automatically transfer to the ACO in order to be entitled to services. New patients would also have to register with the ACO. They will be allowed to sub-contract all “their” services.

    Support this important challenge by donating at CrowdJustice here –


    In Round 1, £26,020 was raised in 26 hours, underpinning their lawyers’ work up to preparing the case for court.

  • International Association of Health Policy - IAHP

    Sunday 11th September 2016

    The International Association of Health Policies (IAHP) stands in support of two of their board members of the European region and members of “Academics for Peace” and Education and Science Workers Union (Egitim-SEN), who were discharged from their positions at public higher institutions in Turkey!

    Turkey experienced a failed coup attempt on July 15, 2016, and the Turkish government holds the religious group led by the US resident cleric Fethullah Gülen responsible. In the aftermath of the failed coup the Government and university administrations have ordered for the dismissal of 42,881 state employees, especially in the Ministry of Education, but also at universities, where 2,346 employees were discharged. The latest mass purge imposed on the basis of a cabinet decree within the context of the state of emergency rule (September 1, 2016), included more than 41 Peace Petition signatories that were deemed “supporters of terrorism” and banned from public service.

    In January 2016, 2,218 scholars from Turkey signed a petition titled “We will not be a party to this crime,” also known as the Peace Petition, which demanded Turkey’s state to abandon its deliberate massacre and deportation of Kurdish and other peoples in the region. Since then the signatories (“Academics for Peace”) have been subject to heavy pressure and persecution and have faced criminal and disciplinary investigations, custody, imprisonment, or violent threats.

    The dismissal of the 41 Peace Petition signatories and Education and Science Workers Union (Egitim-SEN) members in the latest mass purge, among them the International Association of Health Policies (IAHPE) board members ONUR HAZAOGLU and ÖZLEM ÖZKAN, is yet another demonstration of the rapid escalation of violations of human rights and fundamental freedoms in Turkey, where the failed coup attempt has served as a pretext for the Erdogan government to cleanse all critical voices, both political opponents and human rights defenders.

    The IAHP strongly condemns the dismissal of two of its board members, ONUR HAZAOGLU and ÖZLEM ÖZKA, and urgently demand that our colleagues get reinstated to their positions and have their employee rights fully restored.

    Mauricio Torres-Tovar

    On behalf of IHAP

  • The plans may still be fantasy: but NHS cuts are starting to get real

    Sunday 14th August 2016

    Theresa May's government is stepping up George Osborne's programme of relentless real-terms reductions to NHS spending, to reverse Labour's decade of expansion. And NHS chiefs are raising the pressure on hospital trusts, GPs and Clinical Commissioning Groups, demanding concrete plans for cuts to tackle monster deficits.

    The Health & Social Care Act of 2012 made clear that the Secretary of State has no duty to provide health services: so the cuts and privatisation that are taking shape are being done by 'remote control', through Simon Stevens and NHS England, under the approving eye of Jeremy Hunt.

    This is why since Christmas Stevens and NHS England have carved England into 44 "Footprint" areas in which the "local health economy" of NHS trusts, CCGs and local authorities are required to work together rather than compete.

    However this is no enlightened reintegration to scrap the competitive market. It's a desperate effort to cut the deficit, balance the books and "transform" services - collaborating in secret, to develop Sustainability and Transformation Plans (STPs), which must all be vetted, and may be changed, by NHS England.

    It's NHS England's way to assert central control, to speed the implementation of the policies outlined in Stevens' Five Year Forward View. Alongside the rapid development in each "Footprint" of 5-year plans to bring the NHS back within budget, more tangible, painful cuts are already taking shape.

    This very quest for "sustainability" is now threatening services. As a recent report by the King's Fund on trust deficits argues:

    "The scale of the aggregate deficit makes it clear that overspending is largely not attributable to mismanagement in individual organisations - instead it signifies a health system buckling under the strain of huge financial and operational pressures. The recent strategy of driving efficiencies by cutting the tariff has placed disproportionate strain on providers and is no longer sustainable."

    The same report goes on to warn that: "cuts in staffing and reductions in quality of care are inevitable if the government's priority is to restore financial balance".

    Right on cue Stepping Hill Hospital in Stockport, with a deficit of over £40m, is closing 30 beds, cutting 350 staff and selling off part of the site to cut costs and raise short term cash; trust managers argue that this is in line with plans for other similar trusts.

    Just down the road East Cheshire NHS Trust, delivering acute and community services, has declared it is not sustainable in its current form.

    And in a nasty echo of the bad old Thatcher era of cuts in spending from 1985, the chief executive of the Care Quality Commission has argued that he prefers cash-strapped trusts to let waiting times increase rather than reduce the quality of care. Not long ago long waiting times were themselves a measure of poor quality.

    In another blast from the 1980s St Helens CCG has now resorted to a complete 4-month halt to all non-urgent referrals to local hospitals, reducing services to emergencies only.

    Across the country trusts are repeatedly missing targets for prompt treatment of A&E patients - with performance often worst for the more serious Type 1 patients, who need admission to a bed.

    However the regulator mis-named 'NHS Improvement,' now obsessed with the effort to wipe out deficits, has discarded any pretence of concern for quality of care, and announced that staffing wards at more than the bare minimum of 1 nurse per 8 patients is not affordable, warning that trusts with higher staffing levels may have to cut back as a condition of extra funding.

    NHS England, meanwhile, has announced a fresh drive to "reset" the finances. The main components of the "reset" are:

    " Pumping in £1.8m of additional cash in a one-off effort to clear deficits;

    " Setting tight financial cash limits for every trust and CCG;

    " Even tighter controls on use of agency staff;

    " national action to implement Lord Carter's recommendations for savings in procurement and "back office" teams;

    " Setting up another team within NHS Improvement to promote efficiency improvement

    " Programmes in each STP to increase efficiency through "transforming" services.

    But big savings require big cuts. Section 4 of NHS England's Reset plan argues that hospitals and services which now depend on locums and agency staff need to be closed and centralised in "nearby" larger units.

    "By the end of July STPs should have reviewed services which are unsustainable for financial, quality or other reasons […]. They should have developed plans to re-provide these services in collaboration with other providers to secure clinically and financially sustainable services, both for 2016/17 and for future years."

    Despite the fine words about "transformational efficiency" it's plain that NHS England is primarily resorting to old fashioned cuts to balance the books.

    Trusts are being squeezed by CCGs, and in turn have to shed staff and squeeze down on prices they pay to suppliers and agencies.

    In many areas - Cumbria, Calderdale, Oxfordshire, Lincolnshire, Devon, North West London, Bedfordshire, Essex, and more - the most vulnerable targets are A&E units, or smaller hospitals that are to be sacrificed on the altar of "sustainability."

    However little has so far emerged from the 44 "Footprint" areas: the details of the STPs have so far been kept firmly under wraps.

    The completed documents may have little more of substance to offer than early sketchy drafts. They could yet be a diversion from the actual cuts at trust and workplace level.

    The recent publication of at least the 40th version of the North West London STP Plan announces a renewed determination to drive through the closure of Ealing and Charing Cross Hospitals, based on plans debated since 2012 - now openly seen as a way to save money.

    However the rest of the 54 densely-packed, chaotically-presented pages in tiny type, indicates that while the volume of paper consumed has increased, management thinking remains stuck in the realm of fantasy.

    The same old assertions that have been around for well over 20 years are again embraced by desperate NHS managers -despite the absence of evidence that they can deliver the promised results. The STP shows a semi-religious belief in the effectiveness of prevention programmes to produce rapid improvement in public health. Trendy new apps and digital devices are expected miraculously to keep frail older people out of hospital, and the answer to any problem is seen as paying management consultants to draft another document, or strategy.

    It's a wish-list more than a plan.

    However amongst the incantations and pious hopes there is also a commitment in the NW London STP to create "Accountable Care Partnerships" along the lines of the US-style Accountable Care Organisations proposed by the Five Year Forward View.

    These would be provider organisations which would work for a fixed budget to cover a defined population. It's a risky business. In the US private health insurers have homed in on with these, but lost money - despite much higher levels of health spending. Similar NHS "lead provider" projects covering older people's services in Cambridgeshire and cancer care in Staffordshire have seen private sector bids withdrawn, and the Cambridgeshire plan collapsed for lack of adequate funding.

    Nonetheless NHS Improvement have clearly declared their intention to push for much more private sector "partnership" and involvement in local "transformation" plans. The STPs are vehicles to open up contracts for possible privatisation or outsourcing as well as cuts.

    With Labour largely silent on this, the only questions seem to be coming from a few local authorities. Councils are being roped into STPs, bribed by pitifully small additional sums towards their meagre social care budgets, then bullied by threats that this could be withheld.

    Council leaders are being pressured to sign up in support of STPs without seeing or studying the full document - and many are doing so.

    However one or two are standing firm: Hammersmith and Ealing councils in North West London have bravely refused to sign up for an STP which threatens hospitals in their boroughs, and saddles them with even more under-funded responsibilities.

    Northamptonshire's Tory-led county council, facing £60m of cuts, has announced it will cut funding for social care, including support for discharging patients from Northampton and Kettering hospitals.

    In Warrington, the chief executive of the Labour-led borough council has spoken out against NHS "naïve" attempts to drive through STP plans without proper consultation, describing them as a "recipe for disaster," and warning that there was little sign of partnership in the relations between NHS and social care.

    Whether it's STPs, old-fashioned cuts, or the privatisation offensive that is the greatest concern, every part of the country faces a major test in the autumn and winter as a result of the ruthless spending squeeze.

    Health campaigners wanting to understand what's involved, compare their problems and share lessons with others, and reach out to trade unions to build more powerful movements in defence of our NHS are urged to join us at the Health Campaigns Together conference 'The Challenge of STPs', in Birmingham on September 17. More details and registration from

  • The heat is on for NHS cuts

    Thursday 14th July 2016

    In the post Brexit political free-for all it's a nightmare scenario for the NHS.

    Services were already struggling to cope with rising demand on a budget which falls each year to 2020 in real terms value and as a share of national wealth (GDP).

    Nonetheless it seems that - however much rhetoric there may be about the importance of public health - there is no imminent prospect of the extra funding that's needed. Instead there's just huge economic uncertainty ahead.

    The financial squeeze on the NHS flows from the decisions of the Cameron government back in 2010: George Osborne chose the path of austerity and cutting all public spending. He opted to cut the NHS covertly through a 10-year virtual freeze, designed to unpick the previous 10 years of increased spending - while claiming NHS spending was "ringfenced" from outright cuts.

    There has never been any sign that the new Prime Minister, Theresa May, in any way dissented from this approach. Nor is there any sign that her chosen Chancellor Philip Hammond, who established a brutal reputation when he was a Treasury minister for driving through cuts, will substantially change Osborne's approach.

    To make matters worse, the Brexit vote is already undermining the ability of NHS employers to recruit health professionals from the EU, who fear that they may not be welcome or secure in the UK.

    Since the referendum May herself has refused to guarantee that EU nationals working here would be able to stay following the Brexit vote: that potentially includes the 55,000 or more already working in the NHS as well as many more in other jobs.

    May as Home Secretary was an enthusiastic advocate of tighter limits on immigration: her notion of a 'one nation' approach appears to mean excluding people with origins in other nations.

    In the midst of her major reshuffle, Health Secretary Jeremy Hunt appears to be almost unique in holding on to his post - despite, or perhaps because of his stand-off with the junior doctors. May's decision to leave him there signals no retreat from the imposition of a contract which the junior doctors have overwhelmingly rejected.

    With continuing fears of recession there had been talk even from Osborne of freeing up infrastructure spending, but no hint of easing spending limits on health or local government, which is responsible for social care. Hammond is likely to be as mean-spirited.

    However it's not just the health budget feeling the squeeze: social care has been slashed year by year since 2010. With more people living longer with more complex needs, they need social care - and councils are running out of 'efficiencies'.

    The latest survey of all councils in England from the Social Services directors (ADASS) says they have to make further reductions of services of £371m for people needing care - and for their carers. This follows five years of funding reductions totalling £4.6bn, almost one third of real terms net budgets.

    The proportion of social care savings expected to be raised from efficiencies has fallen from 75% last year to 55% in 2016/17 whilst outright cuts in services have increased from 18% to 39%.

    ADASS argues that there are now "next to no further efficiencies to be made from squeezing provider fees paid, or raising income from fees and charges to customers".

    Half the cuts will come from older people and almost 20% from personal budgets - a scheme dear to the heart of NHS England boss Simon Stevens. Only a third of social services chiefs were confident they will even be able to meet their statutory duties this year.

    All this is bad news for the NHS service users, because most NHS new models of care and hopes for savings through 'integration' of services depend on social care: but it's even worse news for service users.

    But big savings are still very much on the agenda on NHS budgets too.

    Since just before last Christmas the new mechanism to drive cuts has been Sustainability and Transformation Plans (STPs), which have to be drawn up in each of 44 'footprint' areas across England .

    Each STP is required to seek new cuts & "savings" to bridge improbably huge gaps between projected needs and available resources by 2020.

    Each plan has to be checked by NHS England, whose boss Simon Stevens has initiated this latest top down reorganisation, hoping to ride roughshod over the structures put in place by the 2012 Health & Social Care Act to impose much more centralised control.

    Stevens was reportedly planning to invoke David Cameron's support in pressing for financial discipline had EU referendum gone against Brexit: but since the vote the central pressure for savings is continuing, made more urgent by the latest revelations that despite extensive "creative accounting" reducing overt deficits by £900 million, the underlying deficit of trusts and foundation trusts last year was £3.7 billion.

    Despite hugely ambitious savings targets, the most optimistic forecast for this year is a total trust deficit of £500m. NHS Improvement has responded by demanding trusts implement another £250m cuts.

    And as this update is drafted NHS England has called for limits on spending on clinical staff - shocking Royal Colleges. NICE guidelines for safe staffing targets have been effectively discarded, with trusts told they need no longer invest to meet CQC or Royal College guidelines. Struggling trusts which have staffing of more than 1 nurse per 8 patients will be told this can no longer be afforded.

    Trusts which appear to be making insufficient savings on "back office" services will be forcibly paired up with other trusts by NHS improvement. The heat is on.

    So far there is precious little information on the content of many STP plans. First drafts of all 44 plans - drawn up in secret, with only the blandest generalities published - were apparently submitted to NHS England at the end of June, according to the HSJ, which also reports that it is unclear when - or if - all the plans will be made public. Behind the scenes there are huge efforts to strong-arm and bribe local authorities to sign up to plans that cut local health care, but offer a token handout to social care budgets.

    Many STPs have plenty to keep secret about: they centre on significant, controversial service reorganisation. More and more A&E units and other services are again at risk throughout England, threatening local access for communities.

    Plans to axe services at Bedford Hospital for example would mean that the nearest hospital would be 19 miles away: patients are being offered the "choice" of providers up to 50 miles away. STPs offer the chance to override local concerns and impose cuts regardless of opposition.

    But the cuts will of course run alongside privatisation: an NHS England director has also promised a conference of the right wing Reform think tank that STPs will offer plenty of opportunities for the private sector to get into contracts for estates management and new models of care.

    So the Keep Our NHS Public campaigners that have renamed STPs as "Slash, Trash and Plunder" are spot on, and campaigners need to join with trade unions to address the danger of STPs and coordinate a response wherever possible.

    That's why Health Campaigns Together has established an STP Watch page on its busy website, and organised a national conference in Birmingham on September 17, which will bring together information and experience and attempt to map out solutions.

    We need to get together to weather the new, dangerous period for the NHS. I hope readers and their organisations will support HCT, come to the conference, share info on STP Watch - and help us build the strongest possible resistance.

  • May the Fourth be with you!

    Sunday 1st May 2016


    Labour's shadow health secretary Heidi Alexander has called an "opposition day debate" on the government's plans to scrap NHS bursaries for student nurses and midwives - on Wednesday May 4.

    The Bursaries or Bust campaign says:


    We will be assembling at Parliament Square to show the government that we will continue to fight NHS bursary cuts.

    Ask your MP to support on the day

    Heidi Alexander has called a debate based on the early day motion 1081 which has been signed by 139 MPs so far.

    This is exciting. This means we can win.

    JOIN US.


    And don't forget


    We want 10,000 of you there!

  • NHS trust deficits hit £2.2 billion - and rising

    Tuesday 16th February 2016

    As Jeremy Hunt demands NHS trust managers clear deficits before they receive any of the £1.5 billion "transformation fund" in 2016-17, figures from a snap survey of trust board papers in early February by pressure group London Health Emergency show trust deficits are bigger than ever, with 138 out of 150 trusts in the red.

    The total deficits for England's 150 acute trusts are now more than a massive £2.2 billion. Just nine trusts were in surplus, sharing a meagre total of £11 million between them, while three have not published figures on their websites.

    10 trusts each face deficits of more than £40 million, while three have shortfalls in excess of £70 million, headed by Barts Health, the biggest NHS trust in England, with the biggest debt at a monster £134 million.

    No less than 74 trusts are showing deficits above £10 million - the figure that triggered the crisis at mid Staffordshire hospitals in the mid-2000s, where management, desperate to clear deficits, sacked nursing and medical staff - reducing services to disastrously poor levels resulting in a national scandal.

    A recent letter from Mr Hunt to foundation and NHS trusts now risks a further widespread repetition of similar cuts in staffing and reduced quality healthcare. Hunt has demanded that trust bosses "balance the books without compromising patient care" to stand any hope of accessing the limited new money allocated in George Osborne's Comprehensive Spending Review. He threatens that boards which fail to clear deficits will be removed and replaced - although it's far from clear how the many dozens of trusts now deep in the red could all be subjected to this treatment.

    But it gets worse: further guidance from NHS regulator Monitor and the Trust Development Agency has urged trusts in deficit to agree actions including "headcount reduction" - in other words large-scale job losses. This could cause chaos in local services all over the country.

    As the Mid-Staffs trust bosses discovered, larger sums can be saved more quickly by reducing numbers of higher paid nurses and doctors than by cutting back on lower paid staff: but the damage done to the quality of care can be equally severe and swift. All these panic moves run alongside Jeremy Hunt's attempts to create what he calls 'seven-day working' in the NHS with no extra staff and no extra money, by imposing an unsafe and unfair contract on junior doctors.

    Responding to the figures Dr John Lister, Secretary of Keep Our NHS Public said:

    "Five years of frozen funding under David Cameron's governments have reduced the NHS to a cash-strapped shadow of the service the Tories inherited when they took office in 2010. Hospital trusts are not just missing financial targets, but also missing targets for treatment of A&E patients, treatment of cancer patients, treatment of mental health patients, and struggling to discharge patients from hospital beds as a result of the brutal cutbacks in social care implemented year after year in Tory spending cuts. There are desperate and growing shortages of GPs. Even Public Health budgets, to reduce future NHS costs by preventing illness and promoting good health have been slashed back.

    "But the latest call for trusts to balance the books by cutting staff is a sure-fire recipe for growing waiting lists, waiting times, trolley waits and all the misery some of us remember from the grim Thatcher years in the late 1980s.

    NHS funding has been frozen in real terms while the population has grown, costs have risen, and staff have become more difficult to recruit and retain as pay levels have fallen steadily further behind since 2010, resulting in soaring spending on agency staff. Dr Lister adds:

    "The only way to get the NHS back on an even keel is for substantial increases in real terms funding, an end to the bureaucratic costs and fragmentation of the competitive contracting system imposed by Andrew Lansley's disastrous health and social care act, and urgent steps to regain the trust and confidence of junior doctors and other healthcare staff, beginning with a reversal of Jeremy Hunt's decision to impose his unsafe and unfair contract."

    Download the survey here

    Full analysis of these figures by John Lister

  • Hunt cracks the whip over NHS bosses

    Friday 5th February 2016

    "The floggings will continue until morale improves" appears to be the human relations strategy of Jeremy Hunt and Cameron's right wing Tory government in their approach to all sectors of the NHS.

    Not content with goading the Junior Doctors into unprecedented - and inspiring - strike action, and cheesing off the majority of NHS staff with five years of real terms pay cuts and the threat of more to come, Hunt has antagonised tens of thousands of GPs with demands that they implement 7-day a week services that cost a fortune and put GPs under stress.

    Ministers are pursuing their 7/7 NHS policy with absolutely no regard to evidence of the failure of most of the pilot schemes.

    Health Minister Alistair Burt told the Commons Health Committee he was "not bothered" whether patients used the extra appointments his colleagues are demanding GPs provide on Saturday afternoons and Sundays. In fact patients have clearly shown they don't want them.

    Nor do ministers seem to care that just one GP in eight has said they would consider the new 7-day access contract proposed by David Cameron, and GPs are debating instead whether to resign from the NHS if more funds are not provided for primary care.

    Scarce cash and human resources are being squandered on gimmick ideas that don't work. NHS England has admitted that the level of take-up of the "midlife MOT" healthcheck for people aged 40-74 had been minimal.

    The drive for 7/7 access to primary care runs alongside a similar campaign on hospital care, which is now a key factor in the Junior Doctors' dispute. Again it's based on prejudice and efforts to con the electorate rather than evidence, with Hunt cynically distorting the available statistics on weekend deaths in hospital to grab Daily Mail headlines.

    Now, on top of all this, Hunt's latest diktat to the boards of NHS and foundation trusts shows he is keen to stick the boot into senior managers as well.

    The tightest-ever squeeze on NHS funding since 2010 has brought the biggest-ever combined deficits, with almost every acute hospital trust and foundation trust deep in the red. Trusts face five even more savage years to come.

    Already NHS performance is visibly falling back, bringing delays of treatment in A&E, delays in accessing cancer treatment, and record levels of delays in discharging patients for lack of community services or social care.

    But instead of recognising these warning signs, Hunt has now demanded that trust bosses do the impossible - and "balance the books without compromising patient care" - or face whole boards being suspended.

    It's a bluff in many ways: almost every hospital is failing on finances - and they can't suspend them all. But it cranks up the heat on already stressed hospital bosses, while giving them no way out.

    Hunt has of course previously imposed arbitrary limits on the use of agency staff to fill growing numbers of vacancies for nursing and medical staff - while simultaneously proclaiming his commitment to enhanced levels of staffing, and urging the regulatory body the Care Quality Commission to get tough on this issue.

    It appears that ministers, the Department of Health and the top bureaucrats in NHS England have all decided the best way to deal with the chaos that has been triggered by the spending freeze and Andrew Lansley's disastrous Health & Social Care Act is to shut their eyes tightly, plug their ears and ignore all of the evidence by just repeating the same impossible demands.

    So Hunt now tells trusts they are supposed to be "equally focused" on treating patients and on "how they can leave hospital" - much of which he knows is out of the control of NHS trusts, and hinges on a largely dismembered social care service that has been hopelessly underfunded, fragmented and privatised to death by local councils in most areas. 80% of "Better Care Fund" projects to link health and social care were failing at the last count.

    Hunt's statement itself shows the monumental task he is setting NHS managers: it estimates that to save £400 million across the NHS it's necessary to make a 1% improvement in staff productivity. Not only is this a hopelessly vague assertion, but it means that simply to clear the £2-3 billion or more of deficits that trusts will carry into the new financial year, "productivity" needs to be increased by at least 5% - and much more in heavily indebted trusts.

    Even NHS England boss Simon Stevens, in his hugely optimistic Five Year Forward View did not expect to achieve "efficiencies" of more than 2-3% per year - while he too ducked out of any discussion on how exactly these "efficiency savings" were to be achieved.

    The managers who are expected to deliver these results are even less confident than Stevens. A survey of the Healthcare Finance Management Association in November found 88% were unconvinced that their organisations could deliver 2-3% efficiency savings, and 84% believed the Five Year Forward View is unachievable because trusts lack the resources required.

    More than half said that quality of care could only be maintained or improved if the promised extra £8 billion funding by 2020 was available soon: 94% felt it was needed in the next 18 months. Instead George Osborn's Spending Review statement soon afterwards offered a very different prospect, with extremely lean years from 2017 onwards.

    Nonetheless Hunt, whose previous involvement with the NHS was limited to signing up with other right wing Tories in support of plans to break it up, is now robotically repeating that none of the £1.8 billion "extra" funding ostensibly allocated to the NHS in 2016-17 will be available to trusts who do not balance the books.

    He has told hospital bosses there is "no choice" to be made between delivering high quality care and having a good grip of finances. Hospitals which perform poorly on either measure will face closer scrutiny and intervention from regulators.

    But reaction to Hunt's statement by NHS managers reading the Health Service Journal ranged from anger at the way they had been set such an "impossible agenda" to cynical suggestions that where boards are suspended the next step could be to wheel in Hunt's "mates" from one of the 'big four' costly management consultancies to develop a "pie in the sky turnaround strategy."

    What's clear is that this latest ratcheting up of pressure on NHS management is likely to drive forward plans for cut backs and closures by hospital and mental health trusts, rationing of care by local commissioners reducing the range of services available, and attempts to force staff to work under even greater pressure with unfilled vacancies.

    Hunt's top-level bullying of managers and trust boards is almost certain to trigger a new round of bullying by these managers and their subordinates across the NHS. And every "failing hospital" will of course be pilloried in an obedient mass media and Tory press as reasons why the NHS itself is "no longer sustainable".

    This is no accident or mistake. Hunt and the Tories are not just blindly creating chaos.

    Since Andrew Lansley's first day as a Tory health secretary in 2010 they have been seeking ways to fragment the NHS, undermine confidence and public support for it, and give more contracts to private providers, more opportunities for private insurers to attract new customers, and more scope to promote the idea of imposing charges for NHS treatment.

    That's why it's so important for Labour to develop a clear alternative approach from top to bottom, based on a commitment to dismantle the costly and wasteful market mechanisms begun under Tony Blair and now driven forward by Cameron, end contracts with private providers, stop any further haemorrhage of cash through PFI, and reinstate the NHS as a public service, publicly funded through taxation, and publicly provided.

    A Bill setting out a clear way to achieve this has been drafted by Professor Allyson Pollock and Peter Roderick. It was supported by Jeremy Corbyn and John McDonnell. It has now been tabled in this parliament by Green MP Caroline Lucas. Labour Parties need to press for Labour MPs and shadow health secretary Heidi Alexander to back the Bill: two Labour Parties in Bristol have already declared their full support.

    But CLPs also need to be part of new moves to build a united resistance to the Tory onslaught on the NHS, bringing together health campaigns, trade unions, pensioners, and doctors' groups at national and local level to fight cuts and privatisation.

    Health Campaigns Together ( is organising an activists' conference on January 30 for which tickets are already sold out - and will be seeking support in every area as it gets going this year. Make sure you and your CLP are part of it.

    The NHS is under the most ferocious ever attack. If we don't fight for it, we can lose it. When it's gone, it's gone.

  • Cash injection won't be enough to rescue NHS

    Saturday 31st October 2015

    Discussion now centres on how big it will be rather than whether it will happen: but everyone it seems, except a few ostrich-like ministers, now agrees the NHS is headed for a massive, unprecedented financial deficit in 2015-16.

    The deficit for the first quarter, the normally cheaper April-June of this year was close to £1 billion - more than the whole of last year. But with winter fast approaching and the hatches being battened down in hospital trust boardrooms discussing deficits in the tens - or hundreds -- of millions, it's clear that the total is likely to far exceed the grim warnings of £2 billion across the NHS.

    The mailbag for applications to the slush fund that has been surreptitiously bailing out floundering trusts and foundation trusts - especially in the run-up to the election - is bulging with applications for loans or even simple handouts to keep services running. Unless more money is funnelled in, this will soon run short.

    We know that this cash crunch is not accidental. While hospitals run out of money and staff, billions are being wasted on the bureaucracy of a competitive market in health - tragically opened up under Tony Blair, but since driven massively forward by Andrew Lansley's cynical Health & Social Care Act.

    That legislation deliberately fragmented the NHS, forced local commissioning groups to put more and more services out to tenders from "any qualified provider," which have led to a whole series of ridiculous and failed contracts with private providers, many of them undermining local NHS trusts.

    The Act also hived off responsibility for the NHS from the Secretary of State to NHS England and a gaggle of regulators. NHS England has since appointed Simon Stevens, a former top executive of US health corporation UnitedHealth - who has in turn connived with George Osborne to promote even more fragmentation through the so-called 'Devo-Manc' and similar local carve-ups.

    The Act is already proving itself a costly disaster, but rather than save money and reintegrate the NHS by scrapping the dysfunctional market they have created, and giving herds of over-paid management consultants their marching orders, the Tories are forcing trusts to dismantle more services and contemplate closures.

    Every problem is made worse by every statement of Jeremy Hunt- cheesing off junior doctors, demoralising and annoying GPs with incessant increases in their workload, and all health professionals with the ludicrous call for 7-day working for which there is no demand in primary care and no staff or funding for staff in already overstretched hospitals.

    Now the government is hell-bent on worsening the staff shortages that are blamed for problems of poor quality care.

    Cameron's gang's plans to slam the door shut on nurses expensively recruited from non-EU countries and give notice of deportation for tens of thousands of overseas nurses who are already part of the NHS workforce have been shelved, largely thanks to a concerted campaign including NHS employers and Simon Stevens, who has pointed out that ballet dancers would be excempt from the Tory restrictions, but nurses would not.

    But don't underestimate the political risk Cameron is taking. Part of his blatantly dishonest pre-election pitch to his core supporters -- many of them elderly - was that he was "protecting" NHS funding (having already frozen funding for five years, with plans to make that a decade of standstill real terms funding, while the population and numbers needing health care have grown).

    Many on the left will have dismissed this as laughable: but it's a certainty that millions of Tory voters took that into consideration, encouraged into that delusion by Labour's inept and unconvincing challenge on the NHS - hamstrung as they were by their limp acceptance of Osborne's fraudulent "austerity" agenda (which has not reduced but increased the deficit).

    So let's not underestimate the importance of the recent extraordinary public criticisms by the chair of a major London hospital trust in the Daily Mail of all Tory papers, saying that people have been "conned" and that the NHS is going broke.

    Of course he had an agenda: he heads an organisation that mobilises volunteers, so naturally his answer was that thre NHS is so broke that the only way forward was to run the NHS on the unpaid labour or millions of men and (mainly) women.

    But this too will have come as something of a shock to Daily Mail readers, who like most Tories will be supportive of the NHS, concerned for local services, and assume that care would be available for them provided by professionals, not by keen (or reluctant) amateurs or their own family.

    The current situation is reminiscent of the autumn and winter of 1987, in the aftermath of a massive Thatcher victory, when the impact of NHS cuts imposed in the April budget hit the hospitals, creating havoc with soaring waiting lists, cancer patients dying waiting for treatment and cuts in children's hospitals. These hit the Tory press - Daily Mail, Telegraph, Times - and combined with open revolt from top consultants and a huge petition of hospital consultants which Health Emrergency helped to organise.

    By December, to minimise the damage, Thatcher, for all her majority, was forced to back down and find more cash for the NHS. Then she followed up with her notorious "review" which resulted in the creation of the "internal market" (the first big costly reorganisation of the NHS).

    Now we have a massive financial problem unleashed by Tory policies, and a newly elected Tory government to the right of Thatcher on most issues, but with a majority of just 12, and a real vulnerability if the cuts force through a massive round of hospital closures, as suggested by minister Lord Prior, who appears to have gone quite mad, and wants to axe 50,000 acute beds.

    It seems likely that the cash crisis will push Osborne into concessions and providing extra cash in the autumn statement. Any extra cash seems certain to be followed, as in 1987, by more far-reaching and reactionary "reforms".

    David Prior in the Lords has set up a commission to discuss the imposition of charges for NHS treatment: others are looking for ways of squeezing in an expanding role for private health insurance.

    Options for even more privatisation are limited by the fact that the private sector itself has found it hard to run even one of the smallest district general hospitals (Hinchingbrooke) while the cash squeeze is also forcing down the cash on the table for new contracts - with big companies pulling out of some high profile contracts. So the profits are in running the NHS budgets rather than delivering front line care.

    Now, while hospital trusts saddled with costly Private Finance Initiative contracts for new buildings struggle to meet their soaring bills from frozen budgets, Osborne's Fiscal Charter commits the government to minimal borrowing even for infrastructure - so any and every new hospital from now on will be forced into seeking private finance, and milked for excess profits.

    All of which makes it urgent for Labour's new front bench to get up to speed with the situation and start hammering the Tories over their despicable record on the NHS and the crisis they have created.

    We need a united campaign of local campaigners, health unions and Labour Party making maximum protest and challenging every local cutback and closures.

    We need to exploit divisions in the enemy. We must take advantage of the fact that the Tory bar on recruitment of nurses from outside the EU has been challenged by Simon Stevens and NHS managers. We need to use the opposition of NHS employers to the brutal anti-union laws now being forced through.

    Labour's new leadership has a golden opportunity, in the NHS crisis, to highlight the dead end of austerity policies, to line up with 'Middle England' as the voice of opposition to local cuts and closures - and to swing Tories away from Cameron using the brazenly broken pledges on the NHS.

    To do so they need to seek out good expert analysis and advice, reach out to trade unions and local campaigners, and raise a coordinated challenge in a much more professional way than has been done so far. Any Blairites who get out of line on this must be slapped down publicly.

    Labour should ditch the ill-conceived Efford Bill, and sign up to the NHS Reinstatement Bill drafted by Allyson Pollock and Peter Roderick, which aims to sweep away the costly and divisive apparatus of the competitive market in health care.

    it's time to put the Tories to the sword over their ruinously expensive, chaotic and disastrous "reforms" that have brought the NHS to its knees while Osborne freeze drives it to bankruptcy.

    It's not the NHS that is unsustainable, for all the Tories tell us: it's the Tory policies on the NHS which are unsustainable - and Jeremy Corbyn's team need to be making that point long and loud.

    It's a winner.

  • Devolving blame as wheels fall off cash starved NHS

    Saturday 31st October 2015

    About six months ago, in the run-up to the General Election, George Osborne and senior council bureaucrats in Greater Manchester unveiled a massive plan to devolve central government powers over public services - including the NHS, which is not a part of local government.

    The so-called "Devo-Manc" plan was expected to put a combined budget of around £6 billion for health and social care in the hands of a newly-formed combined authority of Greater Manchester, which was required as part of the deal to appoint, and eventually elect a Mayor with executive powers.

    But after all the excitement had waned, the harsh reality emerged. The brutal "Devo-Manc" proposals to integrate healthcare with what's left of social care budgets in Greater Manchester has now been exposed by the decision to press ahead with highly controversial plans to strip emergency surgery from six hospitals - Wythenshawe, Tameside, Wigan, Bolton, Bury Fairfield and North Manchester.

    These cost-driven cuts follow on the downgrading of Rochdale Infirmary and Trafford General. They raise questions over the future of A&E and maternity services at all six hospitals - potentially the biggest round of A&E closures so far in the NHS.

    However serious these developments might be, many of our readers may feel that the problems are confined to the North West of England, and nothing to do with Kent. But shortly afterwards came the announcement of a similar devolution of powers - to Cornwall, and George Osborne's offer to roll it out to "all major cities". It would be a big mistake to underestimate how many plans are already being laid: It's happening all around you.

    A recent trade union briefing document identifies similar moves to establish similar "combined authorities," with schemes covering most of the Midlands, East Anglia, Essex, Surrey and Hampshire. Kent seems to be one of a minority of counties not yet to have made a move: that could soon change.

    And with "devolution" of powers and an "integration" of a financially challenged NHS with the remnants of financially drained social services comes the possibility of forcing through unpopular hospital "reconfiguration" schemes aimed at saving money by drastically reducing the level of services provided.

    The Manchester hospital cuts - under the misleading title of "Healthier Together" are just one of a number of almost identically argued schemes that are taking shape in England - across London, and many other areas.

    All of them have their roots not in the quest for improved services, but in the aftermath of the banking crash of 2008, which threatened an end to a decade of yearly above-inflation increases in NHS spending.

    The Labour government turned in 2009 to US-based management consultants McKinsey for proposals to on how to bridge a projected NHS cash "gap" of up to £20 billion by 2015.

    This was a very limited investigation, since any discussion of the potential huge savings of billions that could be made by scrapping the bureaucracy of the new competitive market system in the NHS, ditching private providers, and tackling the various rip-offs in new hospital projects financed through the Private Finance Initiative was, predictably, excluded.

    Instead McKinsey came up with a "report" consisting of 124 PowerPoint slides, which offered no coherent argument but a series of assertions, few of which were backed up by evidence, and none of which were seriously analysed to show potential costs and disadvantages.

    A major focus, now to be found in every local plan for cuts, was the call to reduce demand for healthcare by keeping people healthy, tackling factors that can lead to chronic health problems such as obesity and smoking - all of which are desirable, but none of which can produce short-term savings.

    Today's NHS England boss Simon Stevens is a fan of these proposals - but George Osborne has other ideas. He just slashed £200 million from an already pathetically small budget for public health services, making health promotion an even less likely route to savings.

    McKinsey also proposed shifting health services out of hospitals to "lower cost settings" - which, without proof or explanation, they claimed could save £2.7-£4.1bn.

    An additional shift to "self-care" and chronic disease management was expected to save up to £2.5bn, while "reconfiguration within local health economies" (hospital closures) was said to save up to £1.6bn, plus up to £600m from "estates optimisation" (flogging off the vacated buildings).

    All of these figures appeared to have been simply made up, with no explanation of how these changes - many of them contentious or downright unpopular with local communities - were to be achieved.

    Despite the vagueness of the proposals, NHS managers - egged on by McKinsey and other management consultants, and assisted by Department of Health and external spin doctors - have since produced plans based on many of the same flawed assumptions.

    Back in 2012, McKinsey director Penny Dash admitted at a "community-based care workshop" that "there isn't very much evidence base about models of community care" - the very models McKinsey has been urging local health bosses to adopt.

    In fact the evidence is stacking up to show that all of the big ideas being promoted by those trying to create a McKinsey-style "compelling story" and present a "case for change" share three important qualities - they lack any substance in reality and offer little if any cash saving. But all of them offer years of lucrative work for management consultants.

    The biggest deception of all is the claim that by switching services out of hospitals it's possible to make big savings.

    One of the most advanced schemes of this type is the so-called Shaping a Healthier Future project in west London, which aims to close four A&E units and two whole hospitals (Ealing and Charing Cross).

    It was initially promoted in 2012 as a £190m scheme to help save £1bn from spending. Since then the scheme's cost has already escalated five-fold to £1bn - with no clear explanation of where the money might come from, or what the final plans might be. It's clear that any eventual "savings" could only come at a heavy price.

    There's equally little evidence for David Cameron's pet project - seven-day working in the NHS, much of which already functions seven days a week. Recent experiments in the provision of seven-days-a-week access to GPs have resulted in schemes costing up to three times more than they claim to "save."

    In Manchester, just 65 per cent of the extra GP appointments were taken up, and the extended service reduced A&E attendance by a feeble 3 per cent - all of them minor cases.

    Elsewhere 7/7 pilot schemes have cut back on extended evening access to GPs and some have closed Sunday sessions completely after finding far lower than expected patient demand.

    The evidence that cost savings or reduced demand for hospital treatment come from developing out-of-hospital initiatives in primary care and community health services is very limited.

    Repeated studies have shown there is no substance to claims from McKinsey and others that hospital admissions could be reduced and costs cut by the superficially attractive idea of concentrating extra resources on patients at high risk (cynically dismissed by NHS bureaucrats as "frequent flyers" because they are often admitted to hospital).

    In fact high-risk patients make up less than 2 per cent of hospital caseload. Focusing resources on them diverts GPs and other staff from other patients' needs - and leaves the needs of the 98 per cent unchanged.

    A Nuffield Trust study last year came to similar conclusions. The BMA is calling for other costly pilot projects on reducing hospital admissions through such measures to be scrapped since they are doomed to fail.

    The buzzword of the moment - the call for "integration" of health and social care, trumpeted by Tory ministers, Labour politicians and by Simon Stevens - has come under scrutiny. Again there is no evidence it can deliver the expected efficiency savings.

    Last year, for example, the Commission on Hospital Care for Frail Older People, set up by the Health Service Journal, concluded it was a "myth" that measures such as the "integration" of health and social care and improved services in the community would reduce the need for hospitals or bring cash savings for the hospital sector.

    Agreeing that improving community services was desirable, the report argues that this could only delay rather than avoid the need for hospital stays.

    "The commonly made assertion that better community and social care will lead to less need for acute hospital beds is probably wrong."

    Better social care is perhaps an even more remote prospect than better community health services. Social service spending has been battered by the huge cuts that have cut local government budgets by up to 45 per cent since 2010, and is set for similar-sized cuts in the next five years.

    Indeed there is little in the way of social care left for the NHS to integrate with. What remains is restricted to the patients with the most severe problems, leaving nothing to support those with moderate needs or provide preventive support to those with lesser problems.

    Numerous studies have also challenged the core McKinsey/government argument for the "consolidation" of A&E services into fewer "major units," leaving only free standing urgent care centres, offering limited hours and services.

    Studies by primary care specialists have concluded that most of the people who attend A&E do need to be there, shooting down the assertion that the majority are inappropriate attenders or simply minor cases.

    A 2009 report commissioned by the Department of Health from the Primary Care Foundation specifically challenged "widespread assumptions that up to 60 per cent of patients could be diverted to GPs or primary care nurses," and argued that the real figure was as low as 10-30 per cent.

    A report last year for the King's Fund also concluded that "a proportion of A&E attenders can safely be seen in community settings, but there is little evidence that developing these services in addition to A&E will reduce demand."

    In any case, the cost savings from diverting A&E patients to other services are negligible. Care in other settings is only marginally cheaper - and requires investment.

    The NHS spends less than 3 per cent of its budget on A&E, so even closing all of the remaining units would go nowhere near to solving the NHS cash crisis, which stems not from excess use of A&E but the political decisions of Osborne to cut NHS spending as a share of GDP.

    In practice A&E cuts serve a different purpose, as a prelude to hospital cuts and closures.

    Shifting care out of hospital to expanded primary care or community healthcare has also proved impracticable - there is a national shortage of GPs and practice nurses, worsened by 2010 cuts in training places.

    Primary care budgets have been squeezed even more tightly than hospital budgets. There is no funding available, no plans and no serious commitment to develop expanded community services - and even if there were, it would not save any money.

    As the picture of chaos grows, the deliberate effort to undermine confidence in the NHS has been intensified by Jeremy Hunt's outrageous attack on hospital consultants.

    The constant, complex reorganisations and policy initiatives are fragmenting the efficient, publicly owned and run NHS into a myriad of piecemeal contracts, while the pressure to "integrate" with social care poses a major threat of the introduction of charges for care and the erosion of our NHS free at point of need - since the 2012 Health & Social Care Act, the Secretary of State no longer has any duty to provide healthcare.

    It's never been more important to fight back against every cutback, every closure and every privatisation. The next few years will be crucial in the battle for the NHS, and for its reinstatement. We need to build the biggest, strongest campaign to make sure we have a chance to win.

    John Lister is director of Health Emergency, and joint author of NHS For Sale (Merlin Press 2015).

  • Beware this dangerous "silly season" for the NHS

    Monday 17th August 2015

    Eagle-eyed researcher Richard Grimes and the excellent Our NHS website have flagged up the fact that a newly-appointed Tory Minister for NHS Productivity, Lord Prior, has set up a fresh inquiry into the possibility of funding the NHS through user fees for service.

    The proposal, made apparently informally in the course of a low-profile debate House of Lords, has all the trappings of a stitch-up, since only like-minded peers seem likely to be invited to take part in discussing this zombie idea, which keeps constantly resurfacing, with little if any public involvement.

    It has been swiftly followed by a report from CIPFA - the Chartered Institute for Public Finance and Accountancy - which dismisses the chances of the NHS making the required £22 billion of savings over the next five years. It concludes from this that the government must either come up with more money for the NHS, or reduce services, or … "charge users more".

    "To choose none of those is not a realistic option." We can expect an orchestrated campaign of such arguments to grow in the next year or so.

    This raises the possibility of the new government publicly flouting David Cameron's previous explicit insistence that patients would not face charges for treatment or be required to take out health insurance. But we are in a period in which a newly-elected Tory government feels free to ditch its pre-election promises and earlier commitments, and crack on with the policies which will appease the right wing back benchers and the backwoodsmen who fund the Party.

    Meanwhile Monitor, the NHS regulator, has written to cash-strapped trusts facing a massive £2 billion total of deficits this year, telling them in effect to disregard targets for waiting times, and tear up guidance on safe staffing levels, with all financial penalties suspended in a desperate effort to balance the books.

    Monitor, too, is saying there is simply not enough money to maintain NHS services as before - again proving that Cameron's bland pre-election promises of an extra £8 billion for the NHS by 2020 is no guarantee that services will not be slashed to ribbons and the choicest services privatised.

    We are entering a new, dangerous, silly season in politics. That's why the underlying principles of the NHS, as a tax-funded universal system delivering a comprehensive range of health care free at point of use, and free to plan and allocate resources according to need rather than market forces, are again being questioned - and constantly undermined.

    In addition to the fact that it is socially regressive and economically nonsensical, the very idea of introducing user fees for the NHS is also a major electoral liability. Even the recent King's Fund Barker Review weighing up a series of unpalatable "options" rejected the idea of user charges, while suggesting a range of taxes, mainly on the elderly, to help pay for increased investment in the NHS.

    But just because a policy is mad and unpopular does not mean that neoliberals don't aspire to do it.

    The combination of the continued, tightening freeze on NHS budgets, coupled with demands for massive, unprecedented "efficiency savings" and the chaos of the new, dysfunctional system introduced by Andrew Lansley's Health & Social Care Act, also results in all kinds of common language being turned upside down.

    "Devolution" - in Manchester, Cornwall and now increasingly planned for other areas of England - has been transformed from a progressive measure putting health services to some degree under democratic control, into a bureaucratic monster, with imposed mayors and arrogant decision-making by small cabals of self-important councillors.

    Instead of a transfer of real powers to a more local level, budget pressures mean "devolution" is now an exercise in shifting blame for unpopular cutbacks and closures from central government - which since the 2012 Act no longer has any duty to provide health care - to unwitting but ambitious local authorities.

    In countless 'Our Healthier Area' projects and Simon Stevens' Five Year Forward View, 'public health' and 'preventive' measures now no longer mean long-term interventions tackling the social determinants of ill health and designed to make the local public healthier. Instead they have become a magic incantation which is somehow supposed to achieve miraculous short-term reductions in use of hospitals and health services - and generate billions in "savings," irrespective of the £200 million slashed from public health spending in Osborne's budget.

    The mantra of "integration" of health and social care services is also echoed by all the main parliamentary parties. In itself it's a desirable goal - if the objective is to extend the NHS principle to social care and scrap the present means-tested charges.

    But in place of any genuine "integration" we are faced in real life with the disintegration of an under-funded, largely privatised social care system, which will be further torn apart by another five years of cuts under George Osborne's plans for local government.

    The NHS, too is visibly disintegrating: Clinical Commissioning Groups are one after another restricting the range of services they will pay for, capping numbers of treatments, and finding excuses to exclude smokers and overweight patients from treatment, and conniving with local trusts as they flout targets for patients to wait no longer than 18 weeks for treatment.

    Different CCGs are now adopting different, contradictory plans for future services: in Somerset, GPs appear ready to pool part of their primary care budgets with hospital budgets and social care to create a new "outcomes-based" system of commissioning services.

    But in the North East, a Health Service Journal report reveals Northumberland CCG is proposing a completely different scheme to hand the bulk of its budget and commissioning functions to Northumbria Healthcare Foundation Trust, to be administered by a "provider led Accountable Care Organisation" - not yet established.

    The Trust would deliver emergency and acute services as well as community health, and it already runs a number of GP practices. Other GPs in the area would be encouraged to group together in federations: they too would work under contract with the trust.

    The scheme appears to break down the "purchaser/provider split" that has dominated much of the NHS since Margaret Thatcher's government introduced a costly "internal market" in 1991, later transformed by Tony Blair's government and then the Lansley Act into a full-scale competitive market involving the private sector.

    However the establishment of an Accountable Care Organisation also worryingly copies similar organisational structures in the USA, where ACOs run by private insurers operate in the private sector. This raises obvious fears of a future privatisation - if the private sector could be assured it could make a profit after being stung by a series of losses from NHS contracts to deliver clinical services.

    But while the first NHS ACO is being set up, other CCGs are following different lines. Some are dividing up whole "pathways of care" and groups of services, with each going to "lead providers," many of them private companies. These include Bedfordshire (contracts for Musculoskeletal services and dermatology); Nottinghamshire (who disastrously awarded a dermatology contract to Circle, resulting in the collapse of specialist services in Nottingham as consultants departed rather than work for the company); and Cambridgeshire (where a long wasteful saga of seeking to contract out Older People's services wound up eventually giving the lead provider contract to a consortium led by local trusts).

    The most notorious case is Staffordshire, where the contract for End of Life care seems certain to go to a private provider, while the even more controversial cancer care contract is in chaos after the only Staffordshire trust in the consortium - University Hospitals North Midlands - pulled out of negotiations, arguing that they could not guarantee to treat a rising caseload with the limited funding on offer. Only the Royal Wolverhampton Hospitals Trust is hanging on.

    The Staffordshire CCGs that have been driving the process, shamefully egged on and financed by cancer charity Macmillan, are now left with a lame 'consortium' led by support service provider Interserve, which has no clinical expertise, and now no prospect of being able to offer a viable or accessible service.

    But with so much prestige now at stake for the CCGs, which have defied local opposition to press the scheme through so far, there seems little chance of them seeing sense and scrapping the whole farcical process to negotiate a fresh contract with the trusts.

    It's a crazy, dangerous time for the NHS: the unthinkable is not only being thought, but put into practice by senior managers desperate to balance the books, while the Tory right look for ever more avenues for private sector takeover.

    It's a time for health campaigners, health unions and the growing numbers drawn into progressive politics by Jeremy Corbyn's astonishingly popular challenge for the Labour leadership to get together to build a new, bigger and united challenge to a Tory government with a wafer-thin majority.

    Another NHS is possible - and affordable if the scrounging rich would only pay their share of tax. To reinstate the NHS and protect it we need a movement that is stronger and more powerful than before. While the Tories dream up more unthinkable policies, let's make sure we keep our eyes on the prize - and focus our anger on the enemy in front of us.

  • Hinchingbrooke: the countdown to failure
    John Lister

    Wednesday 18th March 2015

    The disastrous contract for private hospital chain circle to run Hinchingbrooke Hospital in Cambridge has now been branded a "failed experiment" by the Commons Public Accounts Committee. But the MPs have only just woken up to a problem some of us have been warning about for years.

    Almost exactly five years ago, as the shortlist of bids was shaping up in the contest for the 10-year £1 billion franchise to run Hinchingbrooke, health union UNISON warned in a press release "Private firms can't run a general hospital." It took just three years of bitter experience to prove them right.

    In April 2010, the only shortlisted NHS contender, Cambridge University Hospitals Foundation Trust, had just pulled out of the bidding.

    That left Circle Health competing with Ramsay Health Care UK, and Serco for the contract to run Hinchingbrooke, which then had a turnover of £96m, but was lumbered with a £40m historic deficit after falling foul of the government's so-called "payment by results" system as implemented by the inept and insensitive East of England Strategic Health Authority.

    Although it is small in NHS terms, with up to 310 beds, a busy A&E, 25 paediatric beds and 12 SCBU cots on site, and a mix of emergency and elective admissions, Hinchingbrooke hospital was more than six times larger and many times more complicated than the average private hospital in England. It is more than ten times larger than Circle Health's extravagant private hospitals in Bath and Reading - which have scraped through financially only on the strength of treating NHS patients in otherwise empty beds.

    UNISON's Eastern Region Head of Health Tracey Lambert said "We are shocked to find that none of the shortlisted firms has any experience of running clinical care in a medium-sized hospital. Surely that should be a basic requirement?

    "We can't understand how these three companies got through to this stage of the tendering process: they should have been ruled out from the beginning as completely unsuitable to run a busy general hospital."

    But the bids weren't thrown out: instead the bidding became even more fiercely competitive, winding up with Serco and Circle each trying to outbid the other with implausible promises to generate huge cash savings - and restore the fortunes of the hospital.

    East of England SHA was already notorious for its eagerness to promote private sector solutions, and Dr Stephen Dunn, its Director of Strategy, seemed determined to force through a franchise deal to put a profit-seeking company at the helm at Hinchingbrooke, despite the only, grim, precedent.

    Seven years earlier, in a reckless experiment, private contractors (Secta) had been the first company to be put in charge of an NHS hospital (Good Hope Hospital in Solihull). This adventure wound up as a predictable, costly failure, with the Trust even deeper in debt, the contract prematurely terminated, and the management taken over by a neighbouring Foundation Trust.

    Learning nothing from this past fiasco, Dr Dunn and his chums were all too keen to let Circle have a go, and even more enthusiastic when in a final round of bidding, Circle offered the biggest (albeit completely baseless) promise to generate savings, claiming a staggering £311 million could be saved over ten years.

    This outbid the equally tenuous Serco proposition, so the implausible deal, which meant Circle's profits would not begin until they had got Hinchingbrooke's finances into surplus, was rubber stamped by NHS East of England, and by the new Tory-led coalition, already pushing their own plans to split up much of the NHS into bite-sized chunks for private bids. The contract was signed in November 2011, to take effect from the following February.

    Everyone involved seemed to be happy: Dr Dunn said:"This is a momentous day. Circle secured this operating franchise following an open competition. They outshone the best of the best from the NHS and independent sectors. This will usher in a new era, unleashing innovation into the NHS, with staff and patients firmly at the centre."

    The private sector were delighted and grateful: even before the deal had been signed, Dr Dunn had been awarded prizes by Healthinvestor magazine for his efforts to create this franchising experiment.

    Tory ministers and the media embarked on a wild love affair with Circle, the private company that claimed to be a 'partnership' offering 'shares' to its staff - with allusions to the successful John Lewis Partnership - but was run by city slickers and owned by hedge funds.

    Ali Parsa, a former Goldman Sachs director, was the mercurial driving force of Circle, beloved by the media despite his cavalier disregard for facts, and kept popping up, most frequently on the BBC, but also in the Daily Mail and even the health trade press.

    But things quickly started to go wrong. Ten months later, in November 2012 a National Audit Office report on The Franchising of Hinchingbrooke Health Care Trust was published, as the financial performance and patient satisfaction ratings of the hospital took a sharp turn for the worse.

    The NAO criticised NHS East of England's lack of rigour in the scrutiny of the final contract and noted that the Circle contract was based on "assumptions that were not directly informed by previous experience" (page 7). It warned of the franchising out of management: "This approach is untested in the NHS and it is too early to establish and understand the outcome." (page 40)

    The NAO went on to question the central tenet of the contract - the huge commitment to cash savings:

    "Circle's projected savings of £311 million over ten years are unprecedented as a percentage of annual turnover in the NHS. If delivered, Circle's proposal will make savings of over 5 per cent recurrently each year over the ten-year life of the contract.[…] However, Circle's bid did not fully specify how it would achieve these savings." (NAO page 8)

    There was also a brutal bottom line if the company failed to deliver: it would get paid nothing, and could lose up to £7m before escaping if the contract goes seriously wrong:

    "Circle only receives payment when the Trust generates an in-year surplus. If the Trust does not generate a surplus in a given year, Circle must cover up to £5 million of the shortfall from its own resources. If the £5 million threshold is breached, either Circle or the Trust board, with the Authority's approval, have the option to terminate the franchise." (NAO page 29)

    The NAO report did not see that Circle was already expecting to miss its first year £9.9m savings target by almost a quarter. Indeed during the summer of 2012 the company itself was propped up by raising another £47m from its astonishingly patient but as yet unrewarded investors.

    A Health Service Journal report based on an unredacted copy of Circle's business plan, revealed a planned 20% cut in workforce - 320 jobs, 130 of them clinical posts. (HSJ November 8 2012:13)

    Less than a month later Circle's founder, front man and chief executive Ali Parsa stepped down unexpectedly as Chief Executive, with a £400,000 pay-off. Days later a highly critical Commons Public Accounts Committee was told by Sir Neil McKay, chief executive of the SHA at the time of the contract, that there was no real plan B if Circle walked away: there was only a token, 3-person Trust Board in place.

    Somehow in 2013 the company managed to wriggle free of such critical scrutiny, but outside of the limelight the management regime at Hinchingbrooke was a far cry from the carefully-spun public image of Circle Health as a "John Lewis-style partnership," owned by its staff.

    The 2013 NHS staff survey revealed a very different picture, of a Trust that scored worse than average on 19 of 28 key measures, and in the worst 20% on almost half the questions. Despite the talk about "partnership" Hinchingbrooke staff reported above average rates of bullying - and just 27% of staff felt there were enough staff for them to do their job properly.

    Staff didn't feel empowered, but exploited. Circle time and again refused to meet with staff unions. Staff were required to wear new uniforms sporting 'Circle Hinchingbrooke' in place of any NHS logo. The company would not even allow staff time to attend their "partnership" meetings. Vacancy levels grew, as did the bills for more costly agency staff to keep services running.

    In the summer of 2014 Hinchingbrooke was one of just 19 to be referred by the Audit Commission to the attention of Health Secretary Jeremy Hunt because of its chronic financial problems. The level of company subsidy to the Trust was rising towards the £5 million threshold that could allow Circle to cut its losses and walk away. The position of the Trust was undermined further by policy decisions of local health commissioners: Circle were not getting the special treatment they had pinned their hopes on.

    Meanwhile behind the scenes Circle as a company wound up its much-vaunted Virgin Islands-based "Circle Partnership", through which staff had been given worthless shares which gave them no power, paid no dividends, and they could not sell.

    Circle - based in the tax haven of Jersey - decided that staff would now to be given undefined numbers of "free" shares making up less than 10% of the restructured company: so they would still have no voice in the running of either Circle or Hinchingbrooke Hospital.

    The main company, Circle Holdings, which took all the decisions, is almost entirely owned by hedge funds, many of whose top bosses are long-time donors to the Conservative Party. The company has never made a profit, and would have collapsed already without extensive patronage from the NHS (which accounts for 93% of Circle's income) and repeated cash handouts from its wealthy owners.

    Things began to unravel faster towards the end of 2014, with the imminent publication of a highly critical report on standards of care from the Care Quality Commission, a collapse of support from the "Friends and Family" survey which Circle had once boasted about, a deteriorating financial position, worsened by a continued exodus of staff and soaring costs of agency staff.

    Papers for the Trust Board's October meeting listed the dangers of "contract penalties and deductions" for poor performance could add up to a massive £1.6 million - with another £800,000 at risk if the trust lost out on validation of some of its invoices.

    Early in November 2014 Hinchingbrooke's Finance Director Jenny Raine left her post, amid growing signs of chaos. The company's half-year report showed Circle's "support payments" to the Trust had reached £4.85m - just £115,000 short of the £5 million figure that could allow Circle to escape from the contract, or demand a renegotiation.

    UNISON called for Circle to be sacked; but it was not until January, just before the publication of the critical CQC report, that the long-expected announcement was made that Circle was pulling out. Deficits had already exceeded £7 million, allowing the firm to walk away without additional payment - leaving the NHS to clear up the mess they had left behind. The Trust has now called for a £9.6m bail-out from the NHS.

    The Circle era at Hinchingbrooke was a triumph of spin over substance, of clever PR over performance. Even as the company announced its departure it briefly threatened to take legal action to overturn the damning CQC report, and whipped up a short-lived media frenzy over an absurd allegation of a Labour party "plot" to unseat Circle. The Daily Mail did its best to keep this lame horse running, but as the date for its departure loomed, Circle dropped its challenge to the CQC findings - quite possibly to avoid further exposure of its failings as the company bids for other NHS contracts elsewhere.

    So UNISON and the campaigners were right all along: private firms can't run a general hospital. Whenever spurious calls are made to bring in private "expertise", the grim lessons of Circle's failure should be a reminder of how it can go wrong. Hinchingbrooke now looks like the Good Hope scenario all over again, as an NHS Foundation trust could be the best hope for getting the Trust back on track. If the private sector seems to be the answer, you are asking the wrong question.

  • Launch of the campaign for the NHS Reinstatement Bill 2015

    Monday 6th October 2014

    A campaign has been launched on Saturday to reverse the failings of the Health and Social Care Act 2012 and fully restore the NHS in England as an accountable public service. It is encouraging voters to ask candidates in the general election to support including a Bill that would do just that in the first Queen's Speech after the election.

    The launch was being carried out by Prof Allyson Pollock at a special meeting at the Liberal Democrat Annual Conference in Glasgow, and by Peter Roderick at the annual general meeting of the NHS Consultants' Association in London.

    Underpinning the campaign is a proposed NHS Reinstatement Bill 2015 , co-authored by Pollock and Roderick, which would abolish competition and the purchaser-provider split, re-establish public bodies and public accountability, and restrict the role of commercial companies.

    The draft Bill draws on some of the best examples of NHS administration over its history, retains some features of the reforms laid out in the Health and Social Care Act 2012, and would be implemented on a timescale determined by the secretary of state.

    The Bill will both restore the NHS in England and reverse more than two decades of policies which have been intent upon privatising NHS services and funding, ultimately to its demise.

    The proposed NHS Reinstatement Bill is a vital public health measure, and necessary legally to prevent the NHS in England becoming simply a memory, something that we had once upon a time. Pressure must be put on those standing in the general election to restore its founding vision.

    Lord David Owen CH FRCP comments that "as the failures of the 2012 Act become daily evermore obvious, this Bill provides a template for very necessary reinstatement and reform. The secretary of state will decide the manner and the pace of implementation - except for section 1, which would restore his or her legal duty to provide the NHS with immediate effect."

    Comments on the Bill are sought from those who share the concern and commitment to reinstating fully the NHS as an accountable public service as smoothly as possible and with only a minimal and exceptional role for commercial companies. Responses to the Bill can be sent by email to

    For other queries please contact Alex Agombar

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  • Mental health melt down

    Monday 28th April 2014

    There can be no clearer illustration of the abject failure of the Tory-led coalition's competitive market in health care than the disaster facing mental health services.

    Over the last few months the scale of the problem has been more fully revealed, not least the growing gap between the dwindling capacity of the system to deliver care and the growing need - worsened in many cases by this same mean-spirited government's brutal cuts in benefits, bedroom tax and refusal to tackle the problem of affordable housing, all of which take a toll on mental health.

    NHS budgets for mental health in the NHS are not simply frozen, like budgets for physical health needs, while costs and pressures increase, but - for the first time in a decade - actually falling year by year as health bosses inflict cuts where they feel the media will not pay any heed.

    The government response has been to stop compiling the figures that have revealed the cuts.

    NHS England, far from taking steps to address the problem of shrinking mental health budgets, has decided to cut the 'tariff' (the standard fee paid to trusts for treatment) for mental health by 20% more than the cut for other tariffs.

    Health minister Norman Lamb, speaking recently to the NHS Confederation's Mental Health Network, criticised the decision to impose a tariff reduction of 1.8% in mental health contracts, compared with 1.5% in acute care. He told delegates the decision was "flawed, not based on evidence and cannot be defended".

    But then he dumped the problem back onto the mental health trusts, saying they should "fight" with their commissioners over their contracts: "Do not accept a proposed settlement which results in mental health losing out."

    Since his Tory bosses have just forced through legislation that puts all of the financial control in the hands of commissioners, and all of the problems in the court of the mental health trusts, this is a complete evasion.

    We know that in the face of the government's cash squeeze all aspects of mental health have been hit: 1700 beds have closed since 2010, leaving dire shortages in various parts of the country, not least for child and adolescent mental health, where young people are often transported for hundreds of miles to find a spare bed, or even placed on adult wards.

    One area facing especially severe problem is Norfolk and Suffolk, where the mental health trust is simultaneously cutting back on both beds and community mental health provision, while dispatching dozens of patients to beds many miles from their homes and families. Protestors who marched 52 miles from Ipswich to Norwich last week to highlight these savage cuts showed clearly the injustice and the problems from these cuts:

    "If someone had a stroke in Norfolk or Suffolk and had to be taken to Darlington, Somerset, Bradford, Manchester, Harrogate or Glasgow, MPs would be falling over themselves to call for urgent action. But this is the reality for people in Suffolk and Norfolk experiencing a psychiatric emergency."

    The words are from one of the march leaders, Emma Corlett, a Norfolk councillor and UNISON steward, who has been campaigning to stop the cutbacks. In response the Trust chief executive, interviewed by the BBC, desperately tried to deny that there was any crisis - before admitting that his trust, like many other mental health trusts, is facing a squeeze on funding and a shortage of beds.

    Back in 2010 the Care Quality Commission (CQC) expressed concern at the excessive levels of occupancy of the majority of beds on acute mental health wards, with well over half the 486 acute wards in England running at or above 100% occupancy levels, and 35 reported to be running at levels above 125%.

    But last autumn consultants again spoke out on the dire shortage of acute beds: and nothing has been done - instead more NHS trusts are once again using costly and low quality private sector beds, often many miles away, to take their "overspill".

    Clinical Commissioning Groups seem if anything even more willing to cut mental health spending - even intensive care beds - than were the Primary Care Trusts they replaced. But sadly their under-investment in mental health is not new.

    Back in 2010, mental health charity Rethink published a report that showed many of the 1.5 million people suffering from severe mental health problems such as schizophrenia, bipolar disorder, personality disorder and severe depression were not receiving appropriate treatment. As a result they die on average 10 years younger than the rest of the population, are more likely to wind up in prison or homeless, and were much more likely to be unemployed and dependent on welfare benefits.

    In 2012 an LSE report found that only a quarter of the 6 million people suffering from mental illness were in treatment: mental illness then accounted for 23% of the total burden of disease, but received only 13% of NHS expenditure - a share that is shrinking fast.

    The problem is still unresolved. Health minister Norman Lamb, speaking to the NHS Confederation's Mental Health Network, criticised the decision to impose a bigger tariff reduction in mental health contracts than in acute care. He told delegates the decision was "flawed, not based on evidence and cannot be defended".

    But then Lamb dumped the problem back onto the mental health trusts, saying they should "fight" with their commissioners over their contracts: "Do not accept a proposed settlement which results in mental health losing out."

    Since his Tory bosses have just forced through legislation that puts all of the financial control in the hands of commissioners, and all of the problems in the court of the mental health trusts, this is a complete evasion.

    Lamb's speech followed on his appearance with Nick Clegg back in January to launch the Department of Health document Closing the Gap: priorities for essential change in mental health.

    Each of the report's 25 worthy proposals seems light years away from the actual situation in the NHS especially in the last four austerity-squeezed years.

    Proposal number one begins with the statement that "High quality mental health services with an emphasis on recovery should be commissioned in all areas, reflecting local need".

    Who would not agree? Apart that is from NHS England, who are forcing down the tariff for specialist services to unaffordable levels - and the local commissioners who have been spending less on mental health year by year for at least two years, with worse to come.

    Number three promises to establish "clear waiting time limits for mental health services" - at a point where we know children and adolescents are waiting up to 18 months for treatment, and many other services are hopelessly inadequate to deliver swift treatment. Number four promises to tackle "inequalities around access to mental health services" - with no serious explanation of how this might be done.

    Number seven promises that the "most effective services will get the most funding" - but we already know that's not what's happening either: everything is being cut.

    And so it goes on: the document has some good and necessary policies, but has no connection to the current, tightening resource squeeze that is set to run at least to 2021.

    If words alone could fix mental health, there would be no crisis. But at present a small but growing private sector, with limited capacity, limited skills and no wish to take on any complex cases, is profiting from the gaps opened up in the NHS.

    The gaps in social care are perhaps even greater, with massive cuts across the board, also hitting mental health the hardest: a recent report shows that there has been a 48% cut in numbers of people with mental health problems receiving social care since 2005; one in three councils have cut their mental health services by 50% or more.

    The coalition government has set up a dysfunctional NHS that has fragmented services, divided drug addiction services from alcohol misuse, and forced CCGs to seek cost "savings" by opening up services to "any qualified provider" - whether this be cherry picking voluntary sector organisations exploiting unpaid and untrained staff, or profit-hungry private companies.

    For CCGs and NHS England, the bottom line is short term, often illusory cash savings, while quality takes a back seat. This means the mental health trusts, with their superior skill mix, their staff training and their multi-disciplinary teams are facing deficits and loss of contracts, while cheap and cheerless services from less qualified providers win the day - and tens of thousands of mental health patients lack the care they need.

    In East Anglia, and recently in the west of Greater Manchester there have now been small but important recent protests as a fight develops to defend mental health. These protests need to be echoed loud and clear by any politicians claiming to stand up for the NHS this year or next.

    It's not fine words we need from weasel politicians, but hard cash and commitment.

  • 30 years of Health Emergency

    Tuesday 8th April 2014

    30 years ago the first issue of Health Emergency newspaper was published by the GLC-funded London Health Emergency campaign. Its purpose from the outset was to reach out to trade unions and campaigners beyond the capital, and to build a fightback against cuts and privatisation.

    Health Emergency won affiliations from all of the health unions, many of them working with us at national level.

    After the GLC was abolished two years later, LHE was funded as a source of independent information on the NHS for another 12 years by various London boroughs - while the campaigning work has from then on always been financed fromy affiliation fees, donations, and later by commissioned work for the unions.

    This has enabled us to be at the forefront of the fight on every major issue in three decades of camaigning.

    The governments have changed, the ministers have changed, the unions have changed - but 30 years later, with no grant funding, LHE is still functioning, despite the efforts of some who do not share our principles to close us down - and Health Emergency exists as an occasional newspaper, a website, a wealth of experience and published material, and as a consistent voice fighting privatisation in all its forms.

    Health Emergency could not have survived this length of time and these pressures without the loyal support of activists - and some courageous officials - in the health unions who have stood by us, made donations, organised campaigns, commissioned work. They are the real spirit of the NHS.

    Now we are faced with the most reactionary Tory-led government in living memory, with the NHS fighting for its life against threats of a decade-long freeze on funding, the deliberate fragmentation of the NHS and privatisation of the Health & Social Care Act – with the dead hand of Blairism still blocking Labour from a full-blooded campaign to defend our most popular public service.

    Health Emergency is proud to stand firm with its supporters, to defy its detractors, and to wage the key fight in the next 12 months to ensure that Cameron and all remnants of the vicious coalition are removed from office, and that the government that takes over commits itself it advance to break from Tory cash limits, reverse the Health & Social Care Act, restore the duty of the Secretary of State to provide universal health care, clear out the private profiteers, and put our NHS back together.

    We remain a non-party political campaign: this means we will work with anyone from any party or none who will fight to keep our NHS fully funded, and keep it public: and we are also proud to work with Keep Our NHS Public, the campaign that emerged from the fight against Labour's market reforms, and remains at the centre of the fight against the Tory attacks today.

    We know that on these issues we have majority support: the challenge is to translate that into a movement that can defend the NHS and defeat the aims of the current government.

    Together we can win!

  • Peoples Inquiry into London's NHS

    Wednesday 19th March 2014

    The People's Inquiry into London's NHS, supported by Unite the Union, held seven public hearings in the final months of 2013, heard from 95 witnesses plus many more written submissions and compiled over 140,000 words of evidence in transcripts.

    The Inquiry's independent 6-strong panel has since deliberated over the information they accumulated and formulated 18 unanimous recommendations.

    The full Report from the Inquiry, London's NHS at the Crossroads, is to be published on Thursday March 20, and the report and summary will be available online.

    The Panel invites further discussion and comment on the Report and in particular on the conclusions, which aim to shape policy for this and future governments.

    One thing that emerged clearly from the Inquiry was that while London as Europe's biggest and most diverse city is unique, its problems with government spending limits and the coalition government's half-baked "reforms" in the Health & Social Care Act are not a special case.

    Almost all of London's problems can also be found in other parts of the country: the recommendations therefore call for national action as well as specific intervention to prevent the capital's health services deteriorating as a result of squeezed budgets and organisational fragmentation.

    The Inquiry can be contacted at

  • Join the Protest, Join the Lobby!
    Thursday 27 February
    Stop the Hospital
    Closure Clause - 118!

    Tuesday 18th February 2014

    10.30am - Protest & Handing in Petition to Downing St

    11.30am - Protest & Rally, College Green (opp Parliament).

    12.30pm - Inside Parliament for meeting

    speakers include:

    * Andy Burnham MP, Shadow Health Secretary,

    * Louise Irvine, Save Lewisham Hospital Campaign & London MEP candidate for National Health Action Party

    * Dr Kailash Chand, Deputy Chair of the BMA,

    * Dr DavidWrigley, GPC BMA,

    * Caroline Molloy, Editor of OurNHS

    Having lost the battle to close Lewisham Hospital the Government are now attempting to change the law. They are rushing through the 'Hospital Closure Clause' - Clause 118 of the Care Bill - making it legal to close any thriving, solvent hospital whenever they want to.

    JOIN the protest, join the lobby.

    WRITE to your MP

    (see model letter at

  • Hunt has substituted double-speak and deception for action on Francis report

    Wednesday 5th February 2014

    One year after the Francis Report put forward a massive 200 recommendations for action to prevent the recurrence of the catastrophic failures of care arising from cash-driven cuts in Mid Staffordshire Hospitals Foundation Trust, the danger of further failures is greater than ever.

    Dozens of NHS Trusts, seeking as Mid Staffs did to make massive and rapid cuts in spending to meet the criteria for Foundation status, are struggling against the stream of flatline NHS funding and soaring pressures on services: the biggest of all, Barts Health is cutting back on skilled and experienced nursing staff – regardless of quality concerns – as it seeks £77m of “savings” this year. Many Foundation trusts, too are struggling to survive financially. They all face another six years at least of frozen funding under George Osborne’s brutal spending limits.

    On staffing levels, as with every one of his claimed achievements, Hunt’s solution has simply been to dump the problem onto others. He has refused to impose a minimum nurse staffing level, resorting instead to the publication of figures without anything to compare them against.

    He boasts about increases in nurse numbers in acute hospitals, but ignores the fact that there has been a corresponding cut in community health care – to which ministers are trying to divert patients – and the fact that the result is draining even more resources from mental health care, which is now being cut back each year while the government covers up by scrapping the collection of figures.

    Hunt’s warm words about whistleblowers have not been coupled with any measures to protect potential whistleblowers under his own government: already Barts Trust has publicly sacked one prominent union activist, Charlotte Monro, after 26 years unblemished service, for speaking out on cuts to the local council’s health & scrutiny committee. The real message is clear: speak out and desperate managers will victimise or sack you, while ministers look on, mouthing platitudes about a "duty of candour".

    Sacking managers, pillorying “failing” trusts, and putting increasingly impossible demands on front line nursing and clinical staff to keep the system going while Osborne starves the NHS of the funding it needs is not the way to establish a sustainable, safe and reliable system.

    The cash squeeze is so brutal that even McKinsey, Monitor and NHS England have not been able to address the staffing consequences of the massive continued reduction in payroll costs required bridge the yawning gap between resources and demands. yet staffing levels are key to the quality and safety of health care.

    The target for cash "savings" involves annual cuts until 2021 in the prices paid to trusts for front line services, where 70% of trust spending is on staff. This intensified onslaught on jobs, pay, skill mix, terms and conditions comes after four yours of pay cuts have slashed 16% from the value of NHS pay, leaving health workers weary, demoralised and bitter. Meanwhile David Cameron battles on in the EU to protect lavish bonuses for bankers, and rejects Labour's call for an extra 5% tax to be paid on earnings over £150,000 a year.

    The funding squeeze is making the the NHS unsustainable. Without a break from this and serious increases in front line resources there will be more failures and scandals – which we know will be exploited to the full by Hunt. In the past the Tory Health Secretary has made no secret of his own ambition to discredit the NHS – and open the door for private medicine and health insurance.

    The latest hypocritical nonsense on Francis should be dismissed with contempt by all who care for the NHS. The NHS needs more money, an end to the wasteful fragmentation of the Tory market reforms, and a government that supports its basic principles as a public service rather than working to break off profitable slices for the private sector.

  • A challenge for 2014

    Wednesday 1st January 2014

    The end of 2013 came in the same way as the year began, with the Tory-led coalition driving through massive cuts in our NHS and public services, coupled with unprecedented levels of privatisation.

    In January we were still waiting to see if Jeremy Hunt would rubber stamp the brutal plans of the Trust Special Administrator to close 60% of Lewisham Hospital and bulldoze that much of the site to help bail out the failing South London Healthcare Trust next door: in December, having tried to do so, and having lost twice in court to legal challenges to his right to make these cuts, Hunt is pressing for changes to the law to give arbitrary powers to cut, downsize and reorganise any hospital in the vicinity of a failing trust.

    In January we were waiting to see the results of the implementation of the Health & Social Care Act: by December we can see a chaotic picture in which many arrogant, remote Clinical Commissioning Groups - in many cases "led" by just a handful of self-interested local GPs -- are pressing ahead with competitive tendering. Some are even drawing up huge and complex tendering processes for "integrated pathways of care" that threaten to create new, private monopolies at the expense of existing public services - with no consideration of the impact on local NHS providers, and no attempt at public consultation.

    One CCG in Bedfordshire is planning to sign a contract for Musculoskeletal Services with a privately-led consortium that includes a company set up and owned by local GPs. Windfall profits for some Bedfordshire GPs could therefore come at the cost of axing services in Bedford Hospital, obliging patients to trek an extra 17 miles for services to Luton & Dunstable. Asked about the obvious conflict of interest, the CCG's only answer was to argue that the decision was taken by "consensus" (so no votes had been required), and to insist even now that the final contract has not yet been signed.

    Cambridgeshire CCG -- advised and effectively led by relics of the old privatising Strategic Projects Unit of the now abolished East of England Strategic Health Authority -- is planning the biggest-ever privatisation: another "integrated pathway", for all services relating to elderly care, worth up to £800m over five years.

    The plan drew bids from ten consortia, but the massive and complex document setting out the terms of the contract made clear there would be no extra money on the table, and that 15% of the total value would be conditional on meeting various "outcomes". To make matters worse, the winners would have to share any "excess profits" with the CCG!

    Faced with this, two of the ten consortia have already pulled out, including the one led by Capita that included Cambridgeshire Community Services, the Trust which has been delivering the majority of these services. CCS has now thrown in its lot with the bid from the predatory Optum, the company previously known as United Health, the US-owned former employer of the incoming chief executive of NHS England, Simon Stevens. So it's clear that whoever wins will effectively be a new provider.

    However it's also clear that since there's no more money on the table for what are already poorly-resourced services, no profit can be made from the contract unless savings are made either through reducing numbers of more qualified staff, down-banding them to cut the wage bill, or increasing workloads - almost inevitably at the expense of falling quality of care.

    All of which might be expected to mean that the CCG would consult local people on these proposals and the implications for future services: but again no consultation is proposed. The CCG does not want to know local people's views.

    Nor does the CCG want to address concerns over what would happen to the various services (most notably community health services for children) that would be left adrift if this big lump of Cambridgeshire Community Services is broken off and handed over to a privately-led consortium. There appears to be consideration of the fact that by handing this whole "pathway of care" over to one consortium, any notion of "choice" for patients in Cambridgeshire and Peterborough would be killed off for at least five years. The new providers would be a real monopoly, subject to no public accountability. What happens if they fail - as more and more private providers are doing? What option is there to bring the service back into NHS control?

    But while these bureaucratic horrors multiply in the post Lansley NHS there are even bigger potential horrors being lined up by a bizarre alliance of David Cameron, Barack Obama and the EU. The Transatlantic Trade and Investment Partnership, being hatched up behind closed doors by unelected EU bureaucrats, with Cameron's explicit support, masquerades as a means to generate jobs in the EU, but in practice threatens to open up British health care to the greedy claws of US health corporations seeking easy profits.

    The plan is being driven through with minimal public awareness or debate: there is little sign that Cameron's Euro-sceptic backbenchers are aware of the extra powers and control being signed away, under the direction of the Brussels bureaucrats they claim to despise. UKIP is strangely silent. The europhobic Daily Mail and Sun apparently have no view as the proposals take shape.

    The big unions have now recognised the danger to public services: Unite, UNISON and other unions have made clear their opposition to any attempt to open up health to the greedy clutched of US multinational corporations, and this has shifted the TUC away from its previous naïve acceptance of the ostensible plan to jobs and investment. Labour leaders too have started to ask critical questions, although there is no clear policy as yet.

    Meanwhile there is mounting evidence of the social cost of the EU's horrendously unaccountable, undemocratic bureaucracy lining up increasingly blatantly behind brutal neoliberal policies: the most obvious example is the establishment under German leadership of the "troika" of EU commissioners, the IMF and the European Central Bank to impose savage austerity on Ireland, Greece, Portugal and Cyprus under the guise of a "bail-out" package.

    In both Greece and Portugal this has involved especially vicious cutbacks in health spending and public sector health jobs. In Greece a 30 percent cut in spending has run alongside a 50 percent increase in "outsourcing" of contracts. In both countries new and increased charges have been imposed for drugs and treatment, while grim statistics chart the fall in life expectancy, the rise in sickness, suicide and even in Greece the return of malaria.

    These policies are being driven by the arrogant Finnish commissioner Olly &&&&&, a failed right wing politician in his own country, who with German patronage has been elevated to high office in the completely unaccountable EU machinery. &&&&& has easily survived the abject failure of his proclaimed economic objectives in Greece and Portugal, which have prolonged and deepened the recession, and hit none of their apparent targets.

    But it's more sensible to regard the EU intervention, like Osborne's austerity plan, not so much as an effort to restore the economy but more of a deliberate attempt to take advantage of the situation to drive through far-reaching neoliberal policies, privatisation, reductions in state spending, and destabilisation of pay, pensions and welfare benefits.

    This is not blundering bureaucracy, but capitalism red in tooth and claw, prising back open markets that have been dominated by state spending and public provision for half a century or more in much of Europe. This is the rich and super-rich reasserting their power and privilege at the expense of everyone else.

    To inflict a delay or a setback to the Transatlantic Treaty would be an important step in halting this effort to turn back the wheel of history. The Treaty aims to create a new, irreversible fait accompli, in which competition laws and the "rights" of corporations are dominant, and the needs and interests of the majority are subordinated to market forces.

    The control over public services, and public budgets, like our NHS itself, is under threat. 2014 is the crunch year for fighting back.

    Once it's gone, it could be gone forever. Don't let them get away with it!

    Let's renew the fight to keep our NHS and similar health services around the world - and keep them in public hands.

    Best wishes for the new year.

  • Pace hots up as Tory Health & Social Care Act shows its teeth

    Monday 4th November 2013

    October was one of those months: the big news just kept on happening, and the growing crisis gripping the NHS has become more and more obvious.

    To make matters worse, an architect of Labour's costly market-style "reforms," former Blair advisor Simon Stevens - who has for nine years been a high-flying director of the biggest US health insurer UnitedHealth - has now been appointed to replace Sir David Nicholson as chief executive of NHS England. The rapid descent into market chaos seems set to accelerate further.

    The pace was already hotting up. Early in the month, the NHS Confederation threw down its "challenge" to politicians, demanding they sign up to support swingeing and unpopular local cuts and "reconfigurations" in hospital services in the run up to the 2015 election.

    The Confed warns that unless they do so, and MPs stop defending their local hospitals and start attacking their own voters' services, the NHS stands little chance of making the massive cutbacks needed to bridge a growing gap between the miserable frozen budgets set by George Osborne and the rising pressures and demand.

    The current "challenge" of saving £20 billion by 2015 (for which most savings have so far come from effectively cutting the pay of over 1 million NHS staff) is to be followed by an even steeper "challenge" of saving another £30m by 2020.

    In case you are wondering where it went, most of the money "saved" so far has been clawed back by the Treasury, not reinvested in the NHS.

    The Confed threat was followed by the medical director of the obscure new 'London Area Team' of NHS England, Dr Andy Mitchell, who emerged from the shadows to claim that London's hospital services were "unsustainable," and that swift action is needed to close half its A&E units and many of its maternity and children's services.

    On closer examination it was clear Dr Mitchell was concerned first and foremost with finances, since his warning was that action had to be taken to prevent London's NHS running up a £4 billion deficit by 2020, and he went on to argue that the capital's trusts could "not afford" to staff wards safely.

    This blunt statement at least cut through the usual rigmarole in which NHS bureaucrats seeking to drive through cuts insist time and again that the cuts they are proposing are "clinically led". In this case the only real clinical element was it was a doctor insisting on the need for financial balance, and for services and patient to be cut to fit the budget.

    This comes alongside the continuing claim by the government and a rag-bag of so-called think-tanks and professional bodies that the NHS has to close A&E units "to save lives" - although these arguments stop dead in constipated silence when the question arises of how the remaining A&E units, and the hospitals to which they are attached, could possibly cope with the additional tidal wave of seriously ill patients who would be brought from ever-greater distances needing treatment - and beds. There is clearly no spare money to rebuild and expand on the scale required.

    In Worcestershire, where on average 99% of hospital beds were occupied in early 2013, cash saving plans are seeking to close beds and services in Redditch and Bromsgrove to centre them in Worcester.

    There is no serious consideration about the journey times and the problems for elderly and low-income patients who would be forced to make ever-longer journeys to access care: instead we are constantly told about the services that will available to those with the most trivial needs, who would still be catered for locally in "urgent care centres".

    There are constant blustering assertions that hospital care could be replaced by community-based care - but on closer examination there is little if any evidence that this can be done, or that there are any real plans to do it where hospitals are scheduled for downgrading, or that proper community based services are any cheaper than existing hospital care. There is even less evidence that this is what patients would prefer to local access to hospital.

    In place of concrete plans for expanded community services, all we get, everywhere, is fine words, aspirations and wishful thinking: that's not much use to deal with tens of thousands of poorly patients.

    Meanwhile we have been told that hospital budgets will lose another £2 billion per year from 2015, which will be carved out of NHS spending and allocated to social care, where budgets have been brutally slashed by desperate councils facing Osborne's 28% cuts.

    A stark reminder of the limits of community-based care came with some stark warnings during the month that year upon year of cutbacks in mental health budgets had reduced beds to dangerous, crisis levels. This is after years of transforming many services from hospital to the community.

    There have been days this year in London - and even in the whole of the country - in which there have been NO mental health beds - either in the NHS or private sector - available for those with serious needs. Many other days have seen patients in distress dispatched after long delays on lengthy journeys to beds in other cities, many of them hundreds of miles from their homes and family.

    Despite the headlines and crocodile tears from ministers the squeeze on mental health continues.

    The competitive market in health care has also gone badly wrong, with the Competition Commission now wading in to block Trust mergers and reconfigurations, private hospital firms forcing the regulator Monitor to investigate where they are not awarded contracts, and Clinical Commissioning Groups ludicrously blocked by the HSC Act from meeting together to plan services.

    Meanwhile patient "choice" and competition could be wiped out by a new private monopoly in Cambridgeshire, where the Clinical Commissioning Group is pressing ahead with a hugely complex plan to put whole pathways of care out to tender. The existing, successful NHS provider is no longer among the bids - raising the grim prospect of Virgin scooping up a monumental 5 year £800m contract.

    In Bedfordshire too, the CCG is set to hand a similarly complex £120m contract for musculoskeletal services to a privately-led consortium which includes a company owned by almost half of Bedfordshire's GP practices.

    As the fragmented, divisive, wasteful competitive market system set up by the Health & Social Care Act began to display its nonsensical side, Jeremy Hunt tried to smuggle through even more draconian legislation to allow "special administrators" to carve up local services as well as bankrupt trusts - in a clause tagged on to the Care Bill in the House of Lords.

    Even if he gets his way, it will come too late to rescue Hunt from the embarrassment of losing his appeal against the court ruling that prevented him rubber-stamping the closure of most services at Lewisham Hospital.

    And increased powers for the administrator would not help force through the closures in North West London, some of which have been delayed by the Independent Reconfiguration Panel.

    The IRP found that there were no convincing plans for community and other services to replace the closure of A&E and services at Ealing and Charing Cross Hospitals - and ordered the A&Es to be "sustained" until alternative services were in place.

    Desperate NHS hospital managers have begun hoping for the public to turn their backs on the NHS, and allow them to drive through unpopular cuts.

    A shameful article by the chief executive of the Foundation Trust Network, Chris Hopson in the Health Service Journal (and echoed in a wretched Guardian article) celebrated the first small signs of weakening public affection for the NHS, as ministers, the BBC and the right wing press delight in stories of poor care and service failures.

    An opinion poll had found fewer people (60%) supporting the view that "the NHS is a symbol of what is great about Britain and we must do everything we can to maintain it" and a larger minority (30%) have been bludgeoned by the right wing media into believing that "the NHS was a great project for its time but we probably can't maintain it in its current form".

    By most readings, that's still a substantial majority behind the NHS, despite all the bad headlines and cutbacks. Numbers could be pushed up even further if Labour set its face against further cuts and gave hope some services might be restored rather than closed.

    Remember, we are still many, they are few.

    Let's fight on, while there's an NHS to defend.

  • Cash crisis behind new calls for London hospital closures

    Sunday 13th October 2013

    Panic-mongering statements by NHS England claiming that London's hospitals are "unsafe" and that the system is "unsustainable" are a cynical bid to stampede Londoners into accepting hospital closures, according to London's longest-running campaign to defend the NHS.

    The controversial claims have been made by Dr Andy Mitchell, in a Sunday Times article in advance of the publication of a far-reaching report. Dr Mitchell is Medical Director of NHS England's shadowy "Local Area Teams" which have now replaced NHS London.

    But while they will be used by the right wing press as a new way of driving through current - hugely unpopular - plans to axe up to nine of the capital's 27 A&E units and additional maternity and other services, the claims that services are 'unsustainable' are now coupled with calls for EVEN MORE A&E closures.

    According to NHS England up to half the A&E units should close, along with paediatric and maternity units. But even as these announcements are being made cutbacks are already taking place in other services: the capital faces a dire shortage of mental health beds and primary care services too are being slashed to save money.

    Rejecting this approach, London Health Emergency's director Dr John Lister, who has followed health care in the capital for almost 30 years, said:

    "This is not a health crisis but a financial crisis. The problem has been entirely manufactured by unrealistic government spending limits as they slash public services to pay back the billions used to bail out the banks.

    "Ministers have been warned time and again that cuts this big in NHS spending are unprecedented anywhere in the world. We can now see that they threaten the end of a viable NHS in London and elsewhere. To close so many emergency services would require huge investment to provide adequate beds were available in the surviving hospitals, in ambulance services, and in alternatives to hospital. But all of these are actually being cut.

    "This case may be argued by a medical director, apparently citing "clinical" concerns: but the argument for these cuts is not clinical but financial. What doctor could sensibly accept the possibility that London cannot afford to staff its hospitals safely?

    "NHS England admit that maintaining the present system with "zero financial growth" would bring a London shortfall of £4 billion by 2020 and a national deficit of £30 billion. A sensible answer would be to increase spending to sustain health care, not wreck the NHS to impose an artificial balance.

    "And don't let anyone imagine the private sector offers any solution or escape: the services at risk here are precisely the high risk and costly services the private sector will not provide because they make no profit. If London's A&Es are cut back wealthy Tory voters will die alongside the poor in the delays and chaos that would follow".

    NOTE TO EDITORS: The developing crisis in London is being investigated by the Peoples Inquiry into London's NHS, with public hearings in all parts of the capital in the next two months.

    FURTHER DETAILS and COMMENT: John Lister 07774 264112, @JohnRLister

  • Lessons from Lewisham

    Friday 2nd August 2013

    Lewisham Hospital campaigners and Lewisham Council have notched up a major victory for local democracy with their successful pursuit of a judicial review against plans to slash two-thirds of their hospital services.

    The High Court ruling found that both the trust special administrator, trying to find cuts to balance the books of the floundering South London Healthcare Trust and rescue its two bankrupt PFI hospital contracts, and Health Secretary Jeremy Hunt had exceeded their powers.

    Mr Justice Silber also declared that Hunt's decision to rubber-stamp the administrator's plan to hack back on Lewisham's services had broken his own government's pledge not to implement cuts that were not supported by local GP commissioners.

    The case shows how little democratic control there is over NHS England.

    After all the rigmarole of "consultation" had proved itself useless, only stubborn local resistance and a costly legal challenge has prevented Hunt from steamrolling through brutal cuts for which there is no legal basis.

    He would have got away with it if not for those pesky campaigners.

    The judgement is already inspiring other campaigners to consider legal action to challenge cuts which they see as unacceptable.

    But there were key features which made Lewisham special - not least the sheer scale of the popular movement opposing the cutbacks from their first announcement, and the willingness of Lewisham's Labour council to support its own residents in seeking to defend local hospital care.

    The worrying thing is that the legal judgement hangs purely on legal points and the precise wording of legislation - it does not address the likely consequences for patients of the cutbacks and reorganisation of South London Healthcare Trust.

    Nor did the judge pay any attention to the powerful clinical evidence produced by consultants at Lewisham Hospital which showed the excellence of the services that the administrator wanted to close down, and what the consequences of these cuts would be in one of London's most deprived boroughs.

    He took notice of the views of Lewisham GPs and the local clinical commissioning group not so much on the clinical concerns but on the simple fact that they remained unconvinced by the plan and opposed to the cutbacks in Lewisham.

    The Department of Health immediately stated that it would appeal and attempt to reverse the ruling - and if necessary change the law to prevent any similar setbacks.

    So it's clear that Lewisham has been given a limited reprieve that could still be only a stay of execution.

    Meanwhile the sweeping powers which the administrator is given under 2006 and 2009 legislation establishing the "unsustainable providers regime" can even now still be used to impose far-reaching cutbacks on other trusts - as long as no other trusts are affected.

    In other words it's possible in other situations for equally bad plans to be implemented with no possibility of a similar judicial intervention.

    It's also clear that excellence and meeting local clinical need are no defence of services where financial pressures are driving cuts.

    Mid Staffordshire Hospitals, the first foundation trust to be subjected to a South London-style carve up by the trust special administrator, is 20 miles from the nearest alternative hospital.

    It has been delivering high-quality services, praised by inspectors and by patients.

    But the administrator now plans to save money by closing its maternity and paediatric services, which have never been criticised, along with much of its emergency care, leaving only a scaled-down shell of a hospital awaiting the next round of cash-driven cutbacks.

    It seems the only guarantee of hospitals remaining intact is for them to have signed up in the past to ruinously unaffordable PFI schemes, making them effectively "black holes" sucking in every available health budget in the surrounding area.

    Indeed, far from saving money, the administrator's plan for South London Healthcare, including writing off back debts and subsidies for the PFI deals in Queen Elizabeth Hospital and Princess Royal University Hospital, is set to cost taxpayers almost £1 billion extra over the next 20 years - for reduced services.

    It's not clear how the scheme could be remodelled if the court's ruling stands.

    Across the country more PFI deals are also going to have to be massively subsidised to keep trusts afloat.

    Across the river from south-east London, two more massive PFI projects are creating huge financial problems in north-east London.

    The cost of the £230 million Queens Hospital in Romford is forcing virtual closure of A&E and acute services at the Barking Havering & Redbridge Hospitals Trust's other main hospital site, the 20-year-old King George's Hospital in Ilford.

    These plans are being forced through despite massive local opposition and despite the desperate shortage of A&E capacity and acute beds in the trust.

    One hospital likely to feel the consequences of closing A&E at King George's is Whipps Cross Hospital in Leytonstone, which serves the borough of Waltham Forest and is the next hospital around the north circular from Ilford.

    But Whipps Cross, too, is now in danger, not so much from its own long-standing financial problems but as a result of its merger with Newham and Barts & the London hospitals to form one massive, hugely indebted new trust, Barts Health.

    Just two months into the financial year the trust, England's biggest, is already £15.7m in the red and losing £2m a week.

    It is falling well short of its massive £77.5m target for cash savings this year - over 6 per cent of its £1.25bn budget.

    Barts Health now says it is "putting itself into turnaround" to avoid being put "into administration."

    Again the financial problems of Barts Health centre on PFI - in the form of the colossal bills for the new London Hospital in Whitechapel and the redevelopment of the historic Bart's Hospital, which together cost a staggering £1bn, with the first full year of inflation-linked payments £115m this year, rising each year to 2048.

    These unitary charge payments alone are over 14 per cent of the annual turnover of the old Bart's & London Trust. The need to find other resources to help cover this cost was certainly the key factor in the merger last year with the financially troubled Whipps Cross and the struggling Newham Trust to create one massive, essentially bankrupt trust covering much of inner north-east London.

    Of course managers - and no doubt ministers past and present - are in denial, and vehemently reject any suggestion that the £7bn-plus cost of a £1bn PFI hospital is a factor in the problem at Barts.

    They are blaming all kinds of things - increased demand for A&E services, shortfalls in elective services, staff shortages leading to inflated agency staff bills and the continued relentless £20bn national squeeze on NHS spending.

    All these are added problems - but campaigners have warned since the 1990s that the Barts & London PFI plan was unaffordable. They were right.

    And if these and similar PFI payments and cash pressures are not going to tear the guts out of our NHS up and down the country, campaigners learning from Lewisham must not rely on legal action but keep up the old-fashioned protest and mass demonstrations.

    Bad decisions will go through unless local people grasp the need to fight back hard, and keep on fighting.

    Campaigners need to keep on winning because the moment they lose and a hospital closes services, there will be no way back. Once it's gone, it's gone.

  • PFI "smelly white elephant in the room" in Barts Health financial meltdown

    Thursday 18th July 2013

    Desperate measures by bosses of Barts Health, England's biggest hospital trust mean that scarce NHS funds will be squandered on a doomed attempt to get a costly "turnaround team" to tackle a £2m per week deficit.

    Just 2 months into the financial year the trust, which runs Barts & The London, Whipps Cross and Newham hospitals, is already £15.7m in the red and falling well short of its massive £77.5m target of cash savings this year - over 6% of its £1.25billion budget.

    The trust has said it is "putting itself into turnaround" to avoid being put "into administration". What this means is that the board is desperate to avoid being subjected to the draconian measures of "unsustainable provider regime" and the resulting brutal attentions of a Special Administrator, as happened recently to South London Healthcare Trust, with devastating consequences for services in SE London.

    But, like South London Healthcare, at the core of the financial problems of Barts is the controversial Private Finance Initiative (PFI) in the form of the colossal bills for the new London Hospital and the redevelopment of Bart's Hospital, which together cost a staggering £1 billion. This is the first full year of "unitary charge" payments on the PFI contract, which begin at £96.5m and increase each year to the final payment of £223m in 2048.

    The unitary charge payments alone amounted to a massive 12% of the annual turnover of the old Bart's & London Trust, and the need to find other resources to help cover this cost was certainly the key factor in the merger last year with the financially-troubled Whipps Cross and the struggling Newham Trust to create one massive, essentially bankrupt Trust covering much of inner NE London.

    As was the case with South London, managers (and no doubt ministers past and present) will vehemently reject any suggestion that the £5.3 billion cost of a £1 billion PFI hospital is a factor in the problem at Barts.

    They are blaming increased demand for A&E services, shortfalls in elective services, staff shortages leading to inflated agency staff bills and the £20 billion national squeeze on NHS spending.

    Dr John Lister, Director of pressure group London Health Emergency, who has analysed the NHS in London for almost 30 years said:

    "Everyone is pretending it's not there, but PFI remains the smelly white elephant in the room. We have warned since the 1990s that the Barts & London hospital plan was unaffordable.

    "PFI is the reason why - no matter how many management consultants are paid thousands of pounds a day, or what horrific plans an administrator might hatch up - there is no solution to the financial problem within the Bart's Trust without wholesale cuts in services and staffing that would potentially put patient care and safety at risk.

    "The special administrator for South London Healthcare effectively recognised this: he could not solve that problem within the Trust itself. In fact his package will cost the taxpayer upwards of £750 million over 20 years. It rescues the two PFI hospitals and guarantees payments to the PFI shareholders - but savages services in the neighbouring Lewisham Hospital and inflicts cuts elsewhere in SE London.

    "The financial problems at Barts Health are much bigger even than South London: so any 'solution' will be more drastic. And since PFI contracts are seen as inviolable, this is almost certain to mean massive cuts in Newham and or Whipps Cross.

    "PFI has always been an extremely a costly way of building new hospitals, at the expense of other services. It is destabilising trusts and services across England. If ministers don't act on this and go to the root of the problem, Bart's will be the latest and the biggest in what will be a series of massive financial disasters in which the only beneficiaries will be bankers, management consultants and lawyers."

    FURTHER DETAILS AND COMMENT: Dr John Lister 07774 264112,

    MORE INFORMATION on South London Healthcare available:

  • Urgent action needed to rescue NHS!
    Unions call for Sept 29 demo, Manchester

    Sunday 23rd June 2013

    Three years into the Tory-led coalition government, and the damage inflicted on the NHS is beginning to revive memories of the dark days of Thatcher in the late 1980s. Waiting times and cancellations are up, public satisfaction is down, and the far-reaching proposals of the Francis Report to remedy quality failings have almost all been dumped in a ministerial bin.

    Emergency services are struggling to cope with rising demand: ambulances take longer to arrive, some of them staffed with cheaper, less well qualified private sector crew - and face longer journeys to hospitals as A&E units close. Ambulances are already queuing at peak times outside big hospitals waiting to hand over patients as A&E units clog up, with no beds free to admit the most seriously ill, while hospitals struggle to discharge patients as endless cuts in local government again hit social care.

    Elective operations and even cancer treatment are cancelled or delayed by the lack of beds.

    Yet despite the lack of evidence to support them, still more plans are relentlessly rolled out to close A&E units, downgrade them to "Urgent Care Centres" forcing those with most serious illness to travel furthest, axe even more acute hospital beds and "reconfigure" hospital services to save money towards a massive £20 billion target - with the savings being cynically scooped back into the Treasury to pay for tax cuts to the rich.

    The pressure is greatest in emergency care, where seven out of ten hospitals lose money on services, and where any extra patients above 2009 caseload are paid for at just 30% of the tariff cost: but axing A&E also kick-starts the process of closing whole hospitals as related services close one after another.

    Many of the newest hospitals, saddled with massive, rising, long-term unaffordable overhead costs from the Private Finance Initiative, are struggling to avoid bankruptcy, and one Trust, South London Healthcare, has already gone bust, dragging down the neighbouring Lewisham Hospital. The package to rescue the two disastrous PFI schemes at the root of South London's woes will axe most of Lewisham Hospital and cost upwards of £700m: the two PFI hospitals cost just £214m to build.

    Ministers' energy has been focused on privatisation - at the heart of the Health & Social Care Act - and not access to health care. Cambridgeshire is planning the first £1 billion privatisation of services. Virgin, Serco and other multinationals are licking their lips at the profitable prospects ahead. Top NHS Foundation Trusts are using new "freedoms" to expand their private wings, even as budgets for NHS care are cut back.

    The squeeze on the NHS is a vital part of the Tory strategy to expand private medicine and open up more of the £100bn NHS budget to private corporations.

    Hospital cuts & closures up and down the country are the sharp end of this Tory offensive, generating the most public awareness. That's why it's vital that the broadest possible movement unites to defend our hospital services: huge protests at cuts in Ealing, Islington (Whittington), Lewisham and Stafford have shown the way.

    The Thatcher years were bad: but at least we then had a united opposition, and did not need to wait for Labour to make up its mind which cuts to support. We need a clear line now, to unite the vast majority from all parties: an NHS for patients, not profits! No to any closures of A&E, maternity or hospitals; drop the £20 billion cuts target; scrap PFI; halt privatisation, and bring services back in house.

    Despite Tory efforts & the LibDems, it's still mostly OUR NHS. But we have to fight to keep it that way, or your health will become somebody's business. Let's Keep Our NHS Public!

  • New book unmasks destructive "health reforms"
    June 6 launch date for 'Global Health Versus Private Profit'

    Friday 31st May 2013

    The controversial "reforms" to the NHS in England driven through by David Cameron's government -- which fragment the service and open up more of the public health budget to private companies -- are not unique, but part of a world-wide drive to maximise market forces in health care, according to a new book by health campaigner John Lister.

    Global Health Versus Private Profit is a 360-page study of the process through which many public health services are being dismantled. It has been acclaimed by leading experts, academics, and campaigners, who have described it as "essential reading", "all-encompassing", and "a class act".

    It argues that these so called "reforms" are driven not by evidence, but by ideology, and that behind the ideology is a massive material factor: the insatiable pressure from the private sector to recapture a much larger share of the massive $5 trillion-plus global health care industry, much of which only exists because of public funding.

    Nowhere in the world, Lister points out, is there a health care system that can deliver universal or comprehensive health care services purely through the development of a competitive health care market, or a private sector that can operate without subsidies. The role of the private sector, and its potential market is always constrained by an "inverse care law" - that most health care is required by those least in a position to pay the market price for it - whether this be the old, the very young, the poor or those with chronic sickness and disabilities.

    The costly experiment with competition, and slicing off ever more services to encourage private providers, may have gone furthest in England, but that's because there is a more integrated and publicly provided service to dismantle, and because governments since Margaret Thatcher have all - perhaps for different reasons -- embraced hard-line neoliberal ideology.

    But similar "reforms" are being adapted in different ways to different systems across much of Europe, and are even being driven in to the poorest developing countries where they are even less appropriate and more disastrous in their consequences.

    Global Health Versus Private Profit shows how since 1980 global agencies like the World Bank, new powerful players like the Gates Foundation, and even at times the World Health Organisation have played a role in promoting these changes, along with a burgeoning industry of right wing "think tanks" and an elite coterie of academics drawn to the chance of lavish funding rather than the evidence.

    There are chapters on the WHO, the World Bank, and other organisations shaping the reforms, a detailed critique of cost-cutting and the stock "menu" of pro-market reforms, and a discussion of the "Missing Millennium Development Goals" - the massive public health issues which are ignored by current health "reforms". The people involved are summed up as "customers the private sector doesn't want," notably the growing world-wide population of more dependent older people, the millions suffering mental illness, and the "hidden giant" of the millions facing physical disability

    Drawing on over 60 pages of references, Global Health Versus Private Profit offers a critical counterblast to the prevailing orthodoxy, challenging some of the latest thinking from the IMF, World Bank and OECD, and pointing out that market-style reforms serve neither to cut costs nor to improve efficiency: the systems most dependent on private, competing providers have the highest costs - and waste billions while excluding millions from proper access to health care.

    A concluding chapter argues that "It doesn't have to be this way": the policies are not inevitable products or a response to the current situation, but choices that have been deliberately made by politicians, and which can be rejected and defeated by mass political action.

    The reforms don't start from the evident problems facing health care systems: nor do they solve any of them. Instead they result in systems more unequal, more costly, more fragmented and less accountable - but offering more profits to the private sector. That's why the question really is whether we want to see Global Health - or private profit.

    Author John Lister said:

    "As a journalist by trade I have always wanted to get the most up to date, accurate and readable account across, to make people aware of the policies that are being promoted in our name by politicians at home and abroad.

    "I have always wanted to see a serious, critical analysis of these policies, to give an overview of what is happening and put specific issues in context. This is my best shot at doing just that: it will be followed by another volume of detailed case studies of how these policies are working out in countries round the world.

    "I hope it makes many more people aware, angry and active - if we can achieve that, we can start to reverse some of the damage that is being done."

    * Health Policy Reform: Global Health Versus Private Profit is published by Libri, and available from It will be publicly launched on the evening of Thursday June 6 in London.

  • Charities and Hospices warn peers against Section 75 Regulations

    Tuesday 23rd April 2013

    (PARLIAMENTARY BRIEFING: Debate on The National Health Service (Procurement, Patient Choice and Competition) (No. 2) Regulations 2013 (SI 2013/500).

    Lord Hunt of King's Heath has tabled a motion to annul The National Health Service (Procurement, Patient Choice and Competition) (No. 2) Regulations 2013 (SI 2013/500), with a debate scheduled to take place on 24 April. The Regulations set the rules for how Clinical Commissioning Groups (CCGs) should commission NHS services.

    This briefing from Help the Hospices, Marie Curie, National Voices, Sue Ryder and Together for Short Lives provides members of the House of Lords with details of our concerns about the Regulations, and what we believe will be their unintended negative impact on charitable providers of NHS healthcare such as hospices.

    Our concerns, in brief, are:

    1 The Regulations as they are currently worded will mean that competitive tendering could become mandatory in all but the most exceptional circumstances.

    2 Given the burden of having to put each individual service out for tender, CCGs will tend to bundle services together to put out for contract, as currently happens in local government.

    3 If contracts are bundled, then this could put them out of reach of voluntary sector providers who are, by their nature, providers of specialised care.

    4 If voluntary sector providers are forced out of the market then this could have a negative impact on patients and the communities they live in, as voluntary sector providers add value by using charitably raised funds for patient care.

    We know that the Government wants the voluntary sector to have a greater involvement in delivering NHS services. The unintended consequence of this piece of secondary legislation is that voluntary sector providers may have fewer opportunities to provide NHS services, to the detriment of patients and their families.

    We ask that the Lords take this into consideration when they debate and vote on the motion relating to The National Health Service (Procurement, Patient Choice and Competition) (No. 2) Regulations 2013 (SI 2013/500) on 24 April.

    Our Detailed Concerns with the Regulations:

    1. We think that the Regulations as they are currently worded could lead to mandatory use of competitive tendering by CCGs in all but the most exceptional circumstances.

    We know that the Government does not intend for this to happen, as it has made clear on several

    occasions when the Health and Social Care Bill was making its way through Parliament. However,

    the Regulations do not reflect this intent.

    The problem hinges around the use of the word 'capable' in Section 5 of the Regulations, which

    state that CCGs may award a new contract to a single provider without advertising if they are

    satisfied that there are no other providers capable of delivering the service.

    In the Impact Assessment for the Regulations, the Department of Health has taken a broad view of the word 'capable'. A provider might be the only capable provider because it offers the highest standards of clinical safety, or because it can establish and provide the service more swiftly than others.

    We suspect, however, that 'capable' will be interpreted narrowly to mean only that a provider is able to provide the service within the budget set out by the commissioner. This means that:

    * There will be few if any services where there is only one capable provider.

    * Providers will feel confident to regularly challenge CCGs' commissioning decisions.

    * Without legal cover to award contracts without advertising, CCGs will simply put all services

    out to competitive tender to avoid challenge.

    2. We think that, given the administrative and financial burden of having to place each individual service out for tender, CCGs will tend to bundle services when contracting.

    We are not against competition and support a mixed economy in healthcare, particularly where it serves patient interest. However, the Regulations as currently worded will likely lead to all contracts being tendered. This will place huge administrative and financial burdens on CCGs, who will likely seek to bundle contracts to reduce the financial and administrative impact of competitive tendering. This is what currently happens in local government, where competitive tendering is mandatory.

    We are already seeing this happen, with Cambridgeshire and Peterborough CCG, for example - currently, they have put out for expressions of interest for a £1bn contract where all services related to older people have been bundled together. 1

    3. If contracts are bundled, then they are out of reach of voluntary sector providers who are, by their nature, specialist providers of care.

    If the majority of contracts are bundled, this will start to force voluntary providers out of the market. Voluntary providers are by and large specialised providers who are governed by charitable objectives. Even the largest charitable providers would struggle to justify the resource and the risk needed to bid for large, bundled contracts, especially if most of the contracts were for services outside of their specialism. For small organisations, like independent hospices this would be impossible.

    In some instances this will lead to voluntary sector providers being forced out of the market. Some would be able to survive by offering reduced services using their charitable funds alone, but many would lose their NHS income.

    4. If the voluntary sector is forced out of the market then this will have a negative impact on patients and families and also the communities in which they live.

    Ultimately, the loss of voluntary sector providers would lead to:

    * Loss of specialism: voluntary providers deliver niche services, but they do it well.


    * Loss of added value: many providers match or beat the funding they receive from the NHS in charitably raised funds and they use this money to enhance the care they offer, conduct

    cutting edge research, and investing in local communities.

    * Added cost to the NHS, who would have to meet the gap left by charitable funding.

    We know that the Government does not want to exclude voluntary sector providers from delivering NHS services. The Prime Minister and members of the Cabinet have repeatedly stated they want voluntary providers to play a vital role in the newly reformed NHS.

    However, the unintended consequences of wholesale competition is that it could lead to a diminishing of voluntary sector participation. We fear this will lead to a loss of specialist services

    and skills that will ultimately lead to poorer care for patients and their families.

    We ask that the Lords bear this in mind when they debate and vote on the motion relating to The National Health Service (Procurement, Patient Choice and Competition) (No. 2) Regulations 2013 (SI 2013/500) on 24 April.

    About Help the Hospices:

    Help the Hospices is the UK charity supporting hospices and championing hospice care. As the national membership charity for 218 local hospices across the UK, we work with them, and other organisations, to advocate for and raise awareness of hospice care, promote and support clinical excellence and support those providing hospice care.

    About the Marie Curie Cancer Care:

    Marie Curie provides care to terminally ill people and their families across the UK, both through our hospices and nurses providing care directly in patient's own homes. We facilitate one of the largest palliative and end of life care research programmes in the UK. We use the findings to deliver practical improvements in care and support and to campaign on behalf of terminally ill people, their carers, and their families.

    About National Voices:

    National Voices is the national coalition of health and social care charities in England. We work together to strengthen the voice of patients, service users, carers, their families and the voluntary organisations that work for them.

    We have more than 150 members with 130 charity members and 20 professional and associate members. Our broad membership covers a diverse range of health conditions and communities and connects with the experiences of millions of people.

    About Sue Ryder:

    Sue Ryder is a charitable provider of health and social care services across the UK. We provide specialist neurological and palliative care in a range of environments including community and home?based care delivery alongside our seven hospices and six neurological care centres. We work across communities with patients, their families, commissioners, GPs and other health and social care professionals.

    About Together For Short Lives:

    Together for Short Lives is the leading UK charity for all children with life?threatening and life?limiting conditions and all those who support, love and care for them. We support families, professionals and services, including children's hospices.

    For Further Information:

    Scott Sinclair Policy & Public Affairs Manager Marie Curie Cancer Care

    T: 020 7599 7116


  • NHS Health & Social Care Act Section 75: Short letter to send to a peer asap

    Saturday 13th April 2013

    This draft has been produced by Wendy Savage drawing on research by Caroline Molloy, working with Keep Our NHS Public.

    Dear Activist, Here is a shorter letter for you to use in lobbying peers. Please write this letter by hand or send by email having put your name and address, dating and adding anything you want to say personally.


    Dear Peer

    Re: Debate on 24.4.13 on new NHS Health & Social Care Act regulations (SI500)

    Please make time to attend the Lords for this important debate and vote to annul these regulations. They will not give the Clinical Commissioning Groups (CCGs) the freedom to commission services that they (and members of parliament) were promised during the passage of the Health and Social Care Act 2012. Lord Howe said

    ' … commissioners would not have to create markets against the interests of patients. Clinicians will be free to commission services in the way they consider best. We intend to make it clear that commissioners will have a full range of options and that they will be under no legal obligation to create new markets, particularly where competition would not be effective in driving high standards and value for patients. As I have already explained, this will be made absolutely clear through secondary legislation and supporting guidance as a result of the Bill'. (Lords, 6.3.12)

    But this is not what has happened. There was such an outcry over earlier regulations that the government withdrew them, laying SI 500 as the substitute. The words are softer but the impact the same.

    " CCGs will be forced to put all new services out to tender which is costly

    " The wording is ambiguous and may lead to legal challenges

    " Law trumps guidance so do not be fooled by reassurance about guidance

    " The timing has left insufficient time for the public to contact peers

    " Peers have to work on this during their recess, reducing their effectiveness as a second chamber

    " There is no need for these regulations to be rushed through now

    You will have received detailed letters analysing the meaning of the regulations and the legal opinions which confirmed my fears so I will not reiterate these here.

    I am also concerned about the considerable number of peers who have connections with the health care 'industry' and who voted in favour of the Act. I feel they should abstain rather than vote for these regulations which will effectively lock the NHS into a real market under EU law and that US companies are ready to exploit.

    Please take this opportunity to annul the regulations so that they can be rewritten to reflect in law what Lord Howe said to you on 6.3.12

    Yours truly,

    For Lib Dems Last sentence before signature

    "Remember that the H&SC Act was not in the Coalition agreement and that voting to annul these regulations will not affect that agreement. You have an opportunity to ensure that rewritten regulations reflect your own party's policy and protect the NHS as an important social endeavour beloved by the English people."

  • New Section 75 regulations no better than the first version
    Call to urgent action

    Thursday 21st March 2013

    I am writing to let you know that legal advice (funded by 38 Degrees) has just been published which makes very clear that the government has NOT listened to the concerns expressed by many of us, about the broken promises and privatising effect of 'Section 75 regulations'.

    Please write urgently to your MP, asking them urgently to sign the new Early Day Motion (EDM) 1188 to overturn these regulations. I enclose two letters that you could use (depending on whether your MP signed the now invalid EDM 1104, or not - see Please also write to Lib Dem and cross-bencher peers raising your concerns (a list of email addresses is at the end of this letter).

    Also 38 Degrees are meeting health minister Norman Lamb today (Thursday) and is asking people to vote in a survey right now ( about what they should say to him. Based on 38 Degrees legal advice, it is Keep Our NHS Public's view that we should demand Norman Lamb scraps the new regulations and go back to the drawing board until they can meet the promises that were made to the public, parliament and Clinical Commissioning Groups.

    KONP does not consider that the idea of more 'guidance' will do anything significant to protect the NHS from privatisation. 'Guidance' can be re-written any time the government feels like it, without any chance of parliamentary oversight.

    The legal advice says: "There does not appear to me to be anything substantial in the new Regulations which responds to these very real concerns. The assurances given by Ministers in Parliament about the freedoms that commissioners would have to commission services in the way they consider best for their local not appear to be honoured by these new Regulations just as they were not honoured by the old Regulations...[if] the contract is capable of being delivered by more than one provider, the CCG must hold a competition even if it is not in the interests of patients to do so...the introduction of wording about integration and co-operation between providers does not amount to any substantial change to the effect of the Regulations." (The full advice is available here

    Thank you for all you are doing to help protect the NHS from privatisation. There is not much time left to stop the government pulling the wool over people's eyes - please act today and forward this email widely to your contacts.

    Caroline Molloy

  • Save Our Hospitals! No to Privatisation!
    12 noon Jubilee Gardens, Waterloo
    Belvedere Rd, SE1

    Sunday 17th March 2013

    Support for the demo so far includes: Save Lewisham Hospital Campaign, Defend Whittington Hospital Coalition, Save our Hospitals Ealing, Save Hammersmith and Charing Cross Hospitals, Andy Slaughter MP, Steve Pound MP, Virendra Sharma MP, John Cryer MP, Onkar Sahota GLA member, Rachael Saunders Councillor Tower Hamlets, Unite the Union, BMA Tower Hamlets, Save Chase Farm, Brent Fightback, Kensington and Chelsea Residents Save Our Hospital, Ealing Trades Union Council NHS Campaign, Ealing Southall CLP, Kingston Trades Council, Kingston and Surbiton Green Party, Kingston Keep Our NHS Public , Kingston GMB, We Are Waltham Forest Defending Our NHS, Camden Keep Our NHS Public , Tower Hamlets Keep Our NHS Public, City & Hackney Coalition to Defend the NHS, Lambeth Keep Our NHS Public, Lambeth Pensioners Action Group.

    The demonstration has been called by Save our Hospital campaigns across London and London Keep Our NHS Public. It has been backed by Unite the union, a number of MPs and councillors, trade unions and the London Labour Party.

    This coalition of London residents, medical staff, trade unions and health campaigners have come together to raise the alarm regarding the biggest threats to A & E’s, maternity units and in-hospital care for a generation.

    Closures planned across the capital include nine accident and emergency departments, a number of maternity units and thousands of hospital beds that campaigners believe will put lives at risk..

    Hospitals and community services are also threatened with take-over by multi-national private companies. Hundreds of thousands of London residents have pledged their opposition to these privatisation plans for the NHS.

    Across the capital, tens of thousands have taken to the streets to protest and demonstrate to save their local hospitals. 80,000 signed a petition against the closures in North West London. 25,000 joined the demonstration to defend Lewisham hospital.

    The local campaigns have joined up to call on the government to stop these closures. We are working together to undermine the government’s divisive tactics of playing one hospital off against another. Instead we are demanding that the government provide the funding needed for safe levels of care across the capital.

    Please ask your organisation to pledge their support to publicise the demonstration by adding your name.

    Donations towards costs will also be gratefully received (Cheques to Keep Our NHS Public c/o 32 Savernake Rd, NW3 2JP).

    More information from

    To unsubscribe please email


    Sunday 24th February 2013

    Right now, the government is trying to sneak through secondary legislation (under Section 75 of the Health & Social Care Act) to force virtually every part of the NHS to be opened up to *compulsory* competitive markets, open to the private sector. We have just over a month to stop them, and we need to start straight away.

    These regulations (SI 257) are likely to be the final straw for many of our NHS hospitals and clinics, already damaged by too much costly marketisation and cuts.

    Parliament does not normally even debate or vote on this type of regulation - but it is possible. Even those Lib Dems who supported the Health & Social Care Act should be very concerned as the regulations break the reassurances offered to parliament and to the local Clinical Commissioning Groups, that the Act allowed local choice about when to use competition. For example Andrew Lansley promised doctors that "commissioners, not the Secretary of State and not regulators - should decide when and how competition should be used to serve... patients interests" (see briefing for other examples of the promises that were made). But these new regulations do not allow local freedom to decide when to use competition, at all.

    Campaigners may also have heard of the successful Gloucestershire campaign which overturned privatisation of nine hospitals, instead keeping them in the NHS without tendering (in October 2012 - ie, even after the Act). The barrister in that case, David Lock QC, has told me that this option will no longer be possible for anyone else, if these regulations go through.

    These regulations were laid down on 13th February and will become law on 1 April unless all MPs who care about the NHS first insist on a debate and vote, and then vote them down. Over the next few days the political parties are going to be considering their next moves.

    Please take time now to

    a) sign this petition to call for a full debate, vote and defeat

    b) urgently email your local MP to ask them to ensure these regulations are debated, voted on and defeated in parliament. Send them the Keep Our NHS Public briefing, attached (or at this link: & use the bullet points in the briefing to help you explain to your MP why you are so concerned. You can use if you don't have your MP's email address.

    c) ask others to do the same! please spread this message widely to friends, colleagues, any groups you are in, and write to the newspapers using the points in the attached briefing, along with your own experience.

    d) you could also email the clerk of the house of lords committee on statutory instruments which will be examining the regulations shortly, raising concerns about the implications of these regulations and asking them to recommend they get a full debate in the Lords. Their email address is seclegscrutiny[at] I will let you know when I know more about the way the Commons committees operate.

    e) if you are in touch with your local clinical commissioning group (CCG) - and especially if they seem sympathetic - you could ask them if they share your concerns, if they will make a statement about the implication of these regulations, and if they will speak out against them

    You can also read more background here (subscriber only)

    Finally, if you are not already a member of Keep Our NHS Public (without whom this would not have been possible) please consider joining today

    Caroline Molloy

    Twitter @carolinejmolloy

  • A&E closures will trigger crisis across West London Hospitals

    Wednesday 20th February 2013

    In a final destructive act before they are scrapped in April, Primary Care Trusts in North West London voted yesterday to rubber-stamp their own controversial plans to close FOUR A&E units - in Ealing, Charing Cross, Hammersmith and Central Middlesex. This would leave three boroughs - Ealing, Hammersmith & Fulham and Brent, with a combined population of over 800,000, and each with pockets of severe deprivation - with no local A&E.

    Worse, the A&E closures are coupled with complete closure of Charing Cross and near complete closure of Ealing Hospital, and run alongside plans already adopted without consultation by NHS NW London for almost 1,000 bed cuts by 2015, averaging 28% cuts across all eight West London boroughs.

    This includes drastic cuts of around a third of beds in three hospitals set to carry the additional workload when the A&Es are closed - Chelsea & Westminster, West Middlesex and Northwick Park.

    The decision to press ahead with the closures takes place in defiance of the evidence that they will bring chaos: NHS NWL chiefs have been forced to admit that there are NO concrete plans to establish alternative, community-based services to take the place of the axed hospitals, and have offered no answer to expert studies that contradict their claims that 70% of the caseload from busy A&Es can be dealt with in free-standing "Urgent Care Centres".

    Health bosses have also ignored detailed responses to their plans, and shrugged off petitions and sustained popular campaigns to prevent the closures: instead they have forged ahead regardless, hoping to make "savings" of £1 billion through these cuts, coupled with cuts in community health services and mental health services. No section of health care is safe.

    London Health Emergency director Dr John Lister said:

    "This irresponsible decision aims to tie the hands of the new Clinical Commissioning Groups which take over in April, and will have to sort out this ghastly mess or carry the can for the chaos in urgent services.

    "Like all similar "reconfigurations" these plans take the heaviest toll on those with the most serious health care needs, who will face longer journeys to hospital and delays in accessing treatment. While minor cases will be able to access Urgent Care Centres, those needing admission will have to travel miles and wait for scarce beds to become available. Their relatives will face even longer and more miserable journeys to visit them. London's emergency ambulance services are already struggling to cope, and will be set back. These cuts will hit the poor, the elderly and the most deprived and vulnerable hardest.

    "It's a scandal that Hammersmith & Fulham council has abandoned any fight to defend Charing Cross Hospital: Ealing council is absolutely right to fight on and challenge these cuts. MPs and GLA members must also step up the fight against each and every closure and cutback.

    "The Francis Report on Mid Staffordshire was recently strongly critical of NHS managers who made finance-driven cutbacks without regard for the viability of the service - and argued that if there was inadequate money available, managers must say so.

    "So the new CCGs must declare now that their first action on taking office in April will be to reverse this disastrous course, stabilise hospital services, and invest in a sustained expansion of community based health services, without which GPs cannot hope to deliver adequate patient care. And if this causes financial problems they must say so, and enlist public support to press for better funding."


    Sunday 10th February 2013


    An unprecedented coalition of London residents, NHS staff, trade unions and health campaigners has come together to raise the alarm regarding the biggest threats to A & Es, maternity units and in-hospital care for a generation.

    Closures planned across the capital include nine accident and emergency departments, a number of maternity units and thousands of hospital beds that campaigners believe will put lives at risk.

    Tens of thousands of Londoners have protested and demonstrated to save their local hospitals in recent months. 80,000 signed a petition against the closures in North West London. 25,000 took to the streets in January to defend Lewisham hospital.

    The government haven't listened, though they are clearly rattled. First Jeremy Hunt pretends to save Lewisham A&E, and now the Tory council in Hammersmith claim to have "saved" Charing Cross hospital. Local health workers and campaigners can see through these attempts to divert our campaigns to save London's health service.

    In a new move, these campaigns have joined up in a coalition to campaign to call on the government to stop these closures.

    They plan to work together to undermine what they believe are the government’s divisive tactics of playing one hospital off against another. Instead they are demanding that the government provide the funding needed for safe levels of care across the capital. Doctors will challenge the notion that planned closures are clinically led, as increasing numbers of clinicians speak out against the damaging impact these cuts will have on patient care.

    The campaign is being launched with a week of action across London from 09 - 16 February.

    The week-long actions will include protests, a singing flash mob, candle lit vigils, rallies and demonstrations.

    Joint Press Conference

    Monday 11 February House of Commons

    Those attending include: Andy Slaughter MP (Hammersmith), Dr Louise Irvine, Chair Save Lewisham Hospital Campaign, Dr Onkar Sarota, Chair Save Ealing Hospital Campaign, Shirley Franklin, Chair Defend Whittington Hospital Coalition, John Lister London Health Emergency, Frank Wood Chair Unite the Union Health Regional committee, Julie Reay, Save Kingston Hospital campaign

    Defend Whittington Hospital Public Meeting

    Tuesday 12 February 7.30pm Archway Methodist Hall, Archway Close N19

    Speakers include Jeremy Corbyn, David Lammy, Frank Dobson & Emily Thornberry

    Valentine Day card for Ealing hospital

    Thursday 14 February Handed in to NHS NW London

    Save Lewisham Hospital Rally

    Friday 15 February 1pm Lewisham Hospital

    Defend the NHS Singing Flash Mob

    Friday 15 February 5.45pm A central London station

    Hammersmith and Charing Cross Hospitals Campaign Protest March

    Saturday 16 February 12 noon Lyric Square King Street

    Kingston Save Our Hospitals Demonstration

    Saturday 16 February 12 noon Norbiton Station march to Guildhall

    Defend Whittington Hospital Action

    Saturday 16 February Holloway Road N19

    Ealing Hospital Action

    Saturday 16 February 12 noon Ealing Broadway shopping centre

    More information from

  • Francis Report fails to address root problems:
    impossible targets, inadequate cash limits, fragmenting reforms

    Thursday 7th February 2013

    Filling three massive volumes and offering 290 recommendations the Francis Report on the scandalous failures of care at Mid Staffordshire Hospitals Foundation Trust appears to be a heavyweight offering.

    Some of its recommendations are of course welcome, not least recommendation 18 (requiring all NHS trusts and foundation trusts to review their standards, governance and performance in the light of the report); the insistence on the priority of safety and quality in patient care; and the call for enhanced leadership role for doctors and nurses.

    But despite getting some things right, the report ducks many key issues.

    " It avoids pinning any direct responsibility on any of the senior managers, commissioners or strategic health authority bureaucrats whose indifference and negligence allowed such appalling lapses from acceptable standards to go without intervention or investigation.

    " It creates a new 'duty of candour' and imposes legal obligations on front line staff to report failures in care, but offers them no protection, and no sanctions against those who respond with bullying and victimisation.

    " It fails to address the flawed reforms and the unrealistic financial targets that led management into such desperate actions, and therefore fails to make the connection that needs to be made between those terrible days in Mid Staffordshire and the pressures faced today by trusts up and down the country.

    The shocking revelations of the sheer scale of the cash-driven cutbacks in staffing which were central to the calamitous deterioration in care are not adequately reflected in the recommendations, despite the fact that many trusts and foundation trusts - driven by the government's insistence on the £20 billion "Nicholson challenge" are even now embarking on cutbacks as large or larger than those which caused such tragic consequences in Mid Staffordshire.

    The report fails to engage with the broader political context of the Mid Staffordshire crisis: the changing culture of an NHS being transformed by the policy of successive governments from a public service into a competitive market, in which trusts and their directors are driven by targets and balance sheets rather than by a focus on patient care.

    The Mid Staffordshire trust, despite its serious financial problems, was being pressurised to shape up to achieve "foundation trust" status - at the expense of sharply reduced staffing levels and quality of care. But dozens more trusts are even now being driven down a similar path, towards targets to achieve foundation status, as required by the government's controversial Health & Social Care Act, which sets the tight deadline of 2014.

    Many of them are seeking drastic savings through cuts in medical and nursing staff: the Trust Special Administrator report on South London Healthcare, endorsed only days ago by Jeremy Hunt, includes drastic cuts in clinical and nursing staff to save money. And these proposals have been finalised, and now endorsed by ministers despite a chorus of complaints by consultants, nurses, midwives and other health professionals that they will jeopardise standards. It has become routine for NHS managers and their political masters to turn a deaf ear to protests and to hope for the best when they endorse cutbacks. Mid Staffordshire managers were not exceptional on that issue.

    Robert Francis in his report declares that:

    "The Board of the time collectively must bear responsibility for allowing the mismatch between the resources allocated and the needs of the services to be delivered to persist without protest or warning of the consequences. It was or should have been the directors' primary responsibility to ensure either that they did deliver an acceptable standard of service or, if this was not possible, to say so loudly and clearly, and take whatever steps were necessary to protect their patients." (page 211)

    But this welcome, far-reaching challenge to the logic of cash limits and balancing the books, one long argued by campaigners, is not mirrored in the recommendations.

    Nor does Mr Francis explore the contradiction between this approach and the new, competitive health care market being created by the Health & Social Care Act, in which providers are required only to deliver services as contracted by commissioners. He does not discuss whether the new Clinical Commissioning Groups that will be the principal local-level bodies commissioning health care from April have the expertise or resources to monitor standards of care on the level he proposes.

    This will also be made harder as existing NHS providers, themselves already squeezed by constant cuts in tariff and referrals and requirements to deal with historic deficits, face increasing loss of market share to private sector and "social enterprises" - organisations in which scrutiny on the level proposed in the report will run against barriers of 'commercial confidentiality', and accountability is limited to that between a company and its shareholders.

    Given the inadequacies that have been repeatedly exposed in its performance, there are few grounds to be optimistic that the Care Quality Commission could adequately take on most of the duties of Monitor, and the prosecuting role of the HSE - and it is already clear that the CQC does not wish to do so. Francis himself pulled back from proposing to regulate senior managers - but does propose regulation of low-paid and exploited Health Care Assistants, who are far from being the cause of the problem.

    Equally Francis appears to have quite unwarranted faith in the ability of untested local Healthwatch bodies, widely criticised for their limited brief, and lack of teeth and investigatory powers, to deliver improved scrutiny of services from April.

    But perhaps the most glaring omission, since it would have widespread public support, and carry little if any cost, is the failure to stipulate legal protection for those who have the courage to speak out and reveal problems in the quality of care.

    There is much of value in the Francis report: but if the fundamental direction of government reforms to the NHS is not addressed and halted, the brutal pressures of cash limits, business methods and the new health care market will undermine whatever measures are brought forward to improve the quality of patient care.

    (This analysis also appears on the National Health Action party website)

  • Message for 2013: Fight now for NHS - before it's gone!

    Sunday 30th December 2012

    By April this year, the NHS we have known will have been swept away by the Tory Health & Social Care Act. Local and relatively accountable public bodies – Primary Care Trusts and Strategic Health Authorities – will have been scrapped.

    In their place will be a new, experimental system which claims to put GPs in charge through ‘Clinical Commissioning Groups’, but in fact hands local control over to private management consultants and a new, bureaucratic NHS Commissioning Board.

    Planning is to be replaced by a competitive market. Existing NHS hospitals and services will increasingly be cut back to make room for new private sector providers that depend upon NHS contracts. These companies will pick and choose which services they see as profitable, and leave the rest – emergencies, complex cases, chronic illness, most mental health – to what’s left of the public sector.

    The new CCGs will be dominated by government demands for £20 billion “cost savings” by 2015: they will not be so much commissioners as rationers of care, deciding only which hospitals and services to close, which treatments and drugs to exclude, which patients should be treated as second class.

    One area they will not be encouraged to cut is spending on Private Finance Initiative contracts that are milking billions from the NHS in over-priced deals for new hospitals. It’s clear that while everything else is cut, PFI is being left intact whatever the cost, with generous subsidies to satisfy private shareholders.

    We already know NHS managers’ response is to press for more cuts in hospital care: the New Year message from Mike Farrar, chief executive of the NHS Confederation warns politicians not to support local campaigns to stop hospital closures.

    Hospitals under pressure

    But despite all the so-called think tanks and desperate NHS managers like Mr Farrar arguing for closures of A&E units, beds and whole hospitals, official figures show serious pressures on existing services.

    Since 2001, A&E attendances in England have increased by 60%, and routine hospital admissions and emergency admissions by 35%. In London emergency admissions are up by 51% and routine admissions by 60%. Yet numbers of general and acute beds have been cut by 22%, with more cuts to come.

    Reports from the Dr Foster and the King’s Fund have warned that hospitals are “full to bursting” and that 2013 might mark the turning point as spending cuts leave inadequate capacity.

    Plans to “reconfigure,” “centralise” or “downsize” hospitals rest on vague promises of community services for which no plans or resources exist, and wildly over-optimistic and unproven assumptions. There is no actual evidence these policies might work.

    Nor will any NHS cash savings be reinvested in health care: instead we have seen the first £3 billion snatched back by George Osborne and the Treasury … to spend on tax cuts for the rich and big business.

    So 2013 is a testing year. As people have found in Lewisham, where a local hospital faces fast-track closure, we have to fight for services if we want to keep them . We also have to challenge privatisation and the carve up of the NHS budget by grasping private firms.

    We can’t guarantee any of these fights will succeed: but we can be sure that if we do nothing we will see our NHS broken up, with some services closed down and others parcelled out to profiteers.

    Nye Bevan said in 1948 that the NHS would live for as long as there were people ready to fight for it. 2013 is the time for everyone to respond to that call.

  • 2012: the year Cameron hijacked our NHS

    Tuesday 18th December 2012

    We are grinding towards the end of a momentous year - which for millions will be remembered for all the wrong reasons. Yes there was Danny Boyle's celebration of the NHS before the sunshine and gold of the Olympics: but 2012 was also the year that Andrew Lansley's reactionary Health and Social Care Bill was passed into law on the basis of LibDem votes.

    Coupled with the brutal imposition of £20 billion in cuts by 2014, and the continued haemorrhage of NHS cash to the private sector through the Private Finance Initiative (PFI) - soon to be accelerated with its barely distinguishable offspring PF2 - the HSC Act is set to sweep away the NHS as we know it from April 2013.

    The pattern is clear: all of the cuts fall on public sector providers, while all the expansion and opportunities are being offered to the private sector.

    Grasping companies like Serco, Richard Branson's Virgin Health and others are cashing in as an ever wider range of services are opened up for private profit, while those that don't offer profits are run down, reconfigured and closed.

    And behind every reconfiguration, reprofiling and tendering exercise is a consultancy firm charging a fortune for duff advice, dodgy figures, phony theories and failed policies, snapping up fat profits from the crisis. Like the cockroaches that are thought to be the most likely survivors of a nuclear holocaust, the lowest forms of life, management consultants who borrow your watch to tell you the time and charge you £3,000, seem to be the main beneficiaries of the Tory created crisis in the NHS.

    They will be cashing in soon on more and more "Commissioning Support Services" set up to advise GPs on the new Clinical Commissioning Groups on how to spend the budgets they will now be made to feel responsible for, even though it's plain GPs will have little real discretion or control.

    GPs have been press-ganged into these bodies despite a majority of GPs consistently opposing Lansley's Bill. In the run-up to the launch of the CCGs they are now bombarded with bureaucratic rules and paperwork, and by deliberately confusing policy guidance from the NHS Commissioning Board - while the organisations that should have led the fight to stop the Bill stand by paralysed, like rabbits in car headlights.

    Behind all this apparatus of a new market being expensively wheeled into place comes another parasitic group - the lawyers, picking up fat fees from all sides at every stage. One thing they seem agreed upon is that little should be done to challenge the Act - or even to encourage GPs and CCGs to exploit the few loopholes that have been left in the guidance.

    For example CCGs should be taking full advantage of the NHSCB guidance that they are not obliged to operate the "any qualified provider" policy: they should be lining up four-square against a policy that would deprive GPs of any actual control, and which is designed to impose maximum fragmentation and to let a host of new and untested providers into the new healthcare "market".

    Instead lawyers working for campaign group 38 Degrees have drafted up weak-kneed general statements which are so vague they offer no real challenge to the NHSCB. Rather than test the government's willingness to use competition law and the NHSCB's willingness to intervene in local CCG decisions, this approach dodges all conflict - just when we need a real fight.

    In the background, we are always told, are European competition laws (which were of course hatched up and backed to the hilt by British governments). It's like an old war movie in which gallant allied troops are warned "resistance is futile". But is it? How will we know unless somebody tests it out, has a go, makes a fight of it?

    How will this happen if the BMA, and the Royal Colleges which are supposed to uphold ethical values, don't encourage doctors to stand up and fight, or even to assert any real control as commissioners of services? And how likely is this to happen when the TUC health unions are taking such an ambiguous position, occasionally talking a good fight but challenging so little on the ground?

    The unions of course, tend to take their lead from the Labour Party, which is sitting on a hefty lead in opinion polls - and doing as little as possible to draw attention to the fact that Lansley's Bill, and most of the current problems in the NHS, trace back to Tony Blair's disastrous experiments in marketising the NHS.

    Ed Balls and Andy Burnham still doggedly defend PFI and their stupidity in office in rubber-stamping unaffordable deals which are now dragging trusts like South London Healthcare and Peterborough into massive, unpayable debt. South London has gone bust, and Peterborough ran out of money to pay bills on November 30. Labour has nothing to say on how these and other crises they created must be now be resolved.

    New Labour ministers also set up the so-called Cooperation and Competition Panel, which is now used to prise open local NHS contracts to let the private sector pick off the bits they want - and leave the rest.

    It was Labour who commissioned the 2009 McKinsey proposals on cost-cutting, the bogus assumptions and evidence free policies from which are now the basic management bible for cuts up and down the NHS. Labour lined up the Circle takeover of Hinchingbrooke Hospital. And Labour first began the carve-up of community health services and coined the term "any willing provider", and welcomed in profiteering private companies to run Treatment Centres, GP surgeries, and a host of other contracts.

    Of course the Tories are going much further, faster and doing far more lasting damage. They are cutting not only acute hospitals but also mental health services: the mental health budget is now falling for the first time in ten years. Community mental health is cut, broken up and privatised. Disability benefit cuts clobber the mentally ill. Social care is slashed to ribbons, along with crisis services and home support, while employment and day centres for mental health sufferers have also been slashed back.

    But where is the coordinated Labour campaign to stop the cuts and keep private hands off our NHS?

    Why won't they declare they will support all of the tens of thousands of local people protesting against cuts and closures, rejecting the feeble pretence that threatened A&E services will be replaced by community health care for which there is no money, plan or political commitment?

    The stakes are growing ever higher. In South East London the Trust Special Administrator, using dictatorial powers drawn up by Labour, is trying to prop up the disastrous PFI contracts for two hospitals in Woolwich and Orpington by a smash and grab raid on neighbouring Lewisham Hospital.

    Upwards of 30,000 emergencies and seriously ill patients a year in one of the most deprived English boroughs would be unable to access treatment locally at Lewisham Hospital, and face long and arduous journeys for care in other hospitals - which are already full to the rafters.

    4,000 women in labour each year would have to trek out to surrounding hospitals with the closure of Lewisham's maternity unit. Children's services are also to be cut. Hundreds of jobs would go, upwards of 400 hospital beds, and 60% of the Lewisham hospital site would be flogged off and most of Queen Mary's Sidcup.

    In North West London, health chiefs want to axe 28% of beds by 2016, close 4 A&E units and cut 5.600 jobs, most of them clinical staff. In North East London King George's Hospital faces dismemberment in a desperate bid to bail out the bankrupt PFI-funded Queen's Hospital in Romford.

    Other A&E units and emergency services are under threat with reconfigurations threatened across England, from the south coast to Bolton, Yorkshire and beyond.

    The reconfigurations, like that in SE London, are all based on spurious claims, figures and assumptions. But from next April the HSC Act will mean that when gaps appear and services are thrown into crisis there is no strategic planning body able to intervene.

    Our NHS has effectively been stolen: but we must still fight to minimise the damage, oppose the privatisation, keep services intact - and defend those GPs who take a stand and the brave doctors, consultants and health workers who have challenged the cutbacks at Lewisham Hospital.

    We must find every way to delay, obstruct and frustrate those implementing the new system, deter the private profiteers, encourage those who stand for NHS values, and demand Labour spell out plans to roll back the Tory counter-reforms.

    We've got three months before the Act kicks in, and immediate battles to fight right now against cuts. Let's make sure January campaigning gets off to a flier and not a minute is wasted.

    All together now, in the panto spirit: Jeremy Hunt thinks he's going to flog off your NHS. Oh no he isn't! Have a good Christmas and a fighting New Year!

  • Inquiry call as PFI hospital set to run out of cash this month

    Sunday 4th November 2012

    UNISON, the UK’s largest union, is calling for a full inquiry into the disastrous decision by the Board of Peterborough and Stamford Hospitals Foundation Trust to sign up to a costly Private Finance Initiative (PFI) scheme that has brought the Trust to the brink of bankruptcy.

    The Trust currently has cash to pay its bills only to the end of this month, and has admitted that the cost of the PFI – at more than 20% of the Trust’s declining budget – is unaffordable without a massive, ongoing government bail-out.

    UNISON’s call for an inquiry flows from a fresh report “Pure Financial Incompetence” researched for UNISON on the impact of PFI on hospital Trusts in the East of England, where three major hospital schemes – in Norwich, Peterborough and Chelmsford – which cost £642 million to build are set to cost at least £4.25 billion by 2043, and have plunged their Trusts into financial problems.

    The Peterborough scheme has done the greatest proportional damage. Its 30-year contract was signed off by the Trust in 2007 despite warnings by Monitor, the financial Trust regulator, and from UNISON and local campaigners that it was unaffordable.

    The plan was rubber-stamped by the Department of Health and the Treasury – but within weeks of the new hospital opening, the Trust was plunged into a massive deficit, and it is now dependent on continued subsidies of £40m a year to stay solvent.

    While patients and staff in Peterborough now face growing uncertainty over the future of services and jobs at the hospital, nobody has taken any blame for the decisions that were taken then, and the directors and Board members who signed away almost £2 billion over 30 years for a £310m hospital have faced no sanction or public criticism, and are free to go and do the same elsewhere.

    The UNISON report also examines problems created by relatively small PFI schemes in Ipswich and the troubled Hinchingbrooke Hospital, where growing, fixed costs and long-term liabilities have hampered attempts to get hospitals into financial balance. It warns that two more massive plans are waiting in the wings, a £206m rebuild of Papworth Hospital and a £300m project in Watford: we can already predict that these are not affordable on PFI.

    UNISON’s Eastern Regional Head of Health, Tracey Lambert, said:

    “PFI is sucking the life out of our NHS. The costs spiral ever upwards, regardless of the income of Trusts receive. £850m of new buildings are already set to cost more than £5 billion. Jobs and patient care are being sacrificed to keep PFI projects afloat and keep profits flowing to bankers and private equity investors. That can’t be right.

    “To make sure we get a change of policy, we want to expose to public view just what was done in Peterborough: we should know who signed off the deal, and who rubber-stamped it. That’s why we want an inquiry, to put an end to this cavalier attitude that signs away taxpayers’ money with no consequences.”

  • Exposed: plans to axe 28% of West London beds

    Tuesday 23rd October 2012

    Fresh doubts are being raised by public health experts over the viability and impact on patients of controversial plans for hospital services in North West London, as shock plans left out of the publicised proposals aim to axe almost 1000 hospital beds by 2015.

    NHS North West London has just completed a consultation on its document "Shaping a Healthier Future", which proposes the closure of four A&E units - in Ealing, Charing Cross, Hammersmith and Central Middlesex Hospitals, and a large scale diversion of patients away from hospital inpatient and outpatient treatment.

    Opponents of the scheme have up to now focused on the lack of any detailed proposals on what services would replace the axed hospital care (the plan hopes to reduce hospital admissions by 158,000 a year - 148,000 emergencies and 10,000 elective cases - and outpatient attendances by 600,000 a year), the knock-on impact which is likely to lead to the closure of Ealing and Charing Cross Hospitals, and 'hidden' plans in other NHS NW London documents to axe 5,600 jobs, most of them clinical posts. Campaigners have stressed that the hospitals at risk are in some of the most deprived areas in NW London.

    However public health experts, not normally leading advocates of hospital care, have flagged up concerns over the huge number of beds to be cut in hospitals, in addition to those at risk in the four main target hospitals. The total to be cut adds up to more than a quarter of the 3449 available beds in the vast eight borough area.

    These plans are listed in the 'PreConsultation Business Case,' but were not included in the consultation despite the potential impact on patient care for some of the most seriously ill patients in West London.

    The largest numbers and proportion of beds to be cut are in some of the hospitals which do not appear to be directly affected by the A&E closures or the plans set out in Shaping a Healthier Future

    - Chelsea & Westminster (set to lose 144 beds, 36.5% of its total),

    - the costly PFI-funded West Middlesex also loses more than a third of its beds,

    - Northwick Park Hospital, where beds already average more than 95% occupancy, and which is to lose almost a third of its beds while picking up extra emergency caseload from Ealing and Central Middlesex.

    - Hillingdon hospital, close to Heathrow airport and M25 is also to lose 29% of its beds.

    Such a large-scale and rapid closure of beds would pose a huge challenge to health services, putting massive strain on GPs and primary care, and raising fresh questions over the plans for community-based services to replace hospital care. Directly questioned in debate, NHS NW London officials have admitted that these plans are not yet even at the drawing board stage.

    London Health Emergency director Dr John Lister said:

    "This is a shockingly irresponsible plan, which is effectively being smuggled through without proper public debate. We have now heard the grave concerns of public health professionals - the very people whose job it is to take care of the health of whole populations - who fear that the system just will not be able to cope. The figures they highlight show that the danger affects all areas of West London.

    "It's clear from these figures that, as we have argued from the start, the Consultation document told local people and health professionals only part of the story, and kept key details tucked away in obscure documents. Many of the GPs who have been persuaded to go along with this scheme, and the hospital Trusts that were happy to endorse cuts in other Trusts now have to face up to the grim reality: they were conned.

    "The consultation process is deeply flawed. With such important information withheld by NHS NW London there was no way for the public, especially in Hillingdon, Hounslow, Harrow, Kensington & Chelsea or Westminster to respond to the threats to their services.

    "We urge local Health Oversight & Scrutiny Committees, Clinical Commissioning Groups and the Primary Care Trusts to step in and force a reopening of consultation and a proper debate with all the facts on the table for people to see".

    " MORE DETAILS: Dr John Lister 07774 264112,

    " And please note changed email address:

    Planned hospital bed reductions NW London 2012-15

    Current beds total Current used beds Total required in 2015 Reduction from total Reduction as percentage of total

    St Mary's 364 364 295 60 19%

    Hammersmith 414 414 335 70 19%

    Charing Cross 498 498 386 112 22%

    Chelsea & Westminster 394 330 250 144 36.5%

    West Middlesex 323 297 204 119 37%

    Ealing 327 297 223 104 32%

    Central Middlesex 227 209 156 71 31%

    Northwick Park 576 533 390 186 32%

    Hillingdon 326 326 231 95 29%

    Total 3449 3268 2470 979 28%

    Source: Shaping a Healthier Future, Pre-Consultation Business Case, Volume 8, Appendix C, page 15

  • West London NHS bosses opt to advertise rather than consult

    Wednesday 12th September 2012

    Campaigners resisting the closure of four A&E units in West London (Ealing, Charing Cross, Hammersmith nd Central Middlesex) are furious that the health bosses leading the closure plan are spending huge sums of money buying newspaper ads across a vast swathe of London to slag off the campaigners and misrepresent them.

    "They prefer to falsify our position and throw their money into attempting to fool the public rather than engage with the real issues in a proper debate," says veteran campaigner Dr John Lister of London Health Emergency, who has drafted a detailed response to the plans for campaigners in Ealing, Brent and Hammersmith.

    "The decision of NHS North West London to spend very large sums of our public money on advertising across a vast swathe of London boroughs (from Uxbridge to Hampstead and from Harrow in the North to Richmond south of the river) but restrict the distribution of consultation documents to the local public marks a new low in public “consultation”.

    "If the debate on the future of health services is to be conducted through this kind of megaphone propaganda – with the organisation with the biggest advertising budget able to shout down its critics with assertions which nobody else can afford to answer on the same scale – it’s clear there will be little proper discussion on the plans, and NHS managers spending our money will be able to ride roughshod over legitimate public concerns that their plans don't add up.

    "We are also concerned that there is no evidence that these health bosses have even properly consulted the local GPs who will face a huge increase in workload, let alone the public. We know many GPs are strongly opposed to the scheme, and some actively supporting the campaigns."

    The costly advert, promoting plans in the in the “Shaping a healthier future” documents that would bring the closure of 4 A&E units in three boroughs (Ealing, Hammersmith & Fulham and Brent). It claims to refute “myths” which it claims are “frequently heard” although few of them bear any relation to the detailed arguments that have been raising in meetings, petitions and lobbying.

    It denies hospitals will close under the scheme – but nobody said they would.

    What campaigners have warned about is that the closure of A&E and related services in Ealing, Charing Cross, Hammersmith and Central Middlesex Hospitals will start a process of decline and reducing services which in other hospitals (notably Queen Mary’s, Roehampton) has led to their closure.

    This is even more likely now NHS funds are only paid to hospitals per item of treatment delivered, so every patient diverted away takes the money with them, undermining the viability of the hospital.

    They also deny the proposals are "all about saving money": yet their own document repeatedly makes clear the vast scale of the savings they are expected to generate to meet the government’s £20 billion target for “efficiency savings,” and tells us how much each change is set to save.

    Campaigners have pointed out that all of the detail in the proposals is about cutbacks, closures of beds and services, and cash savings, including thousands of NHS jobs in the next few years, while there is no detail at all about any replacement services to be put in place.

    Finally perhaps the most ridiculous claim of the lot is that it is a “myth” for campaiugners to complain that decisions have already been made and there’s no point responding to the consultation: yet 20 NHS managers are spending huge amounts of money on adverts making quite clear that they HAVE made up their minds, and that anyone else is wrong or misinformed.

    They need to say whether and in what way they might consider changing their plan if public responses go against them: we have no reason to believe they would.

    Campaigners are calling for a full and proper debate so that the full implications of the proposals can be brought to the public eye, and local GPs can learn what the hospital cutbacks will mean for them. John Lister adds:

    "I have offered to debate on public platforms with Dr Mark Spencer, NHS London’s Medical Director, or anyone else they want to put up. Let's inform the public, not mislead them about the issues."



    Weds September 12 2012 IMMEDIATE

    Further details: Dr John Lister email john.lister at

    John Lister's report Under the Knife is available:

  • The company that doesn't give Atos about disability

    Saturday 18th August 2012

    John Lister

    Alongside the publicity for the Paralympic Games in London, look out for five days of "Atos Games" from August 27.

    Disability campaigners are furious that one of the main sponsors of the big event is a company making millions by stripping disabled people of their benefits.

    The sponsorship - as surreal and inappropriate as Hitler funding a Jewish hostel - has been publicly and arrogantly defended by the International Paralympic Committee's president, who insisted that Atos is a "top sponsor" of the London games and was "very much part of the committee."

    By spending as little as $10 million a year over 10 years, the company gets the right to pose as a friend and supporter of people with disabilities, even as it pockets the profits from its £100m a year contract to deny people, including potential Paralympic athletes, the benefits they should be entitled to.

    The sponsorship money is a drop in the ocean for Atos, a French multinational based in Bezons with an annual revenue of $8.5 billion.

    Atos's parent company describes itself as "an international information technology services provider."

    Its main practical involvement in the London Olympics is as a provider of computer technology - and annoying lanyards for volunteers and other staff.

    But it runs highly lucrative sidelines in Britain under the name of Atos Healthcare, with contracts both from the Department of Work and Pensions and the NHS.

    The firm's innocuous Google listing proclaims it to be "the UK's leading occupational health service provider," while the website lists other main functions as "well-being," "employee assistance" and "disability assessment."

    The company was first brought into British healthcare by the Labour government, which made it preferred provider of "NHS" walk-in centres - some opened by Labour ministers - and some diagnostic services. It now boasts that it runs 150 treatment centres in England.

    Labour had previously employed Atos to run assessment services for the DWP, with the first contract awarded as early as 1998.

    The contract was then renewed as the pressure to reduce the numbers claiming disability benefits increased.

    Atos and its testing centres are now central to the effort to reassess 1.6m people who have been on incapacity benefit, which is now being phased out.

    The central task is to ensure that far fewer people are deemed eligible for the new "employment and support allowance."

    The tough regime established by Labour in the assessment centres has become even more brutal since 2010, with the Con-Dem coalition seeking to cut £18bn from welfare spending.

    The Atos contract is now to test 11,000 sick and disabled people every week.

    Top British Paralympian Tanni Grey-Thompson is among those who have pointed out that the benefit cuts will affect the development of top athletes among the thousands denied support payments of up to £45 per week.

    Atos Healthcare's website ironically claims that "Atos Healthcare is proud to lead improvements in the way care is delivered, giving control to patients and helping them choose how to manage their health."

    Yet the company has been blamed by tens of thousands of disabled people, charities, GPs and MPs for doing the very opposite - wrecking the lives of people whose benefits are withdrawn after undergoing their hostile "tests," which are designed to ensure that only a tiny minority are deemed sufficiently disabled to fail the "work capability assessment" (WCA).

    Almost two years ago charities attacked the testing system as "not fit for purpose" and demanded changes.

    Last summer, the Commons work and pensions select committee highlighted major concerns over the WCA and said that even the mention of Atos Healthcare caused "fear and loathing" among disabled people.

    In April this year Paul Farmer, the chief executive of mental health charity Mind, finally resigned from the panel responsible for monitoring the work of Atos-employed doctors in administering the WCA tests.

    In May the BMA's GP committee annual conference voted unanimously to call for the WCA to be scrapped.

    And in the run-up to the Paralympics, Atos has come under increased attention with a major exposé in the Daily Mail and a devastating undercover report by Channel 4's Dispatches, in which a GP secretly recorded the training of Atos assessors, in which time and again the emphasis was on the fact that the employment and support allowance was "designed to get people off benefits" and how few people should be found eligible.

    Towards the end of the programme instructors admit that the company would be asked questions if more than 12 per cent of claimants are found eligible for the allowance.

    The "training" is a series of exercises in discounting disability and chronic pain, and ignoring the actual circumstances of the person in front of them and the reality of the employment market.

    So over 1,000 people passed by Atos assessors as "fit to work" have died soon after, and many have committed suicide.

    Dispatches' undercover camera picks up a brutal and cynical training session.

    "One arm is not a problem. You only need one finger to be able to pass the manual dexterity test," says the unpleasant instructor, an east European doctor of unknown expertise whose "speciality is not recognised in this country."

    Cancer patients receiving oral chemotherapy have to be passed as fit for work, she says.

    People who can in theory move themselves in a wheelchair pass the mobility test, even if they do not possess a wheelchair and have no possibility of using one.

    Sight-impaired people who can distinguish a word or two of braille, hearing-impaired people who can lip-read a simple word are to be passed as fit for work.

    Claimants must be judged "hypothetically" fit for work, even if their level of disability means there are no actual jobs they could do in practice.

    And the report also shows how medical professionals prepared to abandon all of their professional ethics and work in this regime are given the fig-leaf of deniability to salve what consciences they may have, with Atos insisting that they "do not actually take the final decision," simply apply the test and leave the decision on benefits to the DWP.

    Even if they get it wrong, and the appeal is heard, the doctors who wrongly deprive a disabled person of benefits would not have to appear or answer for their actions.

    In practice 94 per cent of Atos medical reports are simply rubber-stamped, regardless of advice from the claimant's GP and other doctors.

    Some 40 per cent of decisions result in appeals and thousands of these are successful.

    But many claimants lack the confidence and courage to appeal against even the worst decisions, so Atos delivers the goods for ministers seeking to cut the benefit bill.

    One further factor not addressed by the Dispatches programme is the bias of the tests towards purely physical illness - this has a particularly harsh impact on people with mental illness, many of whom are further distressed and set back by the ordeal of the tests and the consequent loss of benefits.

    Disabled People Against Cuts have been campaigning hard over this barbaric system, and are now determined to make the Paralympics and its embarrassing sponsor a focus of public attention.

    They are planning to deliver a coffin-full of messages about Atos to the company's doorstep on August 27, a "visit" to Atos local offices on Tuesday 28, a spoof Paralympic award ceremony on August 29, a phone jam and Twitter storm against Atos on the Thursday, and a "grand finale" in London organised with UK Uncut on Friday August 31.

    Check out more details on and help make sure the Paralympics help to throw a sharper spotlight on the vicious attacks being waged on people with disabilities by the government, the DWP and their cynical henchmen in Atos Healthcare.

    (from Morning Star Friday 17 August 2012)

  • No local solution for bankrupt South London hospitals trust

    Thursday 12th July 2012

    Andrew Lansley's decision to put the financially troubled South London Healthcare NHS Trust into administration is the latest stage in a crisis that has been running for over 6 years. But unless the administrator is able to persuade ministers to act on issues of national concern, there can be no local solution to the Trust's woes.

    Even the 'nuclear option' of closing the Trust and diverting its 54,000 emergency admissions to other hospitals would leave a nightmare scenario for patients in Bexley, Bromley and Greenwich - with no possibility that other hospitals in the vicinity could cope with this extra caseload, and a legal requirement to pay up to £2 billion for the two hospitals expensively built under the Private Finance Initiative.

    South London Healthcare runs two PFI-funded hospitals and one non-PFI. At the end of 2005, auditors PriceWaterhouseCoopers announced that one of the PFI hospitals, then the 676-bed Queen Elizabeth Hospital Trust (1), was "technically bankrupt" as a result of the costs of the PFI deal that paid for its £93m redevelopment, warning that the annual deficit (then £17.9m) would climb to £100m by 2008-09 unless the government restructured the crippling PFI debt.

    PWC also pointed out that for this one hospital the excess costs of the PFI compared with conventional public funding was an extra £9m per year.

    A large part of this excess costs is rip-off profits. The Comptroller & Auditor General told MPs in 2006 (2) that after refinancing, the PFI contract for the other South London Healthcare PFI liability, the £118m Princess Royal University Hospital in Bromley, was set to generate a staggering return of over 70% for the consortium.

    In 2008 a detailed report in Healthcare Finance (3) pointed out that Queen Elizabeth Hospital was one of the most efficient hospitals in England, but that "during the first 30 years, even if QE operates as efficiently as the average trust in England, it will incur an Income & Expenditure deficit of about 5% of income".

    Carrying this dead weight, the deficits of these hospitals, separately and since the forced merger into South London Healthcare Trust 3 years ago have grown dramatically, from a total of £19m in 2006-7 to£42m in 2009-10 and £65m last year - equivalent to over 2,000 nursing posts. The cumulative deficit is enormous.

    LHE Director Dr John Lister said:

    "These services in SE London are victims of two national policies: Andrew Lansley's £20 billion squeeze on NHS finances, and the PFI scheme that is threatening other hospital Trusts across the country.

    "Short of action by ministers to halt PFI and extricate the NHS from this costly mess, and abandon their attempt to foist the costs of the banking crisis onto the NHS through impossible "savings" targets, there is no way out of the impasse faced by South London Hospitals Trust. Every cutback in services also cuts the income of the Trust. And there is still the rising PFI bill to pay, no matter how few services are left.

    "We know that Mid Yorkshire, Peterborough, Worcestershire and many other NHS Trusts also face PFI-fuelled crises, and there are more to come. Yet Mr Lansley seems set on signing more PFI deals - and forcing through his cuts package, to the embarrassment of many government ministers whose hospitals will be cut or closed.

    "It's time to see sense, call time on PFI, and pump in enough cash to rescue the NHS. Everything else is just rearranging the deckchairs on the Titanic

    "The money could be there if ministers really wanted to maintain public services. If George Osborne just collected HALF of the £120 billion uncollected in tax each year, he could buy out PFI in the NHS: with a fraction of the £140 billion set aside to regenerate the economy he could also cancel the NHS cuts - and reverse the cuts in local government and civil service, creating and saving jobs and delivering useful services."

    Notes to editors




    Follow John Lister on Twitter @JohnRLister

  • Anger as Commissioning Groups rubber-stamp massive hospital cuts in West London

    Wednesday 4th July 2012

    Within days of launching a 14-week "consultation" exercise on health services in North West London health bosses have revealed it to be a costly sham - in which all of the decisions have already been taken, without any chance for local people to have their say.

    The far-reaching proposals, which have been opposed by the Trade Union Councils in Brent, Ealing & Harrow, would axe up to four A&E units - at Ealing, Charing Cross, Hammersmith and Central Middlesex Hospitals - affecting four West London boroughs - Brent, Ealing, Hammersmith & Fulham, and Harrow. They would also cut thousands of outpatient appointments and elective operations, community and mental health services, along with upwards of 5,000 jobs - two thirds of them doctors, nurses and other clinical posts.

    At an angry public meeting in Ealing Town Hall last Tuesday several GPs from Southall denounced the plans, and insisted this was the near-unanimous view of their colleagues. Yet on July 2 NHS North West London bosses told the GP magazine Pulse that the plans had already been endorsed by "leaders of all eight Clinical Commissioning Groups (CCGs)" in NW London. [CCGs are the supposedly GP-led local bodies that will hold NHS budgets from next April].

    Apparently NHS chief Sir David Nicholson regards the NW London plans as a "blueprint to follow" for CCGs looking to axe hospital services across the country as the government drive through its massive £20 billion cuts programme alongside Andrew Lansley's hugely controversial "reforms" which come into force next year.

    If this is in fact the model, then local communities across the country face similar dictatorial top-down cuts drawn up using dodgy figures by management consultants and NHS bureaucrats - none of whom will be around after next April to take responsibility for the consequences of their policies - and arrogantly enforced by self-appointed "leaders" of Clinical Commissioning Groups.

    Dr John Lister, who drafted the detailed response to the NHS NW London proposals for the three TUCs, said:

    "This behaviour reeks of cynicism and contempt for local people, and makes a mockery of Andrew Lansley's claim that ordinary GPs would be put in charge of local services by his reorganisation. Without a single person in NW London having the chance to register their views, the consultation is already claiming full support from the organisations that will be running the NHS this time next year.

    "I challenge NHS NW London to tell local communities and politicians in Brent, Ealing, Hammersmith & Fulham and Harrow, and the local press:

    " Why are GPs in boroughs like Westminster and Kensington & Chelsea, where no services are being cut, having a voice in whether services should be cut elsewhere?

    " How many GPs were asked their views by each of the eight CCGs which are said to have endorsed the cuts, and on the basis of what information? Can we see the minutes of the meetings at which the CCGs each took this decision?

    " How many patients had those GPs had consulted before registering support for plans that will, in many cases, axe popular local services? How did they carry out their consultation? On the basis of what information?

    " How were the CCG "leaders" appointed? What percentage of local GPs participated in electing/selecting them? At what meeting or by what process?

    " How much is being spent on the MORI-led "consultation" which is clearly no more than a charade? What reason is there for local people to believe any notice will be taken of their views?

    " How can the many thousands who will want to register their opposition to closing their own A&E and to any other cuts be able to register these views given the unacceptable "choices" on offer in the "consultation"?

    "As our report points out, there are many glaring holes in the proposals, not least the total absence of any details on WHAT alternatives might be provided to the services they are planning to cut, WHERE they would be, or WHEN they would become available.

    "Any GP who really opts to see local services cut with no guarantee of replacement will deservedly be blamed by their patients and the local public if these cutbacks are forced through.

    "The campaign to stop the closures is just getting under way in the affected boroughs. We urge every GPs to demand a full and balanced discussion by their local CCG, taking account of our report, and a fresh vote on whether or not to allow this major attack on local services by Primary Care Trust bosses who will not be around to answer for their failures after next April."

    Notes to editors

    1. John Lister, Director of pressure group London Health Emergency for the last 28 years, is available for comment on 07774 264112 or

    2. The response from the 3 TUCs to the NHS NW London proposals is at

    3. The Pulse report is at

  • Campaign grows to save St Helier Hospital

    Monday 25th June 2012

    Campaigners fighting to save St Helier Hospital, in the back yard of Health Minister and Sutton MP Paul Burstow, have stepped up their activities with the distribution of thousands of copies of their campaign bulletin across Merton, Sutton, Epsom and the wider South West London area.

    The bulletin has been handed out across the Trust itself as well as being distributed at fairs, street stalls, door to door and at council scrutiny meetings.

    The bulletin, produced by the UNISON branch at St Helier, nails the lies that the planned axing of casualty, maternity and children's services at St Helier is about anything other than a £370 million cuts programme and that the threatened services are easily accessible at other south west London units.

    It also pinpoints the role of Health Minister Paul Burstow who, on the one hand claims to support St Helier while on the other remaining a key member of the Government whose NHS re-organisation and spending plans are driving it's closure.

    Geoff Martin from Merton and Sutton TUC, said:

    "The fight to save St Helier services is up and running and our efforts are based on building action in both the hospital and out in the community where these battles for local services are won and lost. The unions have led the campaign to successfully save St Helier in the past and we are geared up now for round two.

    "This whole package of cuts is based on a pack of lies - lies about transport times to neighbouring units, lies about other hospitals having the capacity to deal with the fall-out and lies about the core fact that these are finance-driven cuts pure and simple. The performance of the officials from the Better Healthcare Better Value mob at the Sutton Scutiny Committee was a shambles. They were unable to answer simple questions and reinforced the view that the forthcoming public consultation will be a farce from start to finish.

    "It has also now emerged that BHBV has cost the taxpayer £1.5 million in management consultant fees - money straight into the pockets of the hired assassins which would have been enough to put four blue light emergency ambulances on our streets 24 hours a day. What a shocking waste of precious NHS cash and what a shocking indictment of this whole sordid exercise.

  • Health care in NW London "under the knife": 4 A&Es at risk

    Sunday 24th June 2012

    Plans to drastically cut health services are exposed in a hard hitting Report “North West London’s NHS - Under the Knife”, written by John Lister, Director of London Health Emergency.

    The Report, commissioned by Ealing, Brent and Harrow Trades Union Councils, shows that far from improving or modernising services, the outcome of the NWL NHS plans, “Shaping a Healthier Future” , would inevitably be a massive reduction in both hospital beds and services, without any corresponding increase in alternative provision.

    Dr Lister states that the proposals “could result in the loss of 1750 NHS jobs in 12 months, and 5,600 jobs by 2015, along with the downgrading and downsizing of many local hospitals and services, and the closure of up to 4 of its 8 A&E units.”

    Although NWL NHS try to avoid stating which hospitals and A&E Departments are under threat; Dr Lister’s analysis shows that the targets of the cuts are likely to be Ealing, Central Middlesex, Charing Cross and Hammersmith, leaving a massive area of London without A&E provision.

    He goes on to say that “trendy arguments ... suggesting that new “settings” can deliver services more efficiently and effectively than hospitals: the only snag is that these “settings” and services exist only on paper, lacking the funds, facilities, staff and any political commitment to make them a reality.”

    Dr Lister will be the headline speaker at the Ealing TUC public meeting on Tuesday 26th June at 7.30pm in Ealing Town Hall.

    The report is attached and available for publication and distribution. Please acknowledge the original source if using.

    Further information:

    John Lister 07774 264 112

    Ealing TUC: Eve Turner 07960 309457, Oliver New 07931 198 501

    Brent TUC: Peter Firmin 0207 624 0032 Ben Rickman 0208 723 5697

    Harrow TUC: John Rattrray 0208 421 0800

  • UNISON fights SW pay cutting cartel

    Saturday 9th June 2012

    With morale in the Trust and much of the NHS already at an all-time low, Derriford UNISON branch is launching a petition to encourage the Trust Board to concentrate on restoring some stability to the organisation and focus on getting a permanent leadership team in place, rather than exploring ways to potentially attack and undermine health workers' Terms and Conditions.

    The petition calls on the Plymouth NHS Trust to lead the way on this issue and not participate in this consortium, pointing out that "it is important that PHNT are able to recruit the quality of staff needed to provide essential services to care for Plymouth's most vulnerable people".

    In addition, given the difficult financial situation that the Trust currently finds itself in, if the Trust has already paid the £10,000 'joining fee', required to be a part of the consortium, UNISON would like to see this money reclaimed.

    Sign the petition at

  • Who stands behind Circle healthcare?

    Monday 2nd April 2012

    from "Not so magic Circle", researched for UNISON Eastern Region (2011) by John Lister.

    The directors

    Prior to Circle, Chief Executive Ali Parsa was an executive director of Goldman Sachs' European technology investment banking team. He also worked at Merrill Lynch and Credit Suisse First Boston. He has a PhD in Engineering Physics from the University of London. Ali won the award for Entrepreneurial Achievement in the 2010 Independent Healthcare Awards, was named in the 100 most influential people in UK healthcare in the Health Service Journal's annual survey in 2010 and has been shortlisted for "outstanding contribution by an individual" in the 2011 Health Investor Awards.

    Other directors are:

    Michael Kirkwood, Non-Executive Chairman - the former head of Citigroup's British operations and one of the City's most senior investment bankers.

    Paolo Pieri, Chief Financial Officer - former Financial Director of two 'boom and bust' companies, and Virgin Megastores.

    Lorraine Baldry, Non-Executive Director - Non-Executive Director & Chairman of Technology company Inventa, has over 35 years experience in a wide range of industries including Financial Services, IT and Property and has held senior executive positions in some of the UK's leading companies in these sectors. She is a Board Member of the Olympic Delivery Authority and is Chairman of its Planning Committee. Lorraine is Chairman of Tri-Air Developments Ltd and a Governor of the University of the Arts London. Before that she was Chief Executive of Chesterton International plc having been previously a Senior Advisor at Morgan Stanley, Investment Banking Division. Prior to that Lorraine was Managing Director and a member of the Executive Committee of Regus, the International Business Centres company. Lorraine joined Regus from Prudential Corporation where she held a number of posts including Managing Director of Prudential Corporate Pensions, Chief Operating Officer of Prudential Portfolio Managers and Managing Director of its property investment division.

    Tim Bunting, Non-Executive Director, like Ali Parsa has a background in Goldman Sachs, with 17 years in which he worked as head of the corporate-finance department of in London, and became vice-chairman in 2005. He has now joined Balderton Capital, one of Circle's principal investors, as partner. Bunting was already familiar with Balderton's portfolio, having served as non-executive chairman of Betfair, the person-to-person betting exchange, and as a director of Alphyra, the pan-European electronic payments provider. Balderton is also one of the backers of, the ultra-high interest lenders of "pay day loans" with rates as high as 3,000% for money borrowed using their i-phone app.

    Peter Cornell, Non-Executive Director, is the former CEO of Clifford Chance, one of the world's leading international law firms with over 3,500 lawyers in 30 offices. During his 36 years tenure with Clifford Chance, Peter became a trusted adviser to the CEOs of some of the world's largest companies and oversaw Clifford Chance's best ever financial performance in 2005-2006.

    Cornell also worked as managing director at private equity firm Terra Firma, and is a partner and head of investor relations at Metric Capital "a pan-European private debt fund providing capital solutions to mid-sized companies." Metric Capital provides debt capital solutions to European Companies with an Enterprise Value of €50 - 500 million. "Our capital solutions include: Financing of buy-outs and acquisitions; Growth capital; Liquidity facilities; Bridge facilities and rescue financing. The members of our management team have run multi-billion euro businesses and corporate divisions across a variety of financial services firms."

    None of these senior figures in the company got where they are by sitting passively on the board of a small loss-making company, and it is clear that the current configuration of Circle is seen as a preparatory phase to substantial profits to be generated in the future.

    The investors

    So who are the real investors behind Ali Parsa's so-called social enterprise?

    Balderton Capital, formerly Benchmark Europe, is an early-stage venture firm founded by Benchmark Capital in 2000. Balderton became independent, while maintaining close ties with Benchmark, in 2007.

    Balderton's portfolio includes Betfair, the person-to-person betting exchange, and Alphyra, the pan-European electronic payments provider, as well as, the ultra-high interest lenders of "pay day loans" with rates as high as 3,000% for money borrowed using their i-phone app.

    Lansdowne Partners is a hedge fund with $16 billion under management, co-founded by Paul Ruddock, a generous donor to the Conservative Party. It made a £12million killing in days by exploiting the collapse of Barclays shares in 2009.

    Within hours of the ban on the controversial practice of short-selling being lifted, Lansdowne Partners sold shares in Barclays worth £28.4million. They were bought back on Wednesday, by which time the bank's value had nose-dived by almost £1 per share, netting a handsome profit for the financiers' investors.

    The company hit the headlines early in 2010 when it signed up Tony Blair to deliver four speeches on world politics to the company's staff for a fee of £200,000. Ruddock and co-financier David Craigen have donated more than £300,000 to the Tories, most of it since David Cameron became leader.

    BlackRock is the giant money-management firm established 23 years ago by Larry Fink, which controls or monitors more than $12 trillion worldwide-including the balance sheets of Fannie Mae and Freddie Mac, and the toxic A.I.G. and Bear Stearns assets taken over by the U.S. government.

    When Fink's $13.5 billion acquisition of Barclays Global Investors was finalised, BlackRock officially became the largest money-management firm in the world, with $3.3 trillion in assets under its direct management including about $1 trillion of pension and retirement funds for millions of Americans.

    BlueCrest Capital Management LLP is Europe's third largest hedge fund or "alternative asset management company" based in Guernsey. It runs $25bn of client assets, managing significant institutional assets across a number of diversified strategies. The two founders of BCM LLP, Michael Platt and William Reeves (now retired), were both Managing Directors and senior proprietary traders at JP Morgan, who left to establish BlueCrest in 2000.

    BCMLLP is fully owned by its principals. AQccording to its website, "BlueCrest's objective has been to construct a trading infrastructure of investment bank quality, upon which trading teams can be built and new strategies developed. BlueCrest believes in a specialist model. … This specialist structure encourages broader overall portfolios with significantly less concentrated risk and can allow the portfolio managers to focus on smaller, more esoteric anomalies that are often overlooked."

    Odey Asset Management is a £3 billion hedge fund, run by Crispin Odey, a donor to the Tories and to the Christian Party, whose slogan is "Proclaiming Christ's Lordship", as well as £18,000 to Libertas EU.

    The London financier criticised by the Irish government for allegedly intervening in the 2009 Irish referendum, has made a fortune by correctly guessing that banks such as Anglo Irish would collapse without state aid.

    Harrow and Oxford-educated Mr Odey made a fortune from short-selling British banks in 2008, and then awarded himself a bonus of almost £28m after his investments came right for his clients, an award that beefed up his £300m personal fortune another notch. He threatened to move his firm out of Britain to avoid the 50% income-tax rate on high earners.

  • GPs urged to "sign the pledge" to resist Lansley's health market

    Saturday 24th March 2012

    The government may have won the vote, but they have not won the argument. The passing of the Health & Social Care Bill means GPs are legally obliged to be members of Clinical Commissioning Groups. But many remain strongly opposed to the Bill, and only a small minority have signed up for commissioning.

    CCGs do not have to go along with Andrew Lansley's plans for a competitive health care market and massive cuts to slash £20 billion from spending: they can take a stand for NHS values.

    Campaigning doctors have put together a short statement of principle that GPs and local campaigners can press their CCGs to adopt, and test out government claims that GPs were to be "put in charge" of commissioning local services.

    Make sure your GP and local CCG are asked to sign up.

    “This CCG will uphold the principle of "first do no harm": we will take no action and adopt no policy that might undermine our patients' continued access to existing local health services that they need, trust and rely upon.

    "In the spirit of clinically led commissioning, we reserve entirely the right to decide whom we contract with to provide services for our patients. We will take those decisions on the basis of the best interests of our patients and wider local communities, and we will refuse to allow Any Qualified Provider to be imposed on us from above.

    "In the interests of transparency we will not engage in any contracts which impose conditions of commercial confidentiality. Once agreed and signed the contract should be open to public scrutiny.

    "We will also work an open book basis with providers and joint commissioners.

    We will also consult local communities before implementing any changes that affect them, and our Board will make all major decisions relating to services in public session”.

  • Merger plan will save NHS and earn Clubcard points

    Tuesday 20th March 2012

    (from NHS Networks Blog 9 March 2012)

    The NHS and supermarket giant Besco are to merge, creating Europe’s biggest provider of healthcare, groceries and tobacco products.

    Industry watchers say the move could solve the financial problems of the NHS and keep government promises of increased competition and choice at a stroke.

    Philip Lucre of investment bank Barkings, which brokered the deal, called it “the ultimate example of synergy between the public and private sectors”.

    “The NHS has a fantastic brand but has not been financially viable since about 1948. It is inefficient, makes poor use of assets and is out of touch with the needs of its customers,” Lucre said.

    A Besco spokesperson said the company would bring its experience in high volume, low margin retailing to bear on the NHS, promising a “stack ‘em high, heal ‘em cheap approach to healthcare which would soon have NHS tills ringing up a healthy profit”.

    Lucre said: “The old NHS business model relied on customers getting sick and just turning up when they felt like it, or being bussed in by ambulance at the NHS’s expense. There was no effective marketing and no attempt to up-sell the customer once they were in store. You had the ridiculous situation where someone would come to hospital, stay for days at a time without buying anything at all, and die or go home leaving the local trust to foot the bill. No wonder the NHS was losing money.”

    Besco argues that customers already visiting its stores to buy groceries, clothes and cheap electrical goods could also be sold a range of health services from varicose vein stripping and mole removal to major organ transplants.

    Junior minister for health Neil Pickle acknowledged that in future all health service commissioning decisions would be taken by store managers. “But rest assured, there will be effective governance arrangements and full clinical input,” he said.

    Pickle dismissed allegations of NHS privatisation as “scaremongering”.

    “The government has always said it wants to increase the choice of services available to patients,” he said.

    “Co-locating healthcare with supermarkets not only makes services more convenient for hardworking ordinary people, it means huge savings in premises and staff costs – savings that can be invested to help struggling and hard to reach sectors such as banking.”

    Analysts say Besco’s retail experience will help it develop healthcare products to suit all budgets. “The NHS tried in vain to give everyone the same product, regardless of their ability to pay, but today’s retail business is all about market segmentation,” said Susan Barcode, retail analyst at Barkings.

    Besco is expected to offer a Value range of procedures alongside an upmarket Finest range.

    “Obviously, if you opt for a low-end operation, you might expect less in the way of infection control, fully qualified consultants and nursing, but customers will be clear what they’re getting,” said the spokesman, adding that different packages of care would be clearly marked with a traffic light system to indicate the patient’s chances of recovery.

    Regular customers will earn Clubcard points to be redeemed as money off fuel or minor surgery purchases.

    “With only a small amount of extra training, staff already offering to pack customers’ bags can now offer to change them. Every little helps,” Besco said.

  • If You Love Virgin Rail, You’re Really Going to Love Virgin Care

    Thursday 8th March 2012

    As if the National Health Service did not have enough to celebrate at present, today brings news of the arrival of a big new player in what we all may soon have to call the UK “healthcare market”. That player is “Virgin Care”. Not content with providing such a popular rail service, and not too busy buying Northern Rock from the taxpayer at a knock down price, Sir Richard Branson has now turned his attention to what may soon be the rich pickings of the NHS.

    Assura Group sold its then loss-making medical services business sold 75% of its stock to “Virgin Healthcare Holdings” in March 2010, in return for a £4 million loan note [1]. That business yesterday changed its name from Assura Medical to Virgin Care.

    In June 2011, it was reported by Pulse Magazine and the Independent that Assura Medical, had links with more than half of the board members at three out of 52 of the first wave of GP consortia (now known as Clinical Commissioning Groups). Most of these board members were GP members of Assura; their practice had formed a joint company with it. These companies provide community-based services in areas including sexual health and out-of-hours care, with profits split evenly between Assura Medical and member practices. [2]

    In September 2011, Assura Medical was named as the preferred bidder in one of the NHS’s biggest ever procurements: a £450 million contract to provide community services in Surrey over five years. The contract was due to begin on 31st December 2011, but the website “Health Investor” has reported it is yet to be finalised. A spokesman for Virgin Care was quoted as saying that “discussions are ongoing” about the handover of services. [3]

    Assura/Virgin Care is already involved in a major dispute with North Yorkshire and York Primary Care Trust and York Hospitals NHS Foundation Trust, which it has reported to the Co-operation and Competition Panel for NHS Services (CCP). The dispute is over procurement of a community based musculoskeletal and orthopaedic clinical assessment, triage and treatment service in the York and Selby areas. Ironically, given claims that compeition will cut NHS costs, Assura have claimed that the winning bidder, York Hospitals, had bid too low for the tender and would not be able to deliver the service for the price stated. The CCP has now launched phase two (the more detailed part) of its investigation and is due to report on Monday 12th March. [4]

    Professor Wendy Savage of Keep Our NHS Public said:

    “Since the last Conservative Government’s hopelessly bungled privatisation of our railways, Virgin Rail has been bringing its unique brand of service to passengers on the West Coast Main Line. Now, if the current Government forces through its even more shambolic break-up of the NHS, patients can look forward to the same happy experience with Virgin Care. If you cut through the oft-repeated mantra that there will be of no privatisation from Mr Cameron and Mr Lansley whenever this is pointed out, you will hear the cries of wolves and vultures waiting to feast on the body of one Britain’s most important and most loved institutions.”


    Professor Wendy Savage: 020-7837-7635

    Ian Willmore (media): 07887 641344

  • Keep Our NHS Public Media Release
    Cameron’s Last Stand?
    PM Circles the Wagons Round Health Bill as Record Numbers Sign E-Petition

    Sunday 19th February 2012

    The Prime Minister has invited the leaders of some of the Royal Colleges of Medicine and other medical organisations to a Monday meeting at No10 to discuss “implementation of the NHS reforms”.

    The invitation list is highly selective, with key organisations that have been critical of the floundering Health and Social Care Bill left out, for example the Royal College of General Practitioners. Campaign group “Keep Our NHS Public” has described the meeting as looking: “less like a peace conference and more like Custer’s last stand”.

    Meanwhile the number of people who have now signed the e-petition to drop the Health Bill has grown to over 147,000

    ( figures at 10.45 am Sunday).

    The petition is likely shortly to reach number 1 ranking in terms of public support.

    Before the election the Conservatives repeatedly promised “no more top down reorganisations” of the NHS. David Cameron said that "with the Conservatives there will be no more of the tiresome, meddlesome, top-down re-structures that have dominated the last decade of the NHS", and this pledge was also included in the Coalition agreement. [1]

    Commenting: Professor Wendy Savage of Keep Our NHS Public said:

    “The Prime Minister is putting himself in the centre of the disaster that is the Health Bill. The attempt to exclude the most vocal critics of the Bill from the No 10 simply makes him look desperate. This is less like a peace conference and more like Custer’s last stand.

    It is now the Prime Minister who is trying to ram the Bill through even as public opposition to it grows to record levels, and its support among health professionals dwindles to nothing. Those who do attend the No10 meeting will need to be careful that they do not find themselves caught up in a political stunt designed to give a false impression of support for the Bill.”

  • As Cameron’s crusades to rescue flagging NHS Bill
    Campaigners offer a key to unpick the spin and translate Lansley-speak

    Sunday 12th February 2012

    David Cameron is to deploy a new level of spin as he mounts a desperate campaign of meetings this week to shore up crumbling support for Andrew Lansley’s hugely unpopular Health and Social Care Bill.

    But as Cameron steps up his spin offensive, campaigners are responding with an expose of the main arguments used to promote the Bill, and a new “Teach Yourself Lansley” short dictionary and phrase book dissecting the Health Secretary’s bizarre use of language to conceal the real nature of the Bill and smuggle through a wholesale drive towards privatisation.

    Cameron will try to make a virtue out of his government's visible lack of any credible support amongst health professionals, by arguing that all of these front-line professionals – including a large majority of the GPs who are supposed to manage tens of billions worth of purchasing budgets within the NHS – along with the unions, are “vested interests” defending the NHS bureaucracy.

    With Lansley having already lost the support of virtually the entire medical profession along with nurses and midwives, the Allied Health Professionals, and even the senior managers’ union Managers In Partnership – all of whom now call for the bill to be dropped – Cameron's new ploy is to use the fight for modernisation against backward-looking “unions” as a populist lever to force the Bill through its final stages.

    And incongruously, given his lack of support amongst doctors, Cameron will claim that the choice is one between a “bureaucratic-led” NHS and “doctor-led” one – even though Lansley’s plans are opposed by 98% of GPs, and involve more layers of bureaucracy than the current system.

    Health Minister Simon Burns has already claimed on Newsnight that the polls and ballots showing professional opposition to the bill are "unrepresentative" and "self-selecting", and dismissed the BMA and RCN as “trade unions” defending vested interests.

    Cameron will argue in the face of all available evidence the GPs actually support the bill. And he will persist in government efforts to force them to take nominal charge of £60 billion of NHS budgets. He does so knowing that Department of Health guidance makes clear that the new Clinical Commissioning Groups are expected to contract out the actual commissioning work, mainly to private sector management firms such as United Health, McKinsey, PricewaterhouseCoopers and others, who are anticipating a juicy £1.3 billion market in these services.

    Dr John Lister, director of the Health Emergency campaign and author of the two new guides to the reforms said:

    “The media have made it easy up to now for Lansley and Cameron to pull the wool over the eyes of the public with their misleading homely talk about ‘local control’, ‘putting GPs in charge’ and ‘fighting bureaucracy’: soft interviews with supporters of the Bill have allowed these distortions to go unchallenged for too long.

    “The reality is the Bill does QUITE THE OPPOSITE of what its supporters claim: it will make health care LESS local, and LESS accountable; take power OUT OF the hands of GPs, MULTIPLY layers of bureaucracy, and put the PRIVATE SECTOR in the driving seat.

    “They are embarking on the privatisation that Thatcher pulled away from, and confirming the suspicions of many that when Conservatives say ‘NHS’ they really mean ‘business’.

    “That’s why GPs and others are so angry at the Bill. And that’s why the tinkering amendments have not solved the problem: the Bill has to be killed off, or it will poison our NHS.”

    Note to Editors: Teach Yourself Lansley is available at

    Unpicking the Spin is avaikable at:

    Further details: John Lister 07774 264112,

  • Lords resumes debate on the Bill
    Rally outside Parliament Weds Feb 8: 2.30-8.30pm

    Tuesday 31st January 2012

    Hackney Keep Our NHS Public (KONP) have received permission to hold a rally outside Parliament on the day that the Health and Social Care Bill is to reach report stage - Wednesday 8th February.

    We ask that you let all your members know about this demo. We ask that all those who might be in the area support this demo - either in person or by promoting it as widely as possible.


    Please bring your placards and banners etc.

    Where: Old Palace Yard, Westminster, Opposite the Lords

    When: 2.30 - 8.30 p.m. on the 8th of February.

  • Lord Owen steps in on Health Bill after Commons “misled”
    What’s Lansley got to hide?

    Thursday 12th January 2012

    Former Health Secretary Lord Owen has stepped up the fight to force Andrew Lansley to release a potentially damning “Risk Register” compiled by Department of Health officials, assessing the controversial Health and Social Care Bill, which Lansley has withheld from MPs and peers since this time last year.

    Lord Owen, who tabled a motion on the Risk Register last month in the Lords, has now written personally to the Presidents of the medical Royal Colleges warning that the dangers of proceeding are far greater than those of stopping the Bill now. Ministers have been encouraging the DoH to implement aspects of the Bill even before parliament decides, to make it seem a “done deal”.

    Publication of the Register was first requested under the Freedom of Information Act last February: but Mr Lansley has flouted the law and defied two instructions from the Information Commissioner to release the document. According to the Evening Standard:

    “Mr Lansley's officials had argued that releasing the Risk Register, when the Standard put in its FOI request in February with debate raging over the NHS changes, would have "jeopardised the success of the policy".

    Almost a year later the Register still has not been released. The Information Rights Tribunal has not yet ruled whether the government's appeal will be heard, or fixed a date for a hearing, but in the meantime the Risk Register has been consciously kept under wraps for the entire duration of the Commons stages of the Bill, leaving MPs to vote time and again in ignorance of the findings. And it has also been withheld from the Lords during its debates, despite further attempts to force its release.

    This secrecy confirms suspicions of opponents of the Bill that the document reveals some of the many weaknesses in Mr Lansley’s proposals for greater private sector involvement and competition in the NHS, and for the Secretary of State no longer to be accountable to Parliament for a fragmented NHS run nationally by an unelected Commissioning Board, and locally by private sector management consultants, who will be steering the “Clinical Commissioning Groups”.

    The danger is that the risks identified in the register, and many proposals in the Bill itself, could escape any scrutiny in parliament, with the pitfalls of the Bill exposed and felt by patients and the public only after the Bill becomes law.

    Campaigner Dr John Lister, a health policy expert at Coventry University, said:

    “What has he got to hide? Mr Lansley has cynically attempted to mislead MPs – most of whom have no idea what the Bill says, but have voted on party whips – by withholding this document. He is now trying to do the same with the House of Lords.

    “Lansley’s plan is not just lacking any supporting evidence: it is being pushed through with damning evidence suppressed. This is taking a massive risk with patient care.

    “If our own Parliament won’t uphold the law on Freedom of Information, or demand the full facts, it speaks volumes on our flimsy democracy.”

    FURTHER DETAILS: Dr John Lister 07774 264112,

    Campaigners fighting on to try to prevent Lansley’s Bill reaching the statute book include hospital consultant and BMA Council member Clive Peedell who is staging “Bevan’s Run” from South Wales to London His route started at Bevan’s birthplace in Cardiff yesterday (January 10), passing through David Cameron’s Witney constituency on Friday January 13, and ends in a bedpan race down Whitehall on the 15th. There will be rallies at each staging post: why not join Clive and colleagues for your nearest rally, or even for the run?

    Clive Peedell

  • Public Health for the NHS
    Lansley’s NHS market could wind up like social care

    Tuesday 10th January 2012

    PRESS BRIEFING: Health & Social Care Bill

    While David Cameron and ministers talk misleadingly about “integration" of services for older people, the real danger is that the shambolic state of elderly care could be replicated across the whole of the NHS if Andrew Lansley’s controversial Health and Social Care Bill is rubber-stamped by the House of Lords.

    The Bill would fragment and “dis-integrate” the NHS: but the disintegration of social care has been taking place over the last 20 years.

    And the threat is that NHS care which is now free at point of use could be “integrated” with the failed social care system, which levies extensive means-tested charges – killing off the NHS as we know it.

    Recent reports by Age UK and the King’s Fund on the crisis in elderly care have shown that 800,000 frail older people today are lacking services they need, rising to 1 million by 2015, while the Local Government Association recently warned ministers that the system of high-cost social care is “not fit for purpose”. BBC reports have exposed a growing problem of “bed blocking” and now hospitals are under pressure to discharge elderly patients despite the inadequate arrangements to care for them thereafter.

    This competitive market in social care was created 20 years ago in sweeping “reforms” initiated by Margaret Thatcher. Until 1993, NHS hospitals were responsible for much long-term care, delivered free to all at point of use, funded from taxation, while those needing nursing home care had their fees covered by social security.

    Now, with most NHS specialist elderly care beds having closed, and social care delegated to local government social services, patients are left dependent on costly, largely privatised domiciliary care, and privately-run residential care and nursing homes " – while many more frail older people are excluded from any support by arbitrary “eligibility criteria” operated by cash-strapped councils facing 28% cuts over 3 years, and by local Primary Care Trusts.

    Elderly care is under-funded, fragmented, uneven, unequal and unsatisfactory, with responsibility split between local health and council commissioners, while 80% of domiciliary care is now privatised, and many care homes are run for private profit.

    In this “market” vulnerable people are forced to “choose” between a multiplicity of low quality providers, who cherry-pick certain services and ignore others, leaving gaps in care. Pay and conditions for staff are notoriously poor, contributing to a demoralised, perfunctory service and the neglect of vulnerable people.

    Competition has not brought improvements but has added new problems: elderly care is marked by poor contract management, sloppy and/or partisan commissioning, loose standard-setting, inadequate inspections, and rising charges as the remnants of public provision are replaced by a burgeoning private sector.

    And while the profits remain in private hands, any failure by private providers – such as the private equity firm that bankrupted the Southern Cross nursing home chain – lands back on the public sector, which has to step in and rescue the victims.

    The social care system is already becoming little more than a bare-bones service for the less well-off, with massive local variation and widening health inequalities. A similar fate is likely to befall the NHS if the current changes are implemented.

    Mr Lansley’s plans for the fragmentation of the NHS involve disbanding its existing organisational structures, and rather than replacing them, turning over service coordination to the market’s “invisible hand”. The plans are devoted to opening up much greater involvement of private companies to deliver services paid for by the taxpayer; they include denationalising NHS hospitals as fast as can be managed. This threatens to fundamentally change, undermine and destabilise the health service.

    The new system would be as poorly regulated, as patchy and incomplete, and as much of a postcode lottery as social care. It would allow private medical corporations or “any qualified provider” to scoop up profits – but dump all of the complex and costly cases onto publicly funded hospitals, for as long as such organisations exist.

    It would even allow local Clinical Commissioning Groups to designate some services as outside the NHS, making them subject to fees and charges for the first time since 1948.

    London GP Jonathon Tomlinson said:

    “If you want to know what a market in health care would look like, just look at elderly care – or dentistry, where charges are rampant, the private sector rules the roost, and many people cannot find an NHS dentist. Now GPs see many patients with dental problems. The NHS leads the world in fair access to care: Lansley’s Bill would undermine that.”

    Lancashire GP and BMA Council member Dr David Wrigley adds:

    “Our NHS was making real progress before Andrew Lansley’s Bill, and recognised as one of the best in the world: the danger is that it could become as unfair and chaotic as care of the elderly.”

    Mr Lansley has the support of only a tiny minority of GPs and doctors for his Bill, which was not put before the electorate last year. His plans have been actively opposed by health workers and criticised by a wide range of think tanks and pressure groups for patients.

    Now a succession of feel-good government “initiatives” and announcements are being used as red herrings to divert the media and public while this retrogressive legislation is forced through the House of Lords.

    That's why David Cameron is now suddenly declaring himself an expert on nursing rotas and prattling about improved standards even while thousands of nursing jobs and support staff are axed, wards closed and services rationed.

    Campaigners will be fighting on to try to prevent Lansley’s Bill reaching the statute book, including hospital consultant and BMA Council member Clive Peedell who is staging “Bevan’s Run” from South Wales to London His route starts at Bevan’s birthplace in Cardiff today (January 10), passes through David Cameron’s Witney constituency on Friday the 13th, and ends in a bedpan race down Whitehall on the 15th. There will be rallies at each staging post: why not join Clive and colleagues for your nearest rally, or even for the run?


    Dr David McCoy

    Dr David Wrigley

    Dr Jonathan Tomlinson

    Clive Peedell

    Dr John Lister 07774 264112,

  • BMA opposes the whole of Lansley's Health Bill!

    Friday 25th November 2011

    BMA press release : BMA Council opposes plans to 'privatise' commissioning support

    For immediate release: Thursday 24th November 2011

    BMA Council today (24/11/11) called for the withdrawal of government plans that are likely to lead to support services for clinical commissioning groups (CCGs) in England being provided solely by large commercial organisations after 2016. An urgent meeting has been requested with the Secretary of State for Health to raise the BMA's concerns.

    Draft guidance from the Department of Health - Developing commissioning support: Towards service excellence - makes a number of recommendations about how clinical commissioning groups should function, including how they should access technical and "back-office" support, such as analysing sensitive population data.

    Current primary care trust (PCT) clusters are forming commissioning support units and, from 2016, would be encouraged to form social enterprises and partner with the private sector, rather than remaining part of the NHS family. Commercially-focused criteria to determine eligibility for providing commissioning support would also be introduced, making it almost impossible for CCGs to have their own, in-house support staff.

    Dr Hamish Meldrum, Chairman of BMA Council, said: "A key plank of the government's NHS reforms was to entrust GPs and other health care professionals to lead on the commissioning of services for patients to ensure local health needs were met. These latest proposals from the government have the potential to seriously undermine this role, restricting the freedom and independence that clinically-led commissioning groups need to make locally sensitive, locally accountable, patient-focused decisions.

    "Doctors tell us about the chaos they are already seeing on the ground as more and more change is implemented. The government should be focusing on ensuring the skills and experience of staff in current PCT clusters are retained. They will be invaluable in supporting the development of CCGs and providing much needed continuity during this period of huge financial pressure and structural overhaul.

    "We will be urging CCGs to urgently review and where necessary change their structures to ensure they are able to fulfil their statutory functions without becoming dependent on external commissioning support."

    Following these deliberations, Council took a decision to oppose the whole Health and Social Care Bill, passing the following motion:

    In view of the implications of the recently published DH document 'Developing Commissioning Support: Towards Service Excellence', BMA Council

    - publicly announces its opposition to the whole Health and Social Care Bill

    - calls for rapid organisation of a public campaign of opposition to the Health and Social Care Bill.

    The BMA will be considering its next steps as part of its continuing activities on the Bill

  • House of Lords briefing on the Health and Social Care Bill 2011,
    by Allyson Pollock and colleagues

    Monday 24th October 2011

    Health and Social Care Bill 2011

    House of Lords – Committee stage, 25 October 2011


    Prepared by

    Allyson Pollock, professor of public health research and policy, Queen Mary, University of London

    David Price, senior research fellow, Queen Mary, University of London

    Peter Roderick, public interest lawyer

    Tim Treuherz, retired head of legal services, Vale of White Horse District Council

    22 October 2011

    1. Introduction

    The Committee stage of the Health and Social Care Bill begins on Tuesday 25 October 2011, with consideration of Clause 1.

    Clause 1 impacts on the legal framework underpinning a comprehensive and universal national health service.

    The briefing is intended to assist peers supporting any of the amendments designed to restore the current statutory framework, although our preferred option is to omit Clause 1 and revert to the wording of the National Health Service Act 2006.

    In three sections below, we outline the legal effect of Clauses 1 and 10 on the Secretary of State’s duties, set out our concerns and questions relating to their impact on patients and services, and conclude with the key health policy issues raised by these clauses.

    [The briefing does not discuss the various amendments that have been tabled to Clause 1. Readers are referred to a legal analysis of these undertaken on behalf of 38 degrees. Our preference is to omit Clause 1 and to revert to section 1 of the 2006 Act.]

    2. The legal effect of Clauses 1 and 10 on the Secretary of State’s duties

    Clause 1 of this Bill proposes to change the fundamental legal basis of the NHS in England which has been in place since 1946. This is unacceptable to many.

    It was:

    • not mentioned in any manifesto

    • not voted for

    • not part of the coalition agreement.

    Under section 1(2) of the 2006 Act, the Secretary of State must provide or secure the provision of services in accordance with the Act for the purpose of promoting a comprehensive health service which s/he has the duty to promote under section 1(1). Under section 3(1) of the 2006 Act, s/he must provide throughout England, to meet all reasonable requirements, the key NHS services that are listed in that subsection, such as medical, nursing and ambulance services, and hospital accommodation.

    Clause 1 proposes to change section 1(2), so the Secretary of State would no longer have the duty to provide or to secure provision of services in accordance with the Act, but would have to exercise his or her functions so as to secure that services are provided in accordance with the Act. In addition, Clause 10 proposes to change section 3(1) so that the Secretary of State’s duty to provide the key NHS services throughout England will be replaced with a duty on the scores – indeed perhaps hundreds – of individual clinical commissioning groups (CCGs) to make arrangements for provision for persons for whom they are responsible.

    One of the key problems with these changes – and this was picked up by the Constitution Committee – is the severance problem. If the government has its way, the body with the duty to promote a comprehensive health service will not be the same as the body which has to make arrangements for provision. At the moment, as Lord Woolf said in the Court of Appeal in the Coughlan case, the Secretary of State “has the duty to continue to promote a comprehensive free health service and he must never, in making a decision under section 3, disregard that duty”. The scores of CCGs will not have that duty.

    The government has tried to argue in Earl Howe’s letter to Baroness Jay on 10 October 2011 in response to the Constitution Committee that the CCGs will have to have regard to that duty. But the Bill does not say that, and it does not give CCGs that duty.

    The government keeps saying that currently the Secretary of State does not actually provide and everything is delegated to the primary care trusts. But this is not the point. Section 3(1) is a unifying duty applying throughout England, and everything flows from that. If that starting point is discarded, then the core part of the current statutory basis for the NHS will also go.

    3. What will this mean for patients and services?

    The implications for patients and services can be considered in four respects.

    Firstly, the Secretary of State’s duty to provide is throughout England, and the PCTs and strategic health authorities are area-based, and these areas are contiguous. The CCGs will be ‘person-based’ or ‘group-based’, largely drawn from GP registrations, but neither the area nor the population are clearly defined. CCGs are supposed to cover all of England (Clause 22: new section 14A(2)), but there is no requirement that within the CCG all their patients live in one particular area, so a CCG area can comprise (say) a part of London, a part of Hampshire and a part of Cumbria. It is impossible to see how planning, monitoring of needs, and equity of access and service use can be safeguarded when the populations are segmented, fragmented and dispersed in this way.

    In effect, now, the entire population of a given area is covered by the NHS and PCT areas are contiguous. In future, this will not be the case: it will depend on what each CCG decides.

    Under current plans resource allocation formula will change from an area-based formula, to one based on GP registrations (GP lists) with all the problems that will bring. These problems which are well documented include, unstable denominators and numerators due to enrollment, disenrollment of persons and turnover of patients, complex risk adjustment methods, and incentives to risk select or cherry pick (McKee M et al. In defence of the NHS). This will adversely affect public health functions including the measurement of access to services, health service needs and equity of resource allocation and funding (Pollock AM, Price D. Submission to the Delegated Powers and Regulatory Reform Committee, House of Lords 10 October 2011)

    Clause 1, in conjunction with Clause 10, will therefore mean that patients in one particular area will not be provided for in the same way that they are at present.

    Secondly, each CCG will decide for itself what the reasonable requirements for services of those persons registered are. They will also decide (Clause 10(2)(b)) what services or facilities are appropriate as part of the health service for the care of pregnant women, women who are breastfeeding and young children (section 3(1)(d)); and for the prevention of illness, the care of persons suffering from illness and the after-care of persons who have suffered from illness (section 3(1)(e)). These two discretions given to each CCG mean there will be different provision for different patients with similar needs, depending on each particular CCG.

    The government says that this is the case under the PCTs now. But the crucial difference is that currently the core legal and unifying duty of the Secretary of State under section 3(1), linked to section 1(1) by section 1(2), is still in place. Currently everything stems from the Secretary of State’s duty to provide. In future, it won’t.

    Thirdly, because of the Secretary of State’s duty to provide, the PCTs are in effect responsible for everybody in their area, underpinned by the resource allocation formula. This will change, and what will happen in future is unclear to us.

    Under the NHS Functions Regulations, (The National Health Service (Functions of Strategic Health Authorities and Primary Care Trusts and Administration Arrangements) (England) Regulations 2002.) PCTs must make sure services are provided for people on GPs lists, and for persons usually resident in its area, or resident outside the United Kingdom who are present in its area, and who are not on GPs’ lists. And under, for example, The National Health Service (General Medical Services Contracts) Regulations 2004, the PCTs prepare and maintain GP lists, and can assign patients to them, subject to a dispute resolution procedure. In other words, although there is never 100% coverage, the intention is that the PCTs ensure that all residents within their geographic area obtain access to GP services and are registered with a GP.

    PCTs must also ensure that certain specified services must be provided for the benefit of everybody in a PCT area, namely (i) accident and emergency services and ambulance services, (ii) services provided at walk-in centres, (iii) facilities and services for testing for, and preventing the spread of, genito-urinary infections and diseases and for treating and caring for persons with such infections or diseases, (iv) medical inspection and treatment of pupils, (v) services relating to contraception, (vi) health promotion services, (vii) services in connection with drug and alcohol misuse, and (viii) any other services which the Secretary of State may direct.

    In future, a CCG will only be responsible for persons provided with primary medical services by a member of that CCG and those who usually reside in the CCG area (Clause 10(3): new section 3(1A)). Temporary residents, visitors, and workers not on those lists will not be covered. Regulations can be made to extend this (new section 3(1B)), and those regulations must cover everybody in the CCG area as far as facilities and services for emergency care are concerned (new section 3(1C)). Regulations may provide that some persons can be excluded from CCG responsibility, including those provided by a particular type of primary medical services (new section 3(1D)).

    We have a number of concerns with new section 3(1A) – (1D), which we have set out below in the form of questions that peers may wish to ask the government:

    • Why is CCG responsibility for persons not made definitive on the face of the Bill?

    • Who, in future, will have the task of ensuring all residents and temporary residents can be registered with a local GP? And what will happen if GPs refuse to accept, or strike off, patients? Who will allocate problem patients, and patients with learning difficulties, severe disabilities, or complex mental health or physical health problems? What about asylum seekers, and the homeless and those of no fixed abode?

    • Why is emergency care to be covered by regulations, not on the face of the Bill? Why are accident and ambulance services not mentioned?

    • Will any of the other services currently to be provided for the benefit of all people present in a PCT have to be arranged by the CCGs? It is intended that some services will move with public health services to local authorities, but the government should explain, category by category, what is to happen, and why is each of these services not also on the face of the Bill.

    • Why is it necessary to give the government the power to exclude some persons from the health service (new section 3(1D))?

    • More specifically, what categories of primary service provider does the government wish to be able to exclude from the health service? For example, new section 3(1D) would allow the Secretary of State to make regulations which took out of the health service persons receiving medical services under Alternative Personal Medical Services contracts – the one of the three basic GP contract types which is open to multinational health companies, such as United Health.

    Fourthly, we are concerned that services currently considered part of the health service by PCTs (under direction from the Secretary of State) will in future not be considered as part of the health service by CCGs – namely the six services and facilities referred to above for pregnant women, women who are breastfeeding, and young children, and for the prevention of illness, the care of persons suffering from illness, and after-care. If a CCG so decides, these might fall out of the health service. This would mean that the qualified guarantee of free access in section 1(3) would not apply, and so charges could be made for services that are currently free.

    This possibility arises because Clause 1 would amend section 1(3). At present, section 1(3) of the 2006 Act reads: “(3) The services so provided must be free of charge except in so far as the making and recovery of charges is expressly provided for by or under any enactment, whenever passed.”

    Under Clause 1, this would read: “(3) The services provided as part of the health service in England must be free of charge except in so far as the making and recovery of charges is expressly provided for by or under any enactment, whenever passed.”

    The proposed new section 1(3) should not be supported, and the government asked:

    • How will the government prevent services that are currently free for pregnant women, young children, and others (as above) from being charged for?

    4. Health policy issues raised by these clauses

    Clauses 1 and 10 of the Bill, considered together, demonstrate that the fundamental principle informing the Health and Social Care Bill is the substitution of the current mandatory system with a discretionary one.

    The net effect of the Bill’s provisions is that, unlike PCTs, which act on behalf of the Secretary of State, CCGs exercise functions in place of the Secretary of State and in the absence of a clear primary legislative framework. Thus, the Secretary

    of State is unable to discharge his or her duty to promote a comprehensive health service throughout England because the commissioning bodies which will control the majority (around 80%) of the NHS budget bodies do not collectively have a duty to cover all patients and in addition they have discretion over the services they provide and discretion to redefine eligibility and entitlements to NHS care. As a result there will be growing inequalities in access to care and NHS entitlements and erosion of progressive tax based funding for health care.

    Furthermore, the loss of area-based population responsibilities has serious implications for the stability and accuracy of measurement of needs and the equity of resource allocation and funding and service provision. This also affects the availability and nature of information to plan for health care needs and services and for monitoring access, service use, and health outcomes, all of which are essential to securing a comprehensive service.

  • UCL students and staff protest Lansley Health Bill stitch-up

    Monday 17th October 2011

    To all those concerned with the future of the National Health Service,

    UCL Provost Malcolm Grant has just been named by Andrew Lansley as the preferred choice to head up the new NHS Commissioning Board.


    Malcolm Grant is not a clinician and has no experience in commissioning clinical services. A lawyer by training, he has presided over the outsourcing of UCL cleaning staff and supported the raising of the cap on tuition fees.

    This year, Grant was part of Prime Minister David Cameron's trip around the Middle-East, along with representatives of major arms companies.

    The choice of Grant as head of the NHS Commissioning Board seems to be based on his friendship with certain politicians and his reputation as an 'innovative' businessman, rather than on the best interests of NHS patients.

    The NHS Commissioning Board will be the body ultimately responsible for the NHS budget and, as well as directly commissioning some services for itself, will regulate the commissioning of services by GP consortia.

    On Wednesday afternoon, we want to make our opposition to the privatisation of the health service clear. We will object to the undemocratic appointment of Malcolm Grant, a supporter of privatisation, to a role of power within our health service.

    The government's plans for education and public health are now clear, and they come together in the person of Malcolm Grant.


    Wednesday October 19th at 1pm, Rally in the UCL Quad, Gower Street


    Contact UCL Occupation:

    Call: 07742067280

  • Over 400 public health doctors ask Lords to kill the Health Bill

    Wednesday 5th October 2011

    You may have seen an open letter to the House of Lords which was published in the Daily Telegraph on October 4th. That letter has now been signed by nearly 450 public health doctors and specialists calling for the Health and Social Care Bill to be rejected in its entirety.

    The full list of signatories which includes 33 Directors of Public Health; 21 Associate, Assistant or Deputy Directors of Public Health; 115 senior public health specialists and over a hundred professors with specialisations in the field of public health.

    Many public health specialists are formally trained in health economics and health systems policy and actively engaged in local authority and the NHS. This is the specialist health discipline that is perhaps most qualified to comment on the NHS reforms as a whole

    They believe that the overall package of reforms is harmful - at the level of the individual patient and at the level of the health system as a whole. Guided by the principle of fairness and the ethical foundations of the NHS, they oppose these reforms from a professional standpoint.

    A covering letter to the Lords who will vote on the Bill next week says:


    We hope you will take our reservations seriously. We believe they are also felt by doctors and health professionals working in other specialities.

    "We ask you to oppose and refer the Bill to a Select Committee for proper scrutiny.

    Dr David McCoy, Professor Martin McKee, Professor Allyson Pollock, Dr John Middleton, Dr Paul Edmondson-Jones, Dr Christopher Birt, Dr Bobbie Jacobson, Professor Rosalind Raine, Professor John Ashton, Dr Alex Scott-Samuel and Professor Simon Capewell

  • Health Minister hits the panic button – and denounces government cuts as "reckless"

    Tuesday 26th July 2011

    Under intense pressure from staff and campaigners, ConDem Health Minister Paul Burstow has at last hit the panic button and called for a pause to plans that would destroy St Helier Hospital in his own Sutton and Cheam constituency.

    The influential Health Service Journal reports today that Mr Burstow has admitted that after lobbying fom staff, he has at last realised what's at stake and is calling for a "pause".

    The Epsom and St Helier Trust has the highest immediate debts - up to £45 million -- of any Trust anywhere in the UK.

    Tomorrow, Weds 27th July, workers will be protesting outside St Helier Hospital at plans that would savage medical secretaries and other patient support services with at least 115 posts under immediate threat.

    Geoff Martin, Chair of pressure group London Health Emergency, who has indicated that he may run against Paul Burstow in Sutton on a "Save Our Hospital" ticket, said:

    "Clearly the health minister has been reduced to a state of panic as the political consequences of a senior government figure attacking his own policies as reckless has suddenly dawned on him.

    "However the fact remains that he has been caught out confirming that the reckless cuts and merger plans down here in Sutton will be bad news for both patients and staff and we will be taking that message to the public with a protest at St Helier tomorrow.

    "We are inviting Mr Burstow to attend to explain his position.

    "We have proved once again that the NHS is a political minefield for Lib Dems in this Government and now we plan to turn the screw starting with the staff protest tomorrow lunchtime."


    More details: Geoff Martin 07831 465 103

  • GP Petition launched against Lansley Bill

    Tuesday 26th July 2011

    Campaigning GP Dr Ron Singer of MPU/Unite has launched a petition that specifically counters the Government's misuse of the number of GPs 'signed up' to Clinical Commissioning Groups as implying support for the whole NHS and Social Care Bill.

    If you are not a GP, you might want to pass the information on to your GP or to local GPs in your area.

    This petition will complement the BMA's decision to launch a campaign to get the bill withdrawn. The petition is open to all GPs - you don't have to be a BMA or MPU member to sign it. We will present the petition to Andrew Lansley, MPs and the press before the next vote in parliament in early September.

    We all know that many GPs have signed up to shadow Consortia (now called Clinical Commissioning Groups) in order to 'keep up' with proposed changes and to protect our patients' interests. Polls show that a majority of GPs have serious concerns about the direction the Government intends to take the NHS and this petition is an opportunity to publicly register our concern. It will also explain to the public why the Government's claim that '90% of the country is now covered by commissioning groups is true but does not indicate support for the Bill.

    If you are a member of Commissioning Group or a member of a practice that is involved in commissioning please sign ther petition.

    The petition will send a strong message to Government that GPs still have grave concerns about the Health and Social Care Bill as now amended. Please sign the petition yourself and then forward it to other GPs in your personal and local network.

    A couple of minutes of your time to sign the petition and forward this email is vital if we are to influence the Government, and more particularly MPs and Peers, as the Bill makes its way through both Houses of Parliament.

    By challenging the Government's argument that GP's involvement in commissioning equals support for the bill, we can really make an impact at a crucial time.

  • NHS Hospital Trusts axe staff and beds under millstone of PFI schemes

    Friday 1st April 2011

    More and more NHS hospitals built at high cost with private finance in the last decade (under the controversial Private Finance Initiative) are already closing beds and axing clinical and other staff in a desperate bid to balance the books as NHS budgets face the biggest-ever squeeze.

    And now cuts and closures of services are being combined with asset-stripping sales of land and property to bail out floundering Trust finances.
    • The financially-strapped South London Healthcare Trust, which includes two financially-disastrous PFI hospital schemes (Bromley's Princess Royal University Hospital and the Queen Elizabeth Hospital in Woolwich) has announced plans to flog off "spare" land assets on several sites. This will virtually dismember what remains of the Queen Mary's hospital in Sidcup, where A&E and maternity services have already been axed, despite pre-election promises that they would be kept open - killing any last faint hopes of restoring the lost services.

    • In West London, the struggling West Middlesex Hospital Trust is planning to axe hundreds of nursing and admin jobs, and close more of the beds in the PFI-funded hospital, seeking to cut spending by 12% in two years.

    • In North East London, the £239m Queen's Hospital in Romford, part of Barking Havering & Redbridge Hospitals Trust, is running with a whole floor unused, while the Trust is still seeking ways to close most of the 18-year old King George's Hospital in Ilford in order to stem its continued yearly deficits.

    • Upwards of 100 beds in the most costly PFI development in the country, the £1 billion Bart's & London Hospital (where each bed is costing £1m to build, and £5m over the lifetime of the contract) are also to be closed - before they are even built, leaving the Trust saddled with the escalating bill for building capacity it cannot afford to run.

    • In Portsmouth, too, a brand new £256m 1,200 bed Queen Alexandra Hospital has announced 700 job losses and the closure of 100 costly beds in a battle to balance the books. The "unitary charge" PFI bill, which rises each year, is £43m this year, making the total cost of the hospital and support services under PFI a staggering £1.6 billion.

    Many other PFI hospitals are facing financial problems but have yet to announce cuts. But perhaps the financial nonsense of PFI is clearly underlined by the plight of the West Middlesex Hospital, which has already paid out £89m to the consortium which built the £60m hospital, but faces another 20 years or more of payments totalling more than £420m before the £515m contract is complete.

    Commenting on the latest revelations, Health Emergency's Information Director Dr John Lister said:

    "PFI means that hospitals face rising bills each year - regardless of their income: and it also means that private sector profits are protected by legally binding contracts taking an increased share of declining Trust budgets, while clinical services, patient care and the jobs of NHS staff are sacrificed - in an impossible battle to balance the books as the NHS faces real-terms cuts for the first time in a decade.

    "Isn't it significant that Andrew Lansley's massive and controversial Health and Social Care Bill is seeking to break up almost every structure in our NHS, claiming to make the system more efficient, but leaving PFI intact, and instead opening even more ways for the private sector to rip off the taxpayer and undermine public services?

    "The Tories appeared opportunistically critical of their own PFI policy when Labour was implementing it, but are now happy to see this growing haemorrhage of cash from the NHS.

    "If ministers really wanted value for money in the NHS, they would scrap Lansley's crazy Bill which hardly anyone - even GPs - supports, and which will cost £3 billion or more to implement, and focus instead on nationalising the PFI hospitals, many of which will be paying through the nose for a generation to come to banks that the taxpayer already effectively owns."

    FURTHER DETAILS: Dr John Lister 07774 264112,

    Or Geoff Martin, 07831 465103

    NOTE TO JOURNALISTS and EDITORS: A new special issue of Health Emergency newspaper will be published on Monday, with the centre pages offering a graphic look at the potential impact of Andrew Lansley's reforms on patient care. A pdf version is attached. Information from the centrespread or other parts of the newspaper may be reproduced with acknowledgement to Health Emergency.

  • Lansley's NHS Bill would be "a disaster for local accountability"

    Monday 24th January 2011

    Health reporters and editors of local and national news media are urged today to lend their voice to the growing numbers of health professionals, academics and campaigners opposing Andrew Lansley's controversial Health and Social Care Bill, now before Parliament.

    Pressure group Health Emergency sounds the alert in a detailed 6-page Press Briefing on the 367-page Bill and its implications. It warns that Mr Lansley's plans threaten to reduce information on health services to the media and local public, and leave patients with less knowledge and influence n local decisions than ever before.

    The Bill, which only applies to England, proposes to scrap existing bodies such as Primary Care Trusts and Strategic Health Authorities which are at present required to meet in public and publish Board papers to press and public.

    These would be replaced by a single, remote NHS Commissioning Board, and a network of GP consortia: but the Bill would allow each of these bodies to meet in secret, and publish no Board papers. They would not even be obliged to consult the pubic on changes including cuts and closures of local services.

    With NHS Trusts also to be abolished and replaced by Foundation Trusts, most of which also meet behind closed doors and publish minimal information, it becomes possible for far-reaching changes to be pushed through while local people are kept in the dark.

    "The first you will hear about your local A&E closing or a change of provider for a local service will be through a Press Release - after the decision has been taken," says Health Emergency Director Dr John Lister.

    "And there will inevitably be cuts, because the NHS is being compelled by the government to make an unprecedented £20 billion in "efficiency" savings by 2014."

    Journalists will no longer be able to track local changes, find financial information or check out stories using Board Papers. Instead carefully laundered annual accounts will be presented once a year to a token "public" session, while information will be closely managed, and the media fed a diet of carefully-spun PR handouts.

    "This level of media black-out would make it extremely difficult even to frame questions under the Freedom of Information Act," warns Dr Lister.

    Health Emergency also dismisses Mr Lansley's gestures towards public scrutiny:

    "We can tell which way the system is going from the way new GP consortia have already been set up around the country with no prior consultation or debate with patients and public," says Dr Lister.

    "We can expect them to continue with just as little concern for their patients' views as they decide which services to cut, and what treatments to withdraw from the NHS to save money.

    "Ministers have claimed there would be scrutiny through new council Health and Wellbeing Committees, but the Bill makes clear these would be stitched up between council officers and consortia with only token public involvement, and the so-called "Local Healthwatch" bodies are feeble local committees controlled by the Care Quality Commission, charged with giving information and advice."

    Dr Lister concluded with an appeal to journalists and editors to protect their access to information on health services:

    "If there is to be no genuine public scrutiny in the spending of £80 billion or more of NHS budgets, it opens the door to corruption and mismanagement.

    "The wider public depends upon the media for information on their health services, and can only be properly informed if journalists are allowed to access information and pose awkward questions of those in control.

    "It's time for editors and health reporters to speak out, before the shutters come down and we are all left in the dark."

  • Hinchingbrooke franchise deal: a triumph of dogma over evidence

    Thursday 25th November 2010

    NHS East of England has, as expected awarded the controversial contract for the management of the troubled Hinchingbrooke Hospital in Huntingdon to a private company, Circle Health. All of the public sector bids had been withdrawn, and Circle's defeated rival at the final decision involved speed camera and prisons company Serco in a deal with a Foundation Trust.

    Hinchingbrooke is a small district general hospital, less than 27 years old, with 310 adult beds, 25 paediatric beds and 12 SCBU cots on the site (run by the PCT), a £22 million specialist elective treatment centre paid for through the Private Finance Initiative (PFI), and two mental health wards run by the Cambridgeshire and Peterborough Mental Health Partnership Trust. Addenbrooke's Hospital runs a dialysis service on the site.

    This scale and mix of services makes it more than six times bigger - and many times more complex to run - than the average private sector hospital in England.

    Private hospitals average just 50 beds, and focus exclusively on elective treatment for non-complex conditions, generally for well-to-do patients of working age. They do not offer emergency surgery or medicine, and any patient developing complications at a private hospital will be transferred by ambulance to an NHS hospital. Private hospitals have relatively few full-time staff (mainly nursing and support staff) with doctors mostly working only on sessional basis.

    Circle Health's hospitals are even smaller: brand new showpiece hospital in Bath, lavishly spacious, designed by Lord Foster 's team and feted by the media for its innovative design, has just 28 beds, but cost £30m, well over £1m per bed. It has less than 10% of the capacity Hinchingbrooke, which is a very different hospital, and of course has no facilities for emergencies or for patients with complex medical or surgical needs.

    Not only has Circle no relevant experience, but the NHS has already been through a very negative experience of private sector management attempting to take over and turn around NHS hospitals. It was a lamentable failure at Good Hope Hospital in Solihull, where a 3-year contract with Secta to manage the 550-bed hospital began amid a welter of optimistic publicity in September 2003, but was terminated eight months early, at the end of 2005, when the running of the hospital was handed to the management of Birmingham Heartlands Hospital Trust.

    Commenting on the East of England decision on Hinchingbrooke, Health Emergency director John Lister said:

    "This is another triumph of blinkered dogma over hard evidence. NHS East of England were determined from the outset - come hell or high water - to privatise the management at this hospital, a hospital which their own policies, coupled with ham-fisted decisions by Cambridgeshire PCT, had driven into financial crisis.

    "That's why NHS East of England has refused to discuss this properly with the unions, run a proper consultation, or listen to any of the many stakeholders who have opposed this approach.

    "The decision really is a first-rate scandal: Circle run tiny, high-cost private hospitals. What possible relevant expertise can they bring to running a medium sized, busy, debt-ridden NHS Trust with thousands of staff and a range of specialist services?

    "At each stage NHS East of England has stacked the odds against any public sector solution to this problem, and now they have got their way. Where is there a shred of evidence this policy can work? Who will carry the cost when it doesn't?

    "Who will pick up the £40m debts that the SHA has dumped upon the Trust? And where will Circle's profit be drawn from? What guarantee do we have they won't just close down the bits that don't make money, sack the staff, and turn Hinchingbrooke into another Circle hospital?

    "All of the plans have been hammered out in secret: the public of course will be the last to know and the first to suffer the consequences of any failure.

    "Now the franchise has been awarded, we demand the full facts are published for public scrutiny, to let people judge what kind of deal has been done."

  • Bin this crazy scheme for call centres to run GP bookings

    Thursday 18th November 2010

    New Department of Health plans to axe the admin support in GP practices and outsource the booking of appointments to regional or national call centres, publicised by the GP website Pulse, have been met by howls of derision from anyone who knows anything about primary care.

    A new DH-commissioned report from the Foundation Trust Network claims that the move could generate massive savings:

    "The majority of GP practices have dedicated administrative support teams, often undertaking identical tasks, including the organization and booking of patient appointments. This system should be radically re-engineered. There is considerable scope to generate substantial efficiencies and savings for redeployment into frontline primary, community and secondary care services."

    GPs and support staff alike have been enraged at the apparent delusion that health centre staff do nothing else but answer the phone and handle appointments, indicating that the report has been written by authors who have never ventured into a busy GP practice.

    Nor, clearly, have they ever attempted to make a call on a local issue to a busy call centre. But the proposals are wild enough to have attracted the support of the NHS National Director for Improvement and Efficiency, Jim Easton.

    Commenting on this latest potentially damaging proposal that could help sever the links between patients and their local GP practice, Health Emergency director Dr John Lister said:

    "This is only one of a series of half-baked policies that could be foisted on the electorate after no discussion, and on the basis of no evidence that it could possibly work. We already have a whole raft of untested and experimental policies in Andrew Lansley's White Paper "Liberating the NHS".

    "Now we have a formula that could leave hundreds of thousands of patients a day hanging on for hours listening to recorded messages telling them that their call is important, while skilled and dedicated primary care support staff, practice managers, receptionists, administrators and others would lose their far from high-paid jobs.

    "It would save nothing, but could cost us all our valuable contact with primary care services. Ministers must tell us right now that this crazy plan has been put straight in the bin."

  • Staffordshire cuts highlight plight of NHS hospitals

    Thursday 18th November 2010

    As the inquiry into the disastrous failures of care at Mid Staffordshire hospitals continues, the neighbouring North Staffordshire Hospitals Trust is staring down the barrel of drastic new cuts which Trust bosses warn will "distress" local people.

    Its plight is similar to many front-line Trusts hung out to dry by desperate Primary Care Trusts attempting to solve their financial problems by trying to reduce numbers of patients receiving hospital care, and refusing to pay for treatment of local people.

    The Trust - which hit national headlines back in 2006 when it was one of the first to announce big job losses as it wrestled with a huge deficit - is now facing a projected £22m deficit by March, much of it due to under-funding from the county's Primary Care Trusts, which have attempted to restrict numbers accessing emergency and elective treatment at the University Hospital of North Staffordshire (UHNS).

    While PCT budgets have been restricted, alternative community-based services to reduce the pressure on A&E have not been put in place, leaving hospital chiefs treating thousands of patients more than they are paid for.

    PCT bosses are believed to be drawing up new plans to axe a list of "low priority" treatment, in a bid to ration care and hold down costs.

    On top of this the Trust must also find another £12m in "efficiency savings" to fund the refurbishment of wards and departments in preparation for the opening of a new PFI-funded £400m hospital in 2012.

    The "unitary charge" for the new hospital, which has already triggered a cut of 300 beds at the Trust, will begin at £41m - 10% of the Trust's current £400m annual budget - and rise each year until 2042, by which point the new hospital will have cost a staggering £1.7 billion.

    As the Trust contemplates a tense and doubtful future, UHNS directors have been warning that painful cuts will have to be made.

    Chairman Mike Brereton told the local Sentinel newspaper that the Trust "will have to stop doing business in some fields. The population will be distressed when we start saying 'no' to them. Finance director Chris Calkin said:

    "Hospitals like our own have to become smaller so care needs to be provided in a different way."

    Non-executive director Professor Pauline Collins told the Sentinel:

    "I am extremely worried about how we will convey all this to the public and how shocked they will be to discover what they have taken for granted may not be available as quickly, or even at all."

    Commenting on the plight of UHNS and other Trusts in similar problems, London Health Emergency Information director Dr John Lister said:

    "Day after day ministers fuel the myth that the NHS is somehow being protected against cuts: yet the situation in North Staffordshire shows the reality for many Trusts up and down the country.

    "They are struggling to cope with thousands of patients that PCTs will not pay for: none of their problems will be any easier if Andrew Lansley pushes through his White Paper proposals to hand commissioning to GPs, and impose another £20 billion of "efficiency savings" from next March.

    "Problems at UHNS are also compounded by the sky-high costs of the Private Finance Initiative: so while a new super-hospital is built, the management are planning to close down services, beds and departments.

    "The tragedy in Mid Staffordshire showed what can happen when brutal cuts are forced through at the expense of patient care. We need not just an inquiry but signs ministers have learned this lesson.

    "What the NHS needs is bold action to slash the costs of PFI and for ministers to step in and ensure PCTs pay up for treatment delivered by NHS hospitals. Sadly Mr Lansley and his government are headed in the wrong direction, and are only making things worse."

  • New South London Hospital promised by George Osborne threatened by £30 million cuts crisis

    Monday 8th November 2010

    Campaigners warned today that a new hospital promised for South London by Chancellor George Osborne in his Comprehensive Spending Review (CSR) could fall victim to a £30 million cuts crisis.

    The Epsom and St Helier NHS Trust is due to receive £219 million to upgrade the crumbling St Helier site in Sutton, South London.

    However, in a dire warning to staff just issued by Chief Executive Samantha Jones she states bluntly that a spiralling, £30 million cuts crisis could scupper the plan:

    "Failing to meet our savings target this year will have a massive impact on the future of the Trust...It could also jeopardise our plans to spend millions of pounds redeveloping both St Helier and Epsom hospitals."

    The news, coming just days after the same Trust announced a first tranche of compulsory redundancies, is deeply embarrassing for the Government: as well as throwing a promised hospital development into doubt, it is also the hospital that serves the Sutton constituency of Health Minister Paul Burstow.

    Geoff Martin, Chair of NHS Pressure Group Health Emergency, said:

    "Epsom and St Helier is one of only a tiny handful of hospital developments supposed to have escaped the cuts axe, the news that it is now under threat is a massive dent to credibility of the Chancellor George Osborne.

    "Epsom and St Helier, like NHS Trusts across the UK, is gripped by a funding crisis that makes a nonsense of Government claims that the NHS is immune from the cuts."

  • As major South London NHS Trust announces new wave of redundancies, NHS pressure group Health Emergency warns that 20,000 health jobs in capital are under immediate threat

    Monday 8th November 2010

    The Epsom and St Helier NHS Trust in south London has confirmed that that they are imposing compulsory redundancies, sparking a warning from pressure group London Health Emergency (LHE) that 10% of NHS posts in London, 20,000 jobs, are under immediate threat from a combination of redundancies and recruitment freezes.

    LHE believes that the vast majority of NHS organisations in the capital have either full or partial recruitment freezes in place as Trusts aim to balance the books. London's health services are under instruction to claw back £5 billion in savings over the lifetime of this Parliament, and are working on plans that will close a third of current bed capacity as well as implementing long-standing plans to close or merge casualty and maternity units.

    Epsom and St Helier is £20 million short of a £30 million cuts plan by next April and campaigners are warning that the 30 redundancies just confirmed are the tip of the iceberg, and that no job is safe.

    London Health Emergency Chair Geoff Martin said:

    "The job cuts at Epsom and St Helier are compulsory redundancies that are very much the tip of the iceberg. We know that recruitment freezes have been smuggled in at Trust's across the capital leaving hospitals desperately short of staff and pushing us to the edge of the worse winter NHS crisis in a generation.

    "These cuts nail the lie that the NHS has been exempted from the Government public spending assault - in fact the NHS is right in the front line, and piecemeal cuts are being bulldozed through the length and breadth of the health service.

    "Local communities will need to unite to fight the health cuts alongside other services at the sharp end or watch while staffing and bed numbers are slashed back to lethally inadequate levels."

  • BMA right to slam Lansley's "deeply flawed" White Paper

    Friday 1st October 2010

    Pro-NHS pressure group Heath Emergency today welcomed the shift of position by the BMA to open criticism of the coalition government's controversial White Paper "Liberating the NHS".

    Health Emergency Director Dr John Lister published a widely publicised open letter to BMA Chair Hamish Meldrum early in August, warning that the doctors' union could be making a "historic mistake" if it lent any support to Andrew Lansley's proposals. He now says doctors are right to have recognised the real dangers at the heart of the White Paper.

    Among Mr Lansley's proposals:

    " GPs would take over the commissioning of £80 billion or more of services in England: the existing structure of local Primary Care Trusts and regional Strategic Health Authorities would be scrapped. And while some GPs have welcomed the potential influence they might gain from this, a growing number have recognised that they would first and foremost become responsible for carrying through £20 billion of "efficiency savings" which will require many unpopular cutbacks and closures by 2014.

    " In addition GPs would either have to spend more time in bureaucratic meetings and administration - leaving less time to care for patients - or employ teams of managers or management consultants to take on this role, effectively creating a new NHS bureaucracy.

    " The plan to replace 150 PCTs with 500-600 "consortiums" of GPs opens up the danger of a new "postcode lottery" in which patients in one area get less or greater access to services than their neighbours in another. And GPs in deprived areas are likely to find their concerns and their patients' needs brushed aside as larger, better-resourced GP practices from more prosperous areas take control of consortia.

    " To make matters worse, the drive towards privatisation would be accelerated with plans to offer NHS contracts for patient care to "any willing provider" - whether for-profit or a non-profit "social enterprise".

    " And in another twist of privatisation, all existing NHS Trusts also obliged to become Foundation Trusts, while Foundation Trusts are to be free to raise as much income as they wish from private patients: with their NHS funding frozen or falling, this means many top Foundation Trusts will focus their energies on attracting wealthy paying patients from home and abroad rather than on NHS patients.

    Commenting on the BMA's official response, which argues that the White Paper could undermine the "stability and future" of the NHS, Health Emnergency's John Lister said:

    "The shift of stance by the BMA makes it clear that more and more GPs as well as hospital doctors are waking up to the many fundamental flaws at the very heart of this White Paper.

    "Many are realising that with £20 billion of cuts to carry through they would not so much be "liberated" to commission better for their patients, but trapped in the role of rationing boards, deciding which patients to exclude and which services to axe.

    "The BMA's critical stance lines them up more closely with the TUC health unions, which have unanimously rejected the White Paper.

    "But it's not enough to criticise Lansley's proposals, which are driven by ideology rather than any evidence. It's clear that this government takes no notice of criticism, and the "consultation" is a sham. If the plans are as bad as the BMA now argues, there must be an active campaign to ensure they are dropped.

    "There is no sign anywhere of significant public support for these proposals, which were revealed in July and have been largely ignored by the media over the summer. Wherever people hear of the full content of the proposals they are angry and opposed to them.

    "The government has no mandate for any of these proposals. Both the Tories and LibDems deliberately opted NOT to put these ideas to the electorate in June - because if they had, they would have been rejected.

    "A combined campaign by all those who reject this commercialisation and privatisation of health care could now push the issue into the front line of political debate, and force the ConDem coalition to back off."

  • Con-Dem White Paper will "Eviscerate NHS"
    Press Release July 13

    Monday 19th July 2010

    The Con-Dem coalition could bring the end of the NHS as we know it - by 2015, according to pressure group London Health Emergency, which has been campaigning since 1983.

    Health Secretary Andrew Lansley has set his sights on reducing the NHS from a public service delivering health care to a fund that commissions care from a range of private providers in the new White Paper unveiled yesterday.

    Tens of thousands of staff face redundancy with the scrapping of Primary Care Trusts and Strategic Health Authorities: tens of thousands more who are delivering front-line health care will also lose their jobs, beginning this year, as £20 billion of "efficiency savings" are pushed through faster than planned, by 2014.

    Increasing numbers of health workers in NHS Trusts and community health services who keep their jobs will find themselves against their will working for so-called "social enterprises," with the loss of their NHS pay scale, pensions and conditions of service.

    Many others working for Foundation Trusts could also face the loss of national NHS pay and conditions, and see their Trust bosses cashing in on government plans to lift the cap on income from pay beds, private medicine, and deals with private companies. Andrew Lansley has made clear his wish to go further and make Foundation Trusts "off balance sheet" as completely external providers to the NHS - meaning that their staff, too, would cease to be NHS employees. All Trusts have to be Foundations by 2013.

    Meanwhile by scrapping any local or regional planning mechanism, and handing £70 billion of commissioning budgets to local consortia of GPs, ministers are opening up a chaotic competitive market, but also the prospect of a new "postcode lottery" for patients and the widening of inequalities in health provision -- as happened when the Tories last experimented expensively and unsuccessfully with GP Fundholding in the 1990s.

    But even the illusion of new powers and freedoms for GPs as commissioners is punctured by the context of massive spending cuts, coupled with the threat that GPs will be held accountable for the consequences of their decisions, and required to take unpopular decisions on cuts and closures of local services. Ministers insist that there will be no bail-outs for organisations which overspend public budgets.

    London Health Emergency director Dr John Lister said:

    "This new set of policies builds on all the worst elements of the previous government's so-called reforms.

    "It will establish even more private providers making profit from the public purse, while NHS staff could become a virtually extinct species in England.

    "Any GPs who really believe that they can deliver improved care for their patients in this type of health competitive market are kidding themselves.

    "Some campaigners have wrongly cried 'wolf' at earlier reform packages, but this White Paper leaves every previous attempt at privatisation and marketisation standing. This time we really are facing the end of the NHS as we know it - by 2015.

    "Now is the time for every health union, professional body, pensioners' group, campaigner and member of the public to get together to force the Con-Dems to back off."

  • Lansley challenged to rule out A&E closures

    Tuesday 25th May 2010

    In the aftermath of ambiguous statements from new Health Secretary Andrew Lansley that hospital "reconfiguration" will be stopped "except where work is already at the implementation stage", campaign group London Health Emergency is today demanding a categoric assurance that plans to axe A&E units in London and elsewhere will be permanently scrapped.

    Prior to the election powerful campaigns had challenged plans for A&E closures in various parts of London including

    " Chase Farm Hospital, Enfield

    " King George Hospital, Ilford

    " Whittington Hospital, Islington

    " Queen Mary's Hospital, Bexley

    " Ealing Hospital

    Mr Lansley's statement suggested that while reconfiguration was being stopped, it could resume if "GP support" could be demonstrated. Campaigners will be suspicious that health bosses such as those in South East London, who have again vowed to press ahead with the dismemberment of Queen Mary's Hospital in Sidcup, could manipulate local GPs to ensure that closures proceed.

    LHE Information Director Dr John Lister said:

    "Everyone living near a threatened A&E will welcome a halt to closures: but they will want a permanent reprieve for these vital services, not a short stay of execution.

    "The problem is that while the immediate threat of cuts has been lifted, if only temporarily, the underlying financial pressures that have been driving the cuts are still very much alive.

    "PCTs and Trusts across the capital have been firming up plans to cut spending this year and every year until at least 2017, cutting a total of up to £5 billion, with inevitable large scale loss of jobs, beds and services. NHS London, which has the most advanced and aggressive plan for cuts in the country, may try to pre-empt their own threatened abolition as a Strategic Health Authority by driving through the cuts they have been planning.

    "Andrew Lansley's party promised to "ringfence NHS spending" against cuts and to increase NHS budgets in real terms each year: voters will be looking to see whether this means what it says, or if the predicted cash freeze sets in this year and throws the NHS improvements like the 18-week maximum wait into reverse.

    "He should start by giving a clear assurance to local people, and an unmistakable instruction to local health bosses, that no A&E should close and that funding will be increased to ensure that vital services will be kept intact."

  • Mental health cuts bring fears of Mid-Staffs-style scandal

    Saturday 3rd April 2010

    Staff in one of London's mental health foundation Trusts are warning that a package of £9 million in spending cuts being brought in by Trust bosses could result in a collapse of care standards on the scale of the recent scandal in Mid Staffordshire Hospitals.

    Most worrying are the cuts proposed by East London NHS Foundation Trust, details of which have been leaked to Lon don Health Emergency. They include cuts in front-line nursing staff on acute wards, reducing by 2 Whole Time Equivalent staff per ward - to save £2m. The changes, which come into force this week, could put the safety of staff and patients alike at risk, and make it next to impossible for the remaining staff to deliver high quality care.

    To make matters worse, new rotas would also restrict the crucial "handover period" between shifts to just one hour, jeopardising the necessary exchange of information on patients with complex needs, and would also oblige nurses to cover six shifts instead of five.

    Other cuts include £500,000 from the medical budget, £500,000 from Therapy budgets, and cuts ranging from £500,000 to £1 million from each locality directorate. £1.5m is also to be cut from corporate services, although it is less clear how this will impact on patient care. More cuts are to follow next year and the year after, as the Trust seeks total savings of £15-£20 million.

    The management proposals to the Joint Staff Committee make clear that all of these cutbacks are cash-driven, stressing that "It has become increasingly apparent that the NHS is going to be expected to make significant savings in coming years to cope with a reduction in income and an accompanying increase in costs … This will result in a reduction of budgets across all areas".

    But East London NHS Foundation Trust bosses have not come clean with the public on the scale and impact of these cuts, and staff fear for their jobs if they speak out publicly. Concerned staff have approached London Health Emergency to help them raise the alarm over the potential damage to patient care.

    Commenting on the cutbacks, LHE's Information Director Dr John Lister said:

    "These cuts are a shocking indictment of the methods of this secretive Trust, which clearly prefers to risk a major collapse in patient care to save relatively small amounts of money than to work with their own trade unions to help publicise the resource constraints that are driving them into these panic measures.

    "We hear that middle and senior managers are among those who have expressed concern that these cuts could have similarly disastrous effects to the previous ill-judged cuts in night staff by the Trust. These resulted in a series of serious incidents, culminating in the attempted murder of a nurse on night shift: the subsequent press furore forced a reversal of the cuts.

    "East London is among the first to translate NHS London's plan for £5 billion of cuts across the capital into actual service cuts, beginning this week: and it shows that the consequences could be as serious as a major collapse in front line services.

    "We are calling on the Trust to withdraw these plans immediately, maintain existing services, and join campaigners across London fighting cutbacks, closures and downgrading of services."

  • NHS cuts put more hospitals at risk of Mid-Staffs failures

    Friday 26th February 2010

    THE SHOCKING failures of management and care at Stafford Hospital revealed in yesterday's report into the scandal could be echoed in other hospitals up and down the country if ministers insist on pushing through the massive cutbacks in spending and impossible "efficiency savings" that are now being discussed, warns pressure group Health Emergency.

    A key factor in the chronic lack of nursing and other staff, and desperately poor staff training at Mid Staffordshire Trust was the 150 jobs that were axed in a £10m cost-cutting operation to ensure that the Trust brought its finances into balance - to secure Foundation Trust status.

    Nurse and medical staffing were slashed to well below safe minimum levels - and the Trust was rubber-stamped as a Foundation shortly before its appalling levels of care were belatedly identified by the Healthcare Commission.

    But dozens, if not hundreds of NHS and Foundation Hospitals are facing cuts much larger than £10m, and much larger cuts in staffing as the squeeze on NHS spending takes effect from 2010-11. Some Trusts such as Leicestershire, Leeds, Derby, Heatherwood and Wexham, and the Royal Free are already axing hundreds of jobs.

    Many more have yet to announce how they aim to deliver the required "efficiency savings" and balance their books while Primary Care Trusts concentrate on diverting as many patients as they can away from hospitals, and slash the "tariff" of payments for treating patients.

    Health Emergency's Information Director John Lister said:

    "Health Secretary Andy Burnham has correctly argued that lessons have to be learned from the Mid Staffordshire scandal: but it makes no sense to keep on having inquiries about it if more and more Trust managers are simply going to be forced into the same desperate situation as the Stafford Hospital management.

    "There is a real danger that the mounting NHS pressure to deliver huge, quite unprecedented demands for "efficiency savings" and spending cuts - on a level never ever achieved in the NHS in its 62-year history - will drive more managers to seek similar irresponsible savings at the expense of patient care.

    "If ministers - and the opposition politicians cynically trying to cash in on this tragic situation - really want to reassure the public that no such thing will happen again, we need them to take the pressure off managers, and back-track on the savings targets and cash allocations for the NHS.

    "We need all the main parties to commit NOW to increase NHS spending by a minimum of 4% per year in real terms. If tens of billions can be created and spent on "quantitative easing" to benefit the bankers, no voter will object to some of the same generosity being shown to prevent unacceptable and dangerous cuts to our NHS."

  • Thirteen London Hospitals set to lose services:
    Big turn-out expected at London-wide rally called by BMA

    Monday 22nd February 2010

    EMBARGO: Not for publication before 12.00 noon Weds February 24 2010

    AT LEAST THREE of the SIX district general hospitals that are due to see services scaled down or closed in North West London have now been identified in the 'Integrated Strategic Plan' drawn up behind closed doors by Primary Care Trusts. This brings the London-wide total of hospitals known to be at risk to THIRTEEN.

    The 72-page NW London document makes clear that it seeks to "reduce the level of acute services on the Ealing [Hospital] site" (page 51), while it reports that "the Board of West Middlesex Hospital Trust have recently clarified that they do not believe that their organisation has an independent future". Central Middlesex Hospital, too is identified as facing further downgrading of services to reduce it to a "local hospital". (page 51)

    With just three "major acute" hospitals to service the NW London population of 1.9 million in eight boroughs, it is clear that three more must be scaled down, raising fears that Hillingdon Hospital, too, and key services at Chelsea and Westminster and Hammersmith hospitals could be scaled back, leaving just St Mary's, Northwick Park and Charing Cross as "major acute" hospitals, and long journeys for patients from many parts of outer London needing hospital care.

    The North West London cutbacks are part of a programme launched by NHS London which it admits could axe up to a third of hospital beds in London. From the most recent Department of Health bed figures from the capital, that could mean a massive 5,600 front-line beds to close from a total of 16,868. Also under threat or facing virtual closure as district hospitals are Chase Farm, the Whittington, King George's Hospital, Ilford, Queen Mary's Sidcup and one other hospital in South East London, and Kingston, Epsom & St Helier and Mayday hospitals in South West London.

    This could mean tens of thousands of the most seriously ill patients in the capital being obliged to travel much further to access hospital care.

    The figures were highlighted last month in a critical BMA report 'On the Brink', which links the large scale cuts to NHS London's goal of cutting over £5 billion from health spending in the capital by 2017 as the growth in NHS funding grinds to a halt.

    It points out that NHS London is seeking to divert more than half of all outpatient work in the capital (5 million appointments), and nearly two thirds of A&E activity (almost 2 million) to experimental "polysystems", few of which as yet exist. This switch of millions of patients from hospital departments to primary care would mean London's hospital budgets would be slashed by upwards of £1 billion a year, an average reduction of almost £40m for each of the capital's 26 acute Trusts and Foundation Trusts - easily enough to force many of them out of business.

    The NHS London plans are based on controversial estimates contained in a document by US-based management consultants McKinsey which is being kept secret, preventing any scrutiny of the assumptions and the data they have used.

    On the Brink author John Lister said:

    "Campaigns are springing up all over London as local people wake up to the threat posed to their local health services. Redbridge campaigners have been protesting for months now, as have Chase Farm. The campaign to save the Whittington Hospital is growing rapidly. And South West London campaigners have already joined forces and launched a combined fight to defend all of the local hospitals that are threatened.

    "This is a problem that will gnaw away at the support of whichever party wins the election, with a succession of high-profile and possibly chaotic changes and cutbacks in the NHS, tearing the heart out of the existing hospital network, and axing thousands of health workers' jobs.

    "Whenever hospital services in London have been threatened over the years there has been a strong campaign to save them. What we don't yet know is where many local MPs and councillors stand on the potential closure of local services. They have to decide. Will they fight with local people - or against them?"


    The BMA Public Meeting has been called for 7pm on Thursday February 27, at BMA House in Tavistock Square, WC1. John Lister will be among the platform speakers.


    Thursday 11th February 2010

    Campaign group London Health Emergency today demanded the publication of a secret hospital strategy document which could see the closure or downgrading of at least 11 of the capital's 31 Accident and Emergency departments.

    Last night, a leaked document passed to the BBC outlined plans that could see the axing and down-scaling of services at five hospitals in North West London alone leaving just three major centres to cover the area.

    In South West London there are growing fears that Kingston, St Helier in Carshalton and Mayday in Croydon will all see front-line services closed or downgraded with the hospitals becoming satellite units of St George's in Tooting. A new cross-South West London campaign to fight the plans will be launched next week.

    In South East London, the threat to Queen Mary's in Sidcup is already well documented, but campaigners fear that one more hospital may be added to the closure programme as the scale of the financial cuts required stacks up.

    In North East London a "business plan" already out to consultation proposes the effective closure of King George's in Ilford and massive bed cuts at Whipps Cross, Barts and the London and the Homerton. Active campaigns are already challenging these plans.

    To the north of the capital, campaigners continue to fight the closure of services at Chase Farm in Enfield, and plans to merge the Whittington with the Royal Free with the loss of A&E at the Whittington.

    Geoff Martin, Chair of pressure group London Health Emergency said:

    "Last night's leak from the North West London review, added to information leaking out in South West London, published details in NE London, and what we know about other parts of the capital, exposes the fact that the biggest closure programme ever cooked up for London's hospitals is being stitched together -- behind closed doors.

    "We are demanding that NHS London end the leaks and speculation by publishing all of the working documents on the London sector reviews and we have submitted a Freedom of Information request today on exactly those lines.

    "It is a scandal that the future of up to a third of London's A&E departments is being carved up in secret meetings despite the fact that these are life or death services paid for by Londoner's out of their taxes. Londoner's need to wake up and realise just what is going on, and just what is at stake, if we don't call the faceless, well-paid NHS London bureaucrats to account."

  • Ministers dismiss Commission findings: now dismiss the Commission!

    Friday 5th February 2010

    Health campaigners have welcomed the news in the Health Service Journal that the Department of Health has dismissed as "anecdote" a report from the "Cooperation and Competition Panel" set up by previous Health Secretary Alan Johnson.

    The panel had been asked to intervene after Great Yarmouth and Waveney Primary Care Trust made clear that a £25m a year contract to run community services would only be open to NHS tenders. Various private sector companies, right wing and pro-market academics and so-called "social enterprises" have complained that this is in conflict with the Department's own principles and rules on competition.

    The PCT has argued that they were only following the new policy announced by current Health Secretary Andy Burnham last autumn, when he announced that the NHS would be the "preferred provider" of services unless there were insuperable failures in the quality of care.

    But despite changing the policy in a more sensible direction, Burnham has left in place much of the apparatus to implement the opposing policy: this includes the Cooperation and Competition panel, chaired by a leading private health boss, Lord Carter of Coles, and staffed almost exclusively with people from the private sector with little if any record of constructive involvement with public services.

    Worse, the competition policy that the Panel was set up to police is now part of the huge and costly bureaucratic structure of "World Class Commissioning", which has soaked up management time and involved Strategic Health Authorities and Primary Care Trusts spending millions on appointing otherwise useless Commercial Directors and other layers of management required to establish and monitor a complex "market" in health care.

    Calling for the Panel to be scrapped as the first of a series of major cost savings that would also improve efficiency in the NHS, Health Emergency information director John Lister said:

    "We're told the NHS faces cuts of £15-£20 billion over the next few years to balance the books as the growth in spending grinds to a halt. So surely the most sensible way to save large sums would be to strip out all of these surplus and unproductive bureaucrats, and the costly management consultants that have been employed to do much of their work: none of them contribute in any way to patient care.

    "The market-style reforms have been an expensive fiasco. Andy Burnham has at last begun to recognise this, but he should go the next step to save money in a way that every health worker and patient would happily support.

    "Boot out the over-paid bureaucrats, and the over-priced private providers, and concentrate on allowing the NHS to deliver top quality services with the minimum of overhead costs."

  • One third of London's hospital beds at risk - official

    Saturday 23rd January 2010

    Up to a third of hospital beds in London could be forced to close under drastic new plans being hatched up by NHS London - and that's according to their own summary of their proposals. From the most recent Department of Health bed figures from the capital, that could mean a massive 5,600 front-line beds to close from a total of 16,868.

    This could mean a dozen or more popular, busy hospitals being forced to close their doors and tens of thousands of the most seriously ill patients in the capital being obliged to travel much further to access hospital care.

    NHSL's assistant director of strategy Sam Higginson gave the shock figures yesterday, responding to a critical BMA report 'On the Brink', which warns of large scale cuts as health chiefs aim to cut over £5 billion from spending by 2017 and the growth in NHS funding grinds to a halt.

    The report was researched for the BMA from Primary Care Trust and other published papers by Health Emergency's Information Director Dr John Lister. It points out that NHS London is seeking to divert more than half of all outpatient work in the capital (5 million appointments), and nearly two thirds of A&E activity (almost 2 million) to experimental "polysystems", few of which as yet exist.

    This switch of millions of patients from hospital departments to primary care would mean London's hospital budgets would be slashed by upwards of £1 billion a year, an average reduction of almost £40m for each of the capital's 26 acute Trusts and Foundation Trusts - easily enough to force many of them out of business. But to make matters even worse NHS London wants annual cuts in the "tariff" that fixes the amount hospitals receive for delivering patient care. And it's not just hospitals under the axe: NHS London wants to slash the workforce in primary care and community services by two thirds (66%), and even cut the length of GP appointments from an average 12 minutes to just 8.

    But it's not clear how reorganising services for minor injuries and outpatients could make it possible to close thousands of INPATIENT beds for those with the most serious health problems. Nor has NHS London shown any evidence to prove that their new proposals would be cheaper, more efficient or deliver better care than the existing hospital services they are threatening with extinction. Their plans are based on controversial estimates contained in a document by US-based management consultants McKinsey - and it is being kept secret, preventing any scrutiny of the assumptions and the data they have used.

    On the Brink author John Lister said:

    "This is not just a future problem. Most of the capital's 31 Primary Care Trusts which hold the purse strings for health services are already facing hefty overspending, and looking for ways to impose cuts as soon as the General Election votes have been counted.

    "Plans like those we have already seen for the effective closure of acute services at King George's Hospital, Ilford, Chase Farm in Enfield, and Queen Mary's Hospital, Sidcup, and the downsizing of Islington's Whittington Hospital will be followed by many similar cuts across London. Nowhere is safe from these reckless proposals.

    "This is a problem that will gnaw away at the support of whichever party wins the election, with a succession of high-profile and possibly chaotic changes and cutbacks in the NHS, tearing the heart out of the existing hospital network, and axing thousands of health workers' jobs.

    "Changes on this scale have never before been imposed in any health system in the world. They threaten to leave the capital desperately short of hospitals and health care.

    "I am challenging NHS London to publish the secret McKinsey document for public scrutiny, produce evidence to prove that their plans would save money or improve services, and show how the heavy cost of creating a new network of polyclinics would be funded.

    "Without sight of the document that is driving these plans nobody can scrutinise the assumptions or the logic underlying the NHS London proposals, which seem to be taking far-reaching decisions on pure guesswork.

    "The people of London deserve better than a cull of a third of their hospital beds and the closure of many popular local hospitals on the basis of secret figures which appear to have been calculated on the back of a fag packet in secret by US-based management consultants."

    On the Brink is published by the BMA's London Regional Council. Their webpage can be found at:

    The report's Executive summary can be found at:

    The Full On the Brink Report, which includes a full PCT by PCT analysis of the growing problems around the capital, is available:

  • GP shake-up: campaigners challenge Burnham to come clean

    Friday 18th September 2009

    Health Secretary Andy Burnham is being challenged to name the sources of his latest controversial proposals to shake up GP services, and explain the full implications of the plan described as "allowing patients to choose their GP", effectively scrapping any fixed boundaries for GP practices.

    The proposal is being sold as a way to allow flexibility for people of working age who wish to register with a doctor close to their workplace, or for "busy mums" who may wish to register at a practice near her children's school.

    But the proposals would offer little benefit for those who are most heavily dependent on primary care services - older people, and the chronic sick, many of whom have mobility problems, low incomes, and lack a car or the money for taxis to travel further for treatment.

    And while controversy still rages over the GP contract which allowed doctors to buy themselves out of the obligation to offer "on call" services overnight, Burnham's plan would involve scrapping another essential aspect of primary care: the legal obligation on GPs to visit patients on their list at home.

    It seems certain that this would involve the privatisation of home visiting services, creating even more problems of ensuring quality and public scrutiny than the costly and problematic out of hours deputising services, which already depend heavily on doctors expensively flown in from Poland, Germany and other European countries to work casual shifts.

    Health Emergency's Information Director John Lister said:

    "We believe this policy is yet another example of back-door privatisation by New Labour.

    "But the question is where have all these policies been coming from? There is no public pressure to privatise GP services - or any other NHS services. Quite the opposite - almost all of these plans are being pushed through without proper discussion or debate because ministers like Andy Burnham know they would be unpopular.

    "And at a time when the costs of bureaucracy in Primary Care Trust are already soaring, with a massive expansion of admin and managerial staff, this new scheme will involve even more wasteful bureaucracy, and divert even more resources away from patient care.

    "Press reports suggest that this idea comes from Lord Darzi - a surgeon with no experience of primary care. Others tell us it was dreamed up by some back-room policy wonk in Burnham's office.

    "Whoever was responsible, we know it was not doctors, the health unions or the public - the people Andy Burnham should look to if he wants a sensible policy."


    Monday 6th July 2009

    NHS pressure group Health Emergency today called again on the government to take the axe to the health services £500 million management consultancy budget instead of following advice to impose a pay freeze on the workforce.

    The chief of the Audit Commission today urged the government to freeze public sector pay, including the NHS, but Health Emergency warned that such a move would hit the lowest paid hardest -- while senior NHS managers and the growing army of management consultants continue to fill their boots at the taxpayers expense.

    Geoff Martin, Chair of pressure group Health Emergency, said:

    "The real waste in the NHS comes from the inflated payments to the growing army of management consultants and in the fees paid to private sector companies involved in PFI and other projects. It's these fat cats, scooping up millions in corporate welfare at the expense of the NHS budget, who are the real enemies of the health service.

    "Nobody should underestimate the ballooning cost of NHS bureaucracy, management consultancy and private sector fees. That's where the axe should be swung, not at the NHS workforce -- the people we rely on to hold the service together."


    Friday 5th June 2009

    Health campaigners today called on the NHS to kick the management consultancy habit and end the addiction to the use of external management advisers who are bleeding £350 million a year away from the patient care budget.

    Yesterday, the Health Select Committee called for greater transparency in the use of management consultants but leading NHS pressure group Health Emergency said that this does not go far enough.

    Health Emergency has also re-issued its call for the expenses of senior NHS managers to be published in full.

    Geoff Martin, Health Emergency Head of Campaigns, said today:

    "We know that there has been an explosion in NHS bureaucracy under new Labour and massive increases in top NHS bosses pay with some managers pulling in over a quarter a million a year. It's a scandal that those same well-paid NHS bosses are then wasting money on management consultants rather than getting on with doing the jobs we are paying them to do. It's a racket, and it's costing the taxpayer a fortune.

    "Front line staff are sick and tired of NHS management consultants prowling the wards on a grand a day with their designer suits and clipboards while the staff that really matter are struggling to cope.

    "The £350 million that's being wasted on management consultants would be enough to put over ten thousand more nurses on the wards. That puts the management consultancy rip off in the NHS into context."


    Monday 1st June 2009

    NHS pressure group Health Emergency today called for the publication of the past five years expenses claims paid out to all senior executives in the NHS.

    Health Emergency want to see full disclosure of expenses from NHS Chief Executives and board-level Directors along with Chairs of Trusts, PCTs and Strategic Health Authorities.

    The demand follows yesterdays statement from the Prime Minister that he may extend financial scrutiny to organisations like the NHS and the BBC.

    Geoff Martin, Health Emergency Head of Campaigns, said today:

    "There has been an explosion in NHS top bosses' pay under New Labour and it's about time the public had a chance to scrutinise their expenses as well as their rates of pay.

    "We know that some Chief Executives are now on pay packages worth over a quarter of a million pounds with London at the heart of the NHS top salaries gravy train. We now want to see the paper trail of what other expenses the top brass are piling on top of their basic pay.

    "This is taxpayers' money and after the scandal of MPs' expenses it's about time a light was shone into the grubby corners of NHS executive pay and benefits," Geoff Martin said.

  • International forum to fight health privatisation

    Wednesday 20th May 2009

    Health workers and campaigners are being invited to Coventry on June 20 for a unique international meeting to discuss the fightback against privatisation in health care systems around the world.

    The one-day event "Condition Critical" is the final open session of a 4-day international conference, which has been called by the International Association of Health Policy in Europe, and supported by Coventry University and a number of organisations.

    Participants and guest speakers will be coming from as far afield as Malaysia, Nigeria, Brazil, the US and Canada as well as Greece. Turkey, Belgium and Germany to take part in the discussions which aim to challenge the marketisation of health care, and expose the role of the media in shaping and controlling public perceptions of government policy.

    Speakers on the Saturday will include Ontario health campaigner Natalie Mehra, NUJ Deputy General Secretary Michelle Stanistreet, a BMA speaker, and a speaker from Keep Our NHS Public.

    The event, which runs in Coventry University from 10am to 3pm, is free of charge, and offers a free lunch: but those attending are required to register in advance, to secure details of the venue and ensure that adequate catering is available.

    Organiser John Lister, a veteran health campaigner who also teaches health journalism at Coventry University, said:

    "This event, following on the more detailed debate we will have at the conference, is a one-off chance for campaigners and health trade unionists to hear first-hand about the situation in other countries around the world, and to compare notes on the success of campaigning tactics in fighting back.

    "Sadly, the problems we face in England are not unique: other health services are going down the same road of marketisation. So we need to link up internationally and maximise the resistance to policies which lack any evidence, and which threaten to undermine successful and popular health services."

    Click here for a pdf flyer

    To register, email


    Sunday 10th May 2009

    Campaigners and trade unions are celebrating a significant victory in the fight to stop the privatisation of NHS services after it was confirmed today that the plan to sell off the surgical unit at Kingston Hospital, a pilot project for the rest of the country, has been scrapped.

    Kingston was to be the first hospital in the UK to bring a private company right into the heart of an NHS Trust to run the entire surgical service.

    Campaigners warned that the move would be dangerous, expensive and divisive and sent alarm bells ringing of a Metronet scenario in emergency theatres with the possibility of a private company literally going bust in mid-operation.

    Management consultant fees have cost Kingston Hospital over £300,000 for the aborted plans at a time when the hospital is facing a multi-million pound deficit and looking for cuts to balance the books.

    Geoff Martin, Chair of NHS Campaign Group London Health Emergency, said:

    "These plans were botched and ill-conceived right from the start and time, money and energy has been wasted pursuing a privatisation strategy which is now dead in the water. We are glad the plan has been stopped in its tracks by our campaign but we want to know who gave the green light to waste over £300,000 of precious NHS cash in the first place. There should be a Public Accounts Committee inquiry."

    Nora Pearce, UNISON and Staff Side rep at Kingston, said:

    "We are pleased this plan has been halted. It has been damaging for staff morale and I hope we can now get on with the job of running NHS services for our patients as a public body and that we won't hear any more of this privatisation nonsense."


    Sunday 10th May 2009

    Campaigners warned today that hospital's and senior medics have been thrown into a dangerous civil war over NHS London plans that will leave the capital with just four main trauma units and eight stroke centres.

    Reports from around London are sending out a clear signal that a number of hospitals, particularly some on the edge of London, are furious that they will be losing key services and that the shift of resources could seriously undermine their financial viability.

    The most serious row to date has come at Chelsea and Westminster which is fighting hard to retain its stroke centre. All of the four planned trauma units are in inner-London leaving hospitals as far apart as Barnet in the north and Kingston in the south wondering what the future holds.

    Geoff Martin, Chair of pressure group London Health Emergency, said:

    "No one should underestimate the anger out there at hospitals that are clear losers under the NHS London plans. It's only the culture of fear that is holding back the whistleblowers who know that this plan will have potentially lethal consequences for patients in the suburbs forced to undertake a 45 minute journeys to their nearest trauma centre.

    This whole exercise has been botched from start to finish by NHS London and we are calling for a proper, independent impact assessment, and a genuine consultation, to be undertaken before we plunge headlong into chaos."

  • Bid to persuade patients to keep "switching" GPs…

    Tuesday 5th May 2009

    In the latest bizarre attempt to create a new, competitive "market" in health care, the government's private sector management consultants Ernst and Young are urging that patients should be encouraged to switch repeatedly from one GP to another in order to create a "competitive tension" in the NHS, with a suggestion that up to 60% should switch each year - as if accessing primary care is like buying a broadband service or gas supply.

    But this is only one of a number of measures aimed at cranking up competition, even while Chancellor Alistair Darling's budget, imposing £2.3billion in cuts in NHS spending, has flagged up the need for more efficient and cost-effective services. Senior NHS figures are already arguing that this should mean a reduced emphasis on expensive options such as patient "choice," and greater focus on cooperation between NHS providers.

    Yet Strategic Health Authorities are headed in precisely the opposite direction. Under the misleading label of "World Class Commissioning," they are driving a further massive and costly fragmentation of community and primary services delivered by Primary Care Trusts - which employ 250,000 staff, and consume £11 billion of NHS spending in England.

    Splitting these services into "arms length" organisations, and then further splitting them to create a "competitive market" in each PCT area will increase management costs, and divert management time and energy from delivery of patient care. The requirement that PCTs cease to provide services, and instead "commission" services from a range of private sector and not for profit providers means that up to 250,000 NHS staff - nurses, therapists, and other professional and support staff - face the loss if their NHS contracts, pensions and pay scales. Of the possible structures put forward for the reorganisation of these services, only one, Community Foundation Trusts, would allow staff to retain NHS employment. But not one of these CFTs yet exists, and many PCTs are ruling this out as an option, arguing that services are too small in scale, or that the timescale does not allow it.

    Yet there is not a shred of evidence to support claims that the new, more costly "market" model will deliver any improvement in patient care. Already PCTs and SHAs are employing additional "commercial directors" and market managers - at a cost of diverting resources from patient care.

    London Health Emergency Director Dr John Lister, whose award winning book* warned against the marketisation of health care, said:

    "Given the electoral hole the government has dug itself into, ministers should drop these expensive ideas which nobody at all supports, and return to the core principles of the NHS - services allocated according to clinical need, and cooperation in place of wasteful competition."

    "It is clear that even while the free market has collapsed in banking, the car industry and elsewhere, the ideology of a free market in health care has become a complete obsession for ministers, regardless of the cost and the consequences, and regardless of the lack of any evidence that can ever work.

    "To have one of their costly private sector advisors dismissing the need for any continuity of care from GPs and effectively regarding primary care as a utility to be bought and sold on the market shows that they have no understanding of health care.

    " NB: John Lister's book The NHS after 60: for patients or profits? (Middlesex University Press) has just been awarded the Medical Journalists Association's Tony Thistlethwaite award for best book on a medical or health topic by an MJA member for a general audience.

    See also more detailed analysis of the current reforms at:

    Charge raises marginal income for NHS but deters poor from treatment

    Wednesday 1st April 2009

    Campaigners today called on the Government to bring England in line with the rest of the UK and move to abolish prescription charges on the day that Scotland cut the price of medicines from £5 to £4 - at the same time as they were being increased from £7.10 to £7.20 for English patients.

    Wales has already abolished prescription charges and Scotland will follow suit by 2011.In Northern Ireland they have been reduced to £3 and will be abolished completely next year.

    Geoff Martin, Head of Campaigns at NHS pressure group Health Emergency, said:

    "Prescription charges have become a grotesquely unfair tax on the sick in England. On the day that the costs are being in Scotland they are being jacked up again south of the border.

    "It cannot be fair that one of Gordon Browns constituents is paying nearly half what I would pay in south London for the same prescription.

    "The time has come to bring England into line with the rest of the UK and to move to abolish prescription charges.

    "In the current recession these charges hit people even harder and there is a very real risk that some people, particularly those recently made redundant and not yet qualifying for benefits, simply won't be able to afford the medicines they need."

    LHE's Information Director John Lister adds:

    "Prescription charges generated just under £500m towards the £110m NHS budget last year. This marginal contribution involves complex and costly bureaucracy, and deters those on the lowest incomes froma accessing all of the medicines they need.

    "In the 61st year of the NHS, ministers should revive the egalitarian spirit of the 1948 NHS, in which all prescriptions were free."

  • As Foundations collapse, campaigners warn of more scandals to come:

    Friday 20th March 2009

    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."


    Friday 13th March 2009

    The UK's leading mental health Trust, the South London and Maudsley, have confirmed another round of cash-led bed closures sparking fears that services will be left unable to cope with the impact of the recession.

    SlaM have issued a consultation document this week that will lead to the closure of the current services at Gresham 1 ward at the world-famous Bethlem Hospital. The announcement comes just weeks after the Trust confirmed plans to axe a ward at the Maudsley Hospital.

    Campaigners and unions have slammed the bed closure plans warning that they make a mockery of the Government's announcement last weekend that they plan to expand services to cope with the mental health fall-out from the recession which is already seeing a surge in people facing anxiety and depression.

    The Samaritans have warned of an increase in suicides as people are driven to the edge by the impact of losing their jobs and homes.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "For the want of less than a million pounds, two wards providing acute in-patient beds for residents of Lambeth and Croydon are facing the axe. That's at a time when billions of pounds of taxpayers money is being pumped in to prop up the banks and bail out the City speculators.

    "There is no doubt that some patients requiring an in-patient bed will slip through the net as a result of these cuts with potentially disastrous consequences. Others will end up in expensive private sector beds, costing the NHS a fortune and making a nonsense of the planned savings.

    "We will fight these cuts and we are urging the Health Secretary Alan Johnson to step in and halt these dangerous reductions in front-line mental health beds."


    Monday 9th March 2009

    Campaigners today slammed plans to axe 9 mental health beds for Croydon residents at the Bethlem Hospital warning that it will leave a desperate shortage of capacity at a time when the recession is sparking a surge in demand for mental health care.

    A consultation document issued by the South London and Maudsley NHS Trust and Croydon Council recommends the closing of the current mixed gender inpatient service provided at Gresham 1 ward at the Bethlem with a net loss of nine inpatient beds.

    The Trust and the Council have made it clear that these are cash led cuts, designed to help meet a 3% Cost Improvement Programme. They do not say exactly how much will be saved but campaigners estimate that it's around £500,000.

    Campaign group London Health Emergency and staff trade union UNISON today pledged to fight the plans and will be contacting politicians, user groups and the wider community urging them to register objections.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "No matter how the bureaucrats dress this up these are real cuts in real services for people who are in desperate need of support.

    "Politicians, campaigners and clinicians all accept that the recession will spark increased demand for mental health services and the loss of these beds will have serious impact and could well leave people who have been pushed over the edge unable to access the care that they need with disastrous consequences.

    "It is also likely to prove a false economy as it will increase private sector emergency referrals, blowing a hole in the Trust's budgets.

    "We are urging Health Secretary Alan Johnson to make emergency funding available to stop these damaging bed losses from being bulldozed through."


    Monday 9th March 2009

    Campaigners today called for an reversal of a package of bed cuts at the country's most famous psychiatric hospitals - the Bethlem and the Maudsley - claiming that they make a mockery of the Government's announcement this weekend that they are targeting additional resources on mental health services in a bid to cope with the impact of the recession.

    Financial cuts have led to the South London and Maudsley NHS Trust announcing plans to close a ward on the Maudsley site with a further ward closure at the Bethlem expected to be confirmed today.

    Geoff Martin, Head of Campaigns at pressure group Health Emergency, said today:

    "At the same time as the Government were announcing £13 million of additional investment in services to cope with the impact of the recession, managers at the Bethlem and the Maudsley were pressing on with plans to close vital acute, in-patient beds.

    "It's a nonsense on the one hand to announce an expansion of services while on the ground vital bed capacity is being hacked back to save less than a million pounds.

    "We are calling on Alan Johnson and the Government to step in as a matter of urgency to stop the bed cuts at South London and the Maudsley and to find the cash that the hospitals need to keep these wards open."


    Thursday 5th March 2009

    Campaigners today pledged to step up the fight against ground-breaking plans to privatise an entire NHS hospital's surgical department, after it emerged that only one company is left in the bidding process to take over the work.

    Kingston Hospital in south west London floated its trail-blazing plans to extend the boundaries of NHS privatisation last year - since then, the hospital's Chief Executive has departed and over £300,000 has been spent pursuing the private surgery scheme, which now appears to be unravelling.

    The Trust have repeatedly refused to name the companies in the frame, but they have now admitted that the two preferred bidders have been reduced down to one as another outfit has withdrawn citing "market conditions."

    Campaigners have slammed the whole botched and expensive process as a waste of time and money which could leave the hospital with a private company providing life-or-death surgery going bust in mid-contract.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "The withdrawal of one of the remaining two companies from the bidding process to take over surgery at Kingston Hospital on the grounds of "market conditions" should set the alarm bells ringing from Kingston to Whitehall.

    "We warned at the start that this NHS privatisation plan was a reckless gamble that could see a contractor going bust in theatres mid-way through emergency surgery and the current economic crisis has deepened that risk.

    "You cannot have a competitive tender with only one bidder in the frame - it makes a nonsense of the whole procedure. You wouldn't get work done on your house on the basis of a price from the first guy who rang the door bell, and you definitely shouldn't hand over a hospital's surgical unit on that basis. The whole botched scheme should be scrapped now, before more NHS cash is wasted."


    Monday 23rd February 2009

    Campaigners and trade unions today called for a halt to a consultation exercise which would lead to the closure of AL3 ward at the world-famous Maudsley Hospital in south London in a desperate bid to save £400,000 from the local mental health Trust's budget.

    In a detailed response to the proposals (see Hands Off Slam at, pressure group London Health Emergency and staff union UNISON warn that the closure of the ward ignores the growing pressure on mental health beds from the impact of the recession and that the loss of capacity will increase private sector referrals - potentially costing the NHS more in private fees that they hope to save.

    The closure of AL3 - a male in-patient, acute ward serving residents of Lambeth - would result in a net loss of 7 beds. Campaigners are challenging the suggestion that there is any spare capacity available in mental health services in south London which could pick up the caseload. With private sector mental health beds costing over £300 a night it is possible that the total annual cost to the NHS of the bed closures could rack up to over £750,000 a year - far more than they are planning to save.

    Staff are also warning that they are already seeing an increased demand for mental health services as a direct result of the recession. Politicians, clinicians, charities and academics are all warning that the recession will increase the rate of breakdowns and will increase the need for high quality, mental health capacity - making a nonsense of the planned bed losses at the Maudsley.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "It is clear that the planned bed losses, through the closure of AL3 ward at the Maudsley, have not been thought through and would have dire consequences for patients as the recession piles pressure on mental health services. That key factor has been totally ignored.

    "We are also warning that the closure would be a false economy. Patients will be driven to expensive private sector referrals blowing a massive hole in the financial projections. The consultation should be halted immediately."


    Sunday 15th February 2009

    In the week when Chancellor Alistair Darling is expected to announce a financial bail out for the private speculators behind the current raft of public sector PFI schemes, health campaigners have demanded a full reversal of the busted-flush of PFI and a return to direct public ownership and funding free from the instability and money-grabbing deals which have left hospitals facing bankruptcy.

    Campaign group Health Emergency hold up the example of the flagship Barts and the Royal London PFI - a scheme worth around £1 billion which will see debt servicing profits of 16% - nearly three times the assuimed figure in the Governments own tariff of Payment by Results charges. The scheme will bleed the NHS budget in East London dry for many years to come if it is allowed to run its course.

    With cash running dry for new schemes it appears that this week Darling will announce a multi-billion pound PFI bail out which will enable the private sector to resume normal profit-taking from hospital building schemes when the market improves and leaving the tax payer shouldering the whole risk of PFI from top to bottom.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "The Government have recognised that private funding of hospitals and other public works is dead in the water but instead of taking the whole raft of planned schemes back into public ownership they are offering the speculators and bankers another fat wodge of taxpayers money to prop up their profits and bonuses. That is an outrage.

    "PFI is part of the same package of reckless financial speculating, fuelled by greed, which has wrecked the UK economy. Rather than an expensive course of intensive care, funded by the taxpayer, the PFI should have the plug pulled right now in favour of the publicly-funded and publicly-owned alternative."


    Friday 13th February 2009

    NHS campaign group Health Emergency today called for the scrapping of prescription charges in England to help ease the financial pressures of the recession and to bring England into line with the rest of the UK where charges either have been, or are on the way to being, abolished.

    Prescription charges have already been scrapped in Wales and Scotland and Northern Ireland are in the process of following that lead. But in England the charge is still set at £7.10 with a limited range of exemptions for some cancer patients.

    Geoff Martin, Health Emergency Head of Campaigns, said today:

    "Rather than lumping billions of pounds of taxpayers money into the back pockets of the bankers the Government could make a real difference to household budgets by axing prescription charges in England and bringing us into line with the rest of the UK.

    " It's a gross injustice that English patients are still paying a tax on sickness when those charges have either been scrapped, or are being phased out, in the rest of the British Isles.

    "With the economic crisis hitting voters where it hurts, now is the time to raise the demand that prescription charges should be scrapped across the whole of the UK."

    Dt John Lister, LHE's Information Director, adds:

    "The really crazy thing about prescription charges is that they have most impact on low-paid workers who are most likely to be feeling the pinch economically. It deters them from accessing the care they need.

    "And they raise almost no real money for the Treasury: less than half a billion in charges collected compared with an NHS budget of £100 billion plus.

    "There is no justification for these charges, which have been scrapped in Wakes and are being scrapped in Svotland, and probably Northern Ireland"


    Thursday 5th February 2009

    Campaigners warned today that London's NHS is descending into chaos after it was revealed that Julian Nettel, Chief Executive of Barts and the Royal London, the UK's most famous hospital, has quit his post amidst rumours of severe performance and financial problems at the Trust.

    Nettel is the second high profile resignation in 48 hours, joining Tara Donnelly who quit as boss at the West Middlesex Hospital Trust in Hounslow on Tuesday after it was revealed that eight patients waited over 12 hours in A&E for a bed two weeks ago.

    Rumours are rife that the winter pressures, which have exposed the lack of emergency bed capacity in the capital and a widespread cover-up of financial performance, could see further resignations with the spotlight now turning on the management of the Strategic Health Authority, NHS London.

    Campaign group London Health Emergency have called for a suspension of the Darzi plans for London, which would see a further reduction in local critical care capacity, along with a halt to any further planned cuts and closures in services pending a full public enquiry into emergency health provision in the city.

    Geoff Martin, Health Emergency, Head of Campaigns, said:

    "The resignations of two hospital chiefs running major services in the capital within 48 hours have plunged London's NHS into chaos and all the signs are that there are more high-profile departures to come.

    "London simply doesn't have enough emergency health capacity and yet NHS London are ploughing on with proposals that would reduce local trauma and emergency care even further. Those plans should now be halted while we get to the bottom of this mess which is putting patients at risk.

    "Barts is in real trouble as a result of a botched £1 billion-pound PFI scheme which is forecast to bleed the NHS budget in the East End dry over the next few years as charges rack up to a punishing 16% of turnover – almost three times the amount covered by the NHS "Payment By Results".

    "That PFI should be scrapped and existing PFI hospitals re-nationalised before more damage is done."

    NB: London Health Emerhency has repeatedly warned that the 11% reduction in numbers of front-line acute beds in the capital in the past two years would leave hospital services struggling to cope with any peaks in demand.


    Tuesday 3rd February 2009

    Campaigners today demanded a full public investigation into the level of emergency health service provision in London, and an end to any further cuts and closures, after the Chief Executive of one of the capitals major hospitals resigned in the wake of a failure to meet acceptable standards in accident and emergency.

    A statement issued today by the Chairman of the West Middlesex University Hospital Trust has confirmed that the Chief Executive, Tara Donnelly, has resigned after eight patients waited over 12 hours in A&E for an admission on the 19th January this year in breach of the Government's targets.

    Pressure group London Health Emergency are warning that other hospital senior managers could be forced to walk as evidence from the front line suggests that breaches of waiting times have been common place since the New Year and will have been worsened by the severe weather conditions over the past two days.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "This extraordinary resignation exposes the very serious pressures that London's hospital services have been under this winter and reinforces our calls for more capacity to be put into the system. It also sets alarms bells ringing over the dangerous strategy of NHS London to reduce emergency provision when this winter has shown that our hospitals cannot cope. The situation at West Mid has collapsed into crisis management and patients and staff deserve better than that.

    "We do not for a moment think that West Mid is the only hospital where breaches on this scale have occurred and we may well be facing a cull of NHS top brass as the scale of the problem is exposed."


    Monday 2nd February 2009

    Campaigners warned today that the latest cold snap will pile pressure on front-line NHS services across the country which are still struggling to cope with a surge in winter demand and the continuing problems of the winter vomiting bug Norovirus.

    A&E staff are already reporting an increase in road traffic accidents and falls this morning as a result of the icy roads with the problem compounded by the difficulties for ambulances of getting through the snow-covered streets.

    Many staff who rely on public transport will also find it difficult to get in to work and the blanket shut-down of the buses and other transport services in London will cause chaos for health workers battling to get in to the hospitals.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "We are already picking up reports of massive pressure on emergency health services overnight and first thing this morning and the expectation is that things are set to get a lot worse. Sussex appears to be particularly hard hit at the moment.

    "With wards still closed as a result of the norovirus, the shortage of capacity at the sharp end of the NHS has been seriously exposed over the past two months and there must be a review of bed numbers to prevent this kind of winter crisis blowing up again.

    "We all owe a huge debt of gratitude to those NHS staff who have battled on to keep our hospitals and ambulance services running this morning."


    Monday 2nd February 2009

    The North West London Hospitals NHS Trust confirmed today that it is looking at cutting £32 million (10%) from its budget over the next 12 months and cannot rule out significant staffing reductions, sparking fears that the impact of the recession is spreading from the shop floor to the UK's hospital wards.

    Local papers in north west London are reporting today that up to 400 jobs could be at risk as the Trust looks to slash its budget by nearly 10% by next March.

    Campaigners are warning that other NHS Trusts are also facing large scale deficits and that we could be entering a new round of hospital job losses that may match the 20,000 posts axed in 2006/2007.

    Geoff Martin, Head of Campaigns at pressure group Health Emergency, said today:

    "The spectre of redundancy has now spread from the high street and the factory floor to the hospital wards proving that no one is immune from the savage consequences of this recession.

    "But while front line health jobs are in the firing line NHS Chief Executives have boosted their pay by 9.5% in the past year. The gravy train is still rolling for the top brass."


    Note: North West London Hospitals Trust provides services for 500,000 people in Brent and Harrow with main locations at Central Middlesex and Northwick Park Hospitals. It employs 4200 staff and has a budget of £330 million.

  • NHS London poised to push through Darzi cuts in capital's A&E services

    Tuesday 27th January 2009

    NHS London, the strategic health authority for the capital, is to discuss far-reaching plans to reshape services for major trauma and stroke patients which could lead to down-grading most of the capital's 32 Accident & Emergency departments.

    The plans, to be debated at tomorrow's Board Meeting of NHS London, would open a "consultation" on proposals for just FOUR A&E units, all of them in the inner part of London, to be designated as providers of major trauma services, and EIGHT hospitals to specialise in high-tech treatment of stroke patients.

    Favoured proposals for trauma services would see them located at King's College Hospital, Camberwell, St George's Hospital. Tooting, the Royal London Hospital in Whitechapel (London's only current trauma centre) and either St Mary's Paddington or Hampstead's Royal Free Hospital.

    This network, close to the centre of London, would leave important centres of population in the outer boroughs facing long journeys for specialist treatment: London's busy Heathrow airport would be left many congested miles from the nearest trauma service - in either St Mary's or the Royal Free, while a resident population of more than 1.5 million in the more deprived north eastern segment of London, with several of the capital's busiest A&E units, would jostle for access to the Royal London Hospital.

    The plans for stroke concede that the capital's population of 7.5 million could not be adequately served by fewer than 8 specialist stroke units: the proposals are that these be located at Charing Cross Hospital, King's College Hospital, Northwick Park (Harrow), University College Hospital, The Royal London, Queen's Hospital in Romford, Princess Royal University Hospital in Bromley and St George's .

    The document for NHS London admits that this leaves uncertainty over provision for NE London boroughs, which has not yet been resolved, but it is clear that many other parts of the capital will also feel alarmed at the long distances to often congested and extremely busy hospitals.

    Londoners are unlikely to be reassured by the news that the new consultation will again be analysed by Ipsos Mori, the company that focused on the minuscule percentage who favoured controversial plans to cut back hospital services in SE London, and which reported the wafer-thin 51% majority in favour of the Darzi proposals from the handful of responses to the previous city-wide consultation. Although that consultation showed a majority of just 3,462 responses who favoured or "tended to agree" with more specialist trauma and stroke centres, the same poll showed that people were concerned that there should be enough of them, and feeling that the transport issues needed to be addressed.

    Commenting on the NHS London plans, London Health Emergency's Information Director Dr John Lister said:

    "Nobody would object to investment in enhanced services for trauma or stroke patients. But Lord Darzi's report in 2007 made it clear that this type of enhanced provision would run alongside the effective downgrading of other A&E departments across the capital, many of which are larger and busier than those chosen in these plans.

    "Patients will be driven past lesser A&E units to the new centres. Services now provided in many units will be run down or closed.

    "The plans make little logistical sense. Looking down this list of selected centres is like reading a roll call of the most congested access routes and over-crowded hospitals in the capital. None of the boroughs with the largest populations would be close to a trauma centre: nor would any of London's airports or motorways.

    "The plans threaten a nightmare for emergency ambulance services. And with over 3.2 million patients attending A&E in London last year, and around one in six of them requiring a hospital bed, we can't afford to see a single unit downgraded.

    "And while NHS London talks of its concern for more equitable access to care, it is hard to see how the Royal Free, the second smallest A&E in the capital, located in well-heeled leafy Hampstead, with notoriously rotten road links, has managed to get on to the short list to treat patients from deprived areas in north and central London."

    LHE will continue to monitor the proposals and work with local campaigns to challenge the run-down of A&E services in the capital.



    London Health Emergency has been a source of information and comment on the capital's health care since 1983.

    The most recent figures (2007-8) show A&E attendances at London's A&E units as follows:

    2007/8 number of A&E attendances

    Queen Mary's Sidcup NHS Trust 71,802

    Royal Free Hampstead NHS Trust 73,717

    Bromley Hospitals NHS Trust 86,132

    West Middlesex University Hospital NHS Trust 87,298

    University College London Hospitals NHS Foundation Trust 91,429

    The Whittington Hospital NHS Trust 91,715

    Kingston Hospital NHS Trust 95,898

    Hammersmith Hospitals NHS Trust 98,386

    Chelsea And Westminster Hospital NHS Foundation Trust 98,648

    Queen Elizabeth Hospital NHS Trust 98,798

    Ealing Hospital NHS Trust 99,908

    Homerton University Hospital NHS Foundation Trust 107,002

    King's College Hospital NHS Foundation Trust 109,999

    Whipps Cross University Hospital NHS Trust 110,263

    St Mary's NHS Trust 110,676

    The Hillingdon Hospital NHS Trust 113,889

    Barts And The London NHS Trust 128,126

    Epsom And St Helier University Hospitals NHS Trust 130,441

    Newham University Hospital NHS Trust 134,162

    The Lewisham Hospital NHS Trust 144,613

    Mayday Healthcare NHS Trust 147,961

    Barnet And Chase Farm Hospitals NHS Trust 148,436

    St George's Healthcare NHS Trust 151,527

    North Middlesex University Hospital NHS Trust 151,702

    Guy's And St Thomas' NHS Foundation Trust 151,801

    North West London Hospitals NHS Trust 176,273

    Barking, Havering And Redbridge Hospitals NHS Trust 242,267

    Total 3,252,869


    Friday 23rd January 2009

    Campaigners today reacted angrily to news that a survey to be published later this month will show that NHS Chief Executive's pay has risen by 9.5% over the past 12 months.

    Nurses, and other members of the health care team, have been awarded 2.75% this year and hospital services across the country have been under massive pressure this winter due to a shortage of front line staff and money to open additional beds.

    Meanwhile, back in the Chief Executive offices, pay has soared to an average of £146,100 a year with various additional benefits, including up to £9,700 to lease a top of the range car, lobbed on top.

    Geoff Martin, Head of Campaigns at NHS pressure group Health Emergency, said today:

    "At a time when the country is plunging deep into recession, and nurses and other members of the health team are being told to tighten their belts, there's a pay bonanza for the bureaucrats at the top of the NHS and that's a scandal.

    "The country is sick and tired of NHS fat cats paying themselves inflation-busting salaries while the UK economy is taking its worst hammering in decades.

    "Some of these Chief Executives are getting nearly as much in car allowances as the cleaners who scrub the toilets and sluices earn in a year and that is a disgrace."

  • Controversial London hospital cuts plan to face fresh review

    Tuesday 6th January 2009

    Plans that would slash back hospital services across South East London have been referred for a full review by the Department of Health's Independent Reconfiguration Panel. The plans, misleadingly entitled "A Picture of Health" would leave the borough of Bexley with no local Accident and Emergency, maternity or children's inpatient hospital care.

    Services at Queen Mary's Hospital, Sidcup, currently a busy District General Hospital, would be reduced to skeletal level, with just minor injuries (Urgent Care Centre), a tiny 45-bed elective surgical unit, and become "a base for many community health care services".

    The hotly-contested proposals for a reduction and restructuring would impact on other outer SE London boroughs, cutting and reorganising services and piling additional pressures on Bromley's Princess Royal University Hospital, the Queen Elizabeth Hospital in Woolwich and University Hospital Lewisham.

    At a time when front line hospital beds across the capital have been cut by 11% in the last two years, and with hospitals struggling in many parts of the capital to cope with the pressures of the winter peaks of demand for emergency care, campaigners have warned that these plans, backed up by only the vaguest promises of improvements in primary and community care, are clearly irresponsible.

    The cutbacks were being driven by the massive cash deficits run up by the building of privately-financed hospitals (QEH, PRUH and Lewisham): but recent plans by NHS London mean that surpluses and a levy on Primary Care Trusts across the capital would clear these debts.

    Welcoming the decision to review a really bad plan, London Health Emergency's Information Director John Lister, who has worked with local trade unions and campaigners challenging A Picture of Health said:

    "This plan has never won any popular support or acceptance in South East London, least of all in Bexley, where the greatest damage would be done to services. The consultation exercise conducted by the Primary Care Trusts themselves revealed that as few as 3% of those responding backed the key proposals for hospital closures and centralisation of services. This is no basis to proceed.

    "We welcome the decision to review the proposals, and urge the IRP to follow the example they set with Horton Hospital in Banbury, and reject proposals which would be seriously damaging to health in South East London."


    Monday 5th January 2009

    The return of the cold weather, alongside the rise in flu cases and the continuing problems of the norovirus, has piled pressure on emergency health services with the North West Ambulance Service and the James Paget Hospital in Gorleston, East Anglia, declaring red alerts over the weekend.

    Campaigners fear that today's return to work will put more traffic out on the icy roads, and lead to more virus being spread in the workplace, with potentially dire consequences for over-stretched emergency health services.

    Hospitals in the North West have been described as "full to bursting" by officials and there is speculation that ambulance services in the West Midlands and the South West may be the next to declare red alerts.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "The period after Christmas and New Year is always heavy going for hospitals as the country gets back into gear but the return of the icy weather, along with the flu and the norovirus, is likely to pile on the pressure.

    "We know from front-line reports that services in many areas are dangerously short of capacity and are working on a knife edge.

    "In the North West, the service is paying a heavy price for the closure of Burnley's A&E department and bed reductions elsewhere have left the NHS dangerously exposed this winter."


    Tuesday 30th December 2008

    NHS watchdog Health Emergency warned today that hospitals across the UK are still under massive pressure from the combined effects of the flu, norovirus and the cold snap as they gear up for New Year's Eve - traditionally the busiest night of the year for emergency health services.

    Information from front line staff sent through to Health Emergency this morning confirms that the pressures are intense right across the country:

    "North West - facing a surge in demand with the Royal Bolton Hospital under particular pressure with four wards closed due to norovirus.

    "East Anglia - facing some of the worst pressures, with the whole region short of capacity with wards closed as a result of norovirus. Ipswich Hospital described as being "exceptionally busy."

    "South West - Royal Devon and Exeter reported as postponing non-urgent operations and with three wards closed from the norovirus. Whole region under continuing pressure.

    "South Coast - Royal Sussex in Brighton, along with other hospitals in the county, reporting exceptionally high levels of demand.

    "Hereford - Hereford County Hospital has three wards closed from the norovirus.

    "West Midlands - continuing pressure on ambulance services and A&E departments from a surge in demand.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "The period around the New Year is traditionally intense for the NHS and this year it is compounded by the continuing problems of the norovirus, the impact of the worst flu levels in a decade and the return of the cold weather. It's a poisonous cocktail of factors that have taken the NHS to the brink.

    Our local contacts are telling us that services are on a knife edge with a desperate shortage of beds as we head for the busiest night of the year. Staff are working flat out to hold the service together, and are paying a heavy price for the reduction in front line beds which have left our hospitals ill-equipped to cope with this winter's pressures."


    Tuesday 30th December 2008

    Campaigners warned today that mental health services across the UK will struggle to cope in the New Year as more people seek help as the recession, and the threat of redundancy and repossession, piles on the pressure.

    Pressure group Health Emergency, who monitor health care provision, have repeatedly warned that mental health services, particularly in London, are already struggling to cope and are desperately short of capacity. There are fears that a surge in demand, fuelled by the impact of the recession, will leave the NHS unable to cope.

    Geoff Martin, Head of Campaigns at Health Emergency, said:

    "Mental health problems are often directly related to redundancy, losing your home and relationship breakdown and the growing fears of a long, and deep, recession will undoubtedly pile more pressure on mental health services that are already struggling to cope with demand.

    "There is no excuse for the Government and the health authorities not planning for an entirely predictable increase in people seeking help and support with mental health problems.

    "If billions can be found to bail out the bankers and speculators who helped get us into this mess then there can no excuse for not expanding the support and advice services that the wider population will need to help them through the tough times ahead."


    Friday 19th December 2008

    Campaigners warned today that a poisonous cocktail of factors have combined to plunge the NHS into its worst winter crisis in a decade as another major Trust - Mid Cheshire Hospitals - closed its doors to patients after an unprecedented surge in demand.

    The Leighton Hospital site within the Mid Cheshire Trust has been dealing with over 200 patients a day - double the expected rate. As a result they have closed the doors to blue light ambulances and have admitted that they "simply do not have enough beds or space to take any more patients."

    Patients are being diverted to other hospitals.

    West Midlands Ambulance are also reporting a massive surge in demand and have been dealing with more 999 calls on a daily basis this week than they would normally expect on New Year's Eve. They have warned this morning that the volume of demand could collapse the emergency ambulance system. Their dire situation follows similar reports in the North West, South West and parts of London.

    Meanwhile, pressure group Health Emergency estimates that up to 100 wards have been closed in hospitals up and down the country as the winter vomiting bug - norovirus - creates havoc.

    Combined with the flu, the respiratory cases sparked by the cold weather and the increased accidents of the Christmas party season, campaigners are warning that New Labour is facing its worst winter crisis in the NHS since they were elected in 1997, with the prospect of worse to come this weekend.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    " I am sorry to say that it is chaos out there. Many hospitals are running dangerously short of beds and we expect a rash of further black alerts between now and the New Year as the pressure on the wards reaches breaking point. Dozens of units are on the edge of a total meltdown.

    "There is a very real fear amongst staff that things will get even worse over the Christmas and New Year period - traditionally the time of peak demand.

    "Health Emergency will be monitoring the situation right through the holiday period and we are repeating our demand to the Government to allow hospitals to overspend without fear of penalty if that helps them to get through the next couple of weeks without a complete breakdown in the service."


    Friday 5th December 2008

    Campaign group Health Emergency warned today that NHS capacity will be seriously exposed this winter as reports over the past few days point to growing pressure on hospital beds across the UK.

    Earlier this week, a leaked email revealed that every A&E department in South East Wales was full and hospital wards were unable to admit new patients with a total of five hospitals put on "the highest state of emergency pressures allocation" - commonly known as black alert.

    Meanwhile, the norovirus is causing havoc with East Anglia hardest hit and reports of ward closures and patients being left on trolleys as bed capacity ran out. One report said that there were virtually no beds available for patient admissions across East Anglia on Monday.

    Norovirus has led to ward closures and bans on visitors this week in Bournemouth, York, Coventry, Worcester, Berkshire, Wigan, Cambridge and Exeter.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "We are seriously concerned that a combination of norovirus, cold weather, the flu and general winter pressures could see dozens of hospitals declaring black alerts over the coming months as the shortage of bed capacity is exposed.

    We are calling on the government to make cash available to open emergency capacity in our hospitals this winter or run the political risk of a full-blown NHS winter crisis."


    Thursday 20th November 2008

    Government NHS reforms are forcing a number of hospitals into bankruptcy. New figures from Dr Foster show that more than a third of UK hospitals have recorded a fall in patient numbers as a result of the changes to patient referrals, with a number experiencing such a sharp drop that their viability is being questioned.

    One of the biggest losers appears to be Barnet and Chase Farm in North London where key services are already being hacked back to balance the books.

    Geoff Martin, Head of Campaigns at pressure group Health Emergency, said today:

    "We warned that competition and the introduction of market forces into the NHS would force some hospitals into bankruptcy and that's exactly what's happening.

    "Hospitals will become blighted and will find it hard to recruit key staff if they are seen as losing patient numbers and that will unleash a vicious spiral of decline.

    "We are not talking about Zoom and XL Airlines here - we are talking about local District General Hospitals dragged into insolvency.

    "The patient choice agenda means nothing if you wake up one morning to find that your nearest hospital, which you and your family have relied on for years, has been boarded up by the bailiffs."


    Tuesday 4th November 2008

    Campaigners warned today that the Government announcement allowing patients to "top up" their NHS treatment by buying drugs privately could drive a wedge into the principle of an NHS free to all, encourage NICE to delay drug approvals and force some people into bankruptcy as they borrow money to fund expensive treatments.

    Geoff Martin, Head of Campaigns at NHS pressure group Health Emergency, said:

    "We understand why people would blow their life savings to fund drugs denied them by the NHS but this policy shift is fraught with danger and could turn the clock back to the days before the NHS when your life chances were decided by your ability to pay. This cuts a swathe through the key principle of an NHS free at the point of need regardless of the ability to pay.

    "Our position is simple - if the drugs work and are safe they should be available to everyone regardless of income.

    "There is a very real danger that NICE will slow down drug approvals as a cash saving measure knowing that desperate patients and their families will plunge deep into debt to get the best medicines.

    "This takes us into the world of the American health system where patients and their families bankrupt themselves in a desperate struggle to access the best drugs and treatments."

    LHE's chief researcher Dr John Lister added:

    "This is a shameful decision by Alan Johnson that strikes a body blow at the core principles of the NHS that treatment should be based on clinical need and not on the ability to pay.

    "The costs of providing free medicines to the handfuls of desperately, often terminally ill people for whom these expensive medicines are sometimes required is insignificant in relation to the £10 billion NHS drugs bill each year.

    "But the distinction that is now being made between "affordable" illness and "expensive" illness now means that those who pay privately will get very different treatment from those who cannot pay.

    "Alan Johnson should hang his head in shame at announcing this policy just weeks after claiming to celebrate the 60th anniversary of an NHS free to all at point of use, funded from general taxation."


    Thursday 16th October 2008

    Campaigners warned today that two major London hospitals top the "at risk" list of privately financed NHS facilities that face meltdown as the impact of the global financial crisis begin to hit key public services.

    Pressure group Health Emergency have examined PFI hospitals up and down the country and have concluded that Queens Hospital in Romford and the Princess Royal University Hospital in Bromley are both teetering on the edge of financial ruin.

    The key factors turning the spotlight on Bromley and Romford are the levels of historic debt combined with the precarious financial gearing of the PFI hospital schemes.

    Both Bromley Hospitals and Barking, Havering and Redbridge Hospitals are faced with historic debt around the £90 million mark. With PFI hospitals struggling to service debt charges in the face of the chaos in the financial markets, there simply isn't enough cash in the system to prop up the Bromley and Romford PFI projects long term. The scale of the problem in Bromley is compounded by the recent external report slamming years of financial mismanagement.

    The chaos in the financial sector also throws huge doubts over the ability of planned NHS PFI projects to raise cash which could jeopardise schemes at Northwick Park in Harrow, Hillingdon Hospital and Epsom and St Helier in south London.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    " PFI in the NHS was always a speculative gamble and we believe that the chickens are now coming home to roost. If there isn't enough hard cash in the local NHS to cover the inflated overhead costs, the hospital risks going bust.

    "If the Government can bail out the city and nationalise part of the banking sector then there's no reason why they can't renationalise PFI hospitals and bring them back onto a sound financial footing."


    Wednesday 17th September 2008

    Campaigners today demanded that the Government intervene to stop the asset strippers from the shady world of private equity from taking over a huge chunk of the UK's GP and primary care services.

    City analysts have confirmed that some of the biggest beasts in the world of global private equity - including the financial basket case Merrill Lynch - are eyeing up government contracts worth a cool £1.25 billion for the running of over 250 GP and primary health care centres - with each contract underpinned with taxpayers cash.

    Geoff Martin, Head of Campaigns at pressure group Health Emergency, said:

    "It defies belief that this Labour Government would even consider knocking out your local GP services to the asset-strippers and corporate raiders from the dodgy world of private equity.

    "If Merrill Lynch are in the frame to take over primary health care services in the UK, what next? XL Airlines running the air ambulance? It's a sick joke.

    "The track record of these guys is to hit and run, to maximise their returns. Opening the door of the GP surgery to private equity is the ultimate measure of this Government's obsession with big business and just underlines why their core supporters are lining up to give them a kicking at every opportunity."


    Thursday 4th September 2008

    Campaign group London Health Emergency have slammed the decison to axe maternity and casualty services at Chase Farm Hospital in Enfield - confirmed today by Secretary of State Alan Johnson - and warned that it could open the floodgates on a new wave of hospital closures across the capital.

    The closure of services at Chase Farm means that mothers and the sick and injured will have to travel miles across north London, with appalling public transport and a clogged network of busy roads, to get the care and treatment that they need. There is a stark warning today that for some, those extra minutes on the journey, could be the difference between life and death.

    Health Emergency have raised the alarm that the Chase Farm closure decision could bring forward similar moves at a number of other London hospitals including Kings George's in Ilford, Queen Mary's in Sidcup, St Heliers in Sutton and either Northwick Park in Harrow or Central Middlesex in Brent.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    " For over a decade the community have fought the plans to close Chase Farm's frontline services and I don't expect that fight to end now just because Alan Johnson has given his approval today.

    "This decison is an insult to democracy as the views of local people in the public consultation, which overwhelmingly opposed the closure, have been completely ignored.

    "It also sends out a warning shot to those other London Hospitals which are firmly on the hit list that the time has come to up the profile of the local campaigns and to turn up the political pressure."


    Monday 1st September 2008

    Pressure group Health Emergency warned today that London is facing a looming shortage of qualified nursing staff in key areas after in emerged that £39 million was diverted from the NHS London training budget in 2007/2008 to meet a Government demand to declare a financial surplus at the end of the year.

    The full extent of the raid on the London NHS training fund - which is allocated to train professionals in all disciplines including nursing - has been exposed following a Freedom of Information battle waged by the magazine Nursing Times. Across the country a total of £165 million was diverted from training budgets in the past year.

    London Health Emergency have been receiving regular reports from the front line of the capital's health service that there is a growing crisis in staffing key areas including intensive care, paediatrics, theatres and coronary care. There have also been reports of a shortage of paramedics.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "Siphoning funds from the NHS training budgets just at the time when there is growing evidence of a serious shortage of specialist staff in key areas is scandalous mismanagement which will have severe long tem consequences for patient care.

    There's no point the Government bragging that the NHS has declared a massive surplus when a big chunk of that cash in the bank has been ripped off from funds that should have been used to train up the staff that we will need in the future. This is boom and bust economics of the very worst kind."


    Monday 1st September 2008

    An NHS Trust that was embroiled in a major row earlier this year over attempts to appoint an external adviser who presided over a deadly C Diff outbreak at Stoke Mandeville Hospital has spent a massive £1.67 million on management consultants in the past year.

    Figures obtained by pressure group Health Emergency under Freedom of Information show that spending on external management consultants at the Epsom and St Helier NHS Trust has rocketed by more than a million pounds over the past two years from £611,000 in 2006 to £1,670,000 in 2008.

    As well as the aborted attempt to appoint Ruth Harrison as an adviser - the senior manager at Stoke Mandeville when 33 people died from a C Diff outbreak and the sister-in-law of the current Epsom and St Helier Chief Executive - Epsom and St Helier was caught up in another row last year when consultants recommended removing one in three lightbulbs to save cash.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "At the same time as Epsom and St Helier was axing staff posts on the wards and slashing bed numbers to claw back a £24 million deficit they were spending money on an army of advisers and bureaucrats like it was going out of fashion.

    It's a scandal that spending on management consultants has almost trebled over just two years. While nurses and other staff have been told that they need to tighten their belts there's been a cash bonanza for the private consultancy industry."


    Friday 4th July 2008

    A special 16-page edition of Health Emergency newspaper is published today, celebrating the 60th anniversary of the NHS - and warning of the dangers in many of the government's so-called "reforms".

    Published just before this week's Darzi Report, Health Emergency highlights the doctor/minister's contradictory proposals, the break-neck race by some Primary Care Trusts to implement some of his less popular policies, the drive towards increased links at every level of the NHS with the private sector, and recent reports which question the effectiveness of key "reforms" since 2000.

    A whole page feature argues the strength and value of the NHS despite these current policies - and the newspaper focuses on campaigning issues, celebrating as it does the 25th anniversary of London Health Emergency as a pressure group to defend the NHS against cutbacks and privatisation.

    9,000 copies of the newspaper are being distributed up and down England, Wales and Scotland, mainly through trade union branches and local campaign groups which remain affiliated to the longest running campaign of its type.

    Health Emergency editor and LHE's Information Director Dr John Lister said:

    "We have a lot to defend in our NHS - and a lot to lose if ministers persist in unpopular and expensive policies that promote the for-profit private sector in place of well-loved public services. That's why our campaign is still running 25 years after we first challenged Maggie Thatcher's cuts.

    "We want people to be celebrating our NHS and its core values in 10, 20 and another 60 years. For that we need a change of line by ministers, to spend the increased resources to meet patient need, not private greed. We want to keep our NHS public."


    Tuesday 3rd June 2008

    Health campaigners tonight slammed plans due to be unveiled by the Government tomorrow which will see private companies like BUPA and American giants United Heathcare take over the running of entire NHS hospitals.

    This evening, Health Minister Ben Bradshaw admitted that the Government was looking to sell "franchises" in NHS hospitals similar to the selling of franchises for Kentucky Fried Chicken.

    Campaigners have set out to nail the lie that private companies have been a success in the NHS, pointing out that:

    * Privatisation destroyed cleaning standards in the NHS paving the way for MRSA and C Diff to get a deadly grip on the wards.

    * Private companies involved in NHS PFI schemes have ripped off the taxpayer to the tune of billions

    * Privately run Independent Sector Treatment Centres have been a disaster with the taxpayer paying for operations never carried out.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "The Government's suicide mission to alienate core supporters takes another leap with this effort to privatise the NHS on a scale that even Maggie Thatcher would have balked at.

    The big American health corporations will be scenting blood and the opportunity to make a killing on the UK's NHS hospital wards.

    There will one almighty row about this, that's for sure."


    Tuesday 27th May 2008

    Pressure group Health Emergency today backed calls from the Sainsbury Centre for Mental Health for major improvements to mental health services within the prison system.

    A Sainsbury Centre report issued today has identified significant variations in the funding of prison inreach teams and calls for the trebling of average prison mental health staff from four to twelve.

    Health Emergency have warned that the quality of mental health services in prison is being compromised by massive pressure on local Primary Care Trust budgets.

    Geoff Martin, Health Emergency Head of Campaigns, who also works with Billy Bragg on the Jail Guitar Doors project which put guitars into prisons in memory of Joe Strummer, said:

    "Both prison officers and prisoners have told me that complex mental health problems are a massive issue in our jails and a failure to grasp the scale of the challenge is putting huge pressure on the prison system.

    We welcome the Sainsbury Centre report and we hope that it sparks off a proper debate about how we tackle the growing mental health crisis in our prisons."


    Wednesday 14th May 2008

    The Healthcare Commission survey on patient satisfaction, published today, shows that the bottom five hospitals in the country are all in London and that 13 out of the bottom 21 units nationwide are all in the capital city.

    The hospital trusts in the five relegation places in this latest league table are:

    North Middlesex in Haringey

    Barking, Havering and Redbridge

    Mayday in Croydon

    The Homerton in Hackney - a Foundation Trust

    Ealing Hospital

    Pressure group London Health Emergency blamed the poor performance of hospitals in the capital on massive financial pressures, a shortage of key staff, a lack of beds and a wholesale failure by NHS London, the strategic health authority, to provide serious leadership and co-ordination in the city.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "For too long senior hospital managers and the bosses at NHS London have been wasting time and money on grandiose plans and have failed miserably to deliver on key issues for patients like mixed sex words, hospital food and cleaning and infection control. Those failures have now come home to roost in this damning patient survey."


    Wednesday 14th May 2008

    Ministers were forced onto the defensive over maternity and accident and emergency closures this morning after Health Minister Lord Darzi admitted on the Today Programme that no services will be closed or re-organised without the support of local people and NHS staff.

    The concession comes as Lord Darzi publishes his guidance on the strategic review of NHS services across the country.

    The Ministers comments have been seized on by health campaigners who have promised to jack up local campaigns where unpopular closures of key services are still on the agenda.

    Geoff Martin, Head of Campaigns at national NHS pressure group Health Emergency, said:

    "Lord Darzi has this morning given a clear commitment that no changes to key local services will be bundled through without the support of staff and the public. We will today be issuing an urgent call to all the local campaigns fighting maternity and accident and emergency closures and downgrades to get back out on the streets and to hold the Government to their word.

    "The Minister has given a shot in the arm to local health campaigns the length and breadth of the country."


    Wednesday 14th May 2008

    NHS campaign group Health Emergency warned today that key areas on health policy had been eroding the Government's support amongst NHS staff and patients long before the hammer blow of the local election results on May 1.

    Health Emergency have identified a raft of issues that Gordon Brown and his government urgently need to address if they are to rebuild trust amongst their key supporters in the NHS:

    * An end to the expensive and inefficient obsession with the use of the private sector in the NHS. The scrapping of plans to hand over GP services to the giant American healthcare corporations and a return to direct public procurement of hospital building free from the multi-billion pound rip-off of the Private Finance Initiative (PFI).

    * Suspension of plans to close dozens of Accident and Emergency Deaprtments and Maternity Units across the country. An end to bogus consultations and development of a genuine consensus on the future patterns of local services engaging staff and patients.

    * An end to the "target culture" - driven by expensive external management consultants - and a recognition that top-down management has failed and has seriously damaged staff morale on the wards.

    * A period of stability - allowing staff to get on with doing their job free from the "permanent revolution" of re-organisation and cash-driven cuts to jobs and services.

    * Refocussing energy and resources on the issues that really matter - hygiene and infection control, hospital food, single-sex wards, long-term workforce planning and building enough capacity to deal with peaks in demand.

    Health Emergency are holding urgent talks with Health Minister Lord Darzi next month to set out their vision for the future of the NHS.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "Labour's reputation amongst its core supporters in the NHS had taken a battering long before the local elections and there is no doubt that in many areas voters used the threat to their local hospital services as a stick to beat the Government with.

    "Next month we will be telling Lord Darzi in blunt terms that if the Government want to rebuild their reputation on the NHS they have to act sharply or they will be on the fast train to oblivion."

  • New book marks NHS 60th birthday

    Wednesday 14th May 2008

    Gordon Brown's government's controversial reforms to the National Health Service are creating a new regime of "surplus centred care," warns a new book to mark the 60th anniversary of the NHS, published today.

    Its author, veteran health campaigner John Lister, argues that more harmful and far-reaching changes have been made to the NHS in the last seven years than in the previous 53.

    As Information Director of London Health Emergency since 1984, Lister has been at the centre of debate on NHS policies for more than a third of the six decades of the NHS, and his new book The NHS after 60: For patients or profits? (Middlesex University Press) argues that New Labour's so-called "reforms" have actually made things worse by increasing costs and bureaucracy and undermining morale of health workers and professionals.

    These policies have been forced through by Blair - and now Brown - in the absence of any evidence that they can improve efficiency or effectiveness, and despite evidence that they can reduce equity in access to services.

    John Lister says:

    "The new system of "payment by results", increasingly fierce competition between NHS and Foundation Trusts, the involvement of Independent Sector Treatment Centres, the "commissioning" of services with ever greater involvement of private sector consultants and corporations, and now the drive towards private provision of primary care are all undermining the inherent strengths of the system set up by Labour's Aneurin Bevan in 1948, and pushing even public sector providers to focus on finance-driven targets, contracts and cash surpluses rather than on patient care.

    "Ministers know their policies don't reflect the views or wishes of NHS patients or the general public: tens of thousands have rallied in protests and campaigns to save local services from closure threats, while there is little if any popular support for government policies."

    Lister's book argues that "another NHS is possible" and calls for costly private sector management consultants to be "released into the community", and a fresh start to build on the undoubted strengths that remain in the NHS.

    This extensive, detailed, fully referenced 340-page study of the developing crisis in our most popular public service offers food for thought to managers, politicians, health workers and campaigners alike.

    NB: The NHS After 60: For patients or profits? was published on April 28 by Middlesex University Press at £25. Discount copies available via


    Sunday 30th March 2008

    With the national deep clean of all NHS hospitals due to conclude tomorrow (Monday), health campaigners have warned that there are serious inconsistencies in the programme and that some hospitals may only have scratched the surface of the hygiene problem.

    At the Labour Party conference last October, Prime Minister Gordon Brown promised that all NHS hospitals would complete a deep clean by the end of March this year.

    Health Emergency understand that there are major variations in the level of deep clean that has actually taken place across the country and that many hospitals have been physically unable to decant ward areas and steam clean and fog them as happens in France and other parts of Europe when they are looking to eradicate MRSA and C Diff.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "We understand that many hospitals, because of the sheer pressure on beds, have been unable to decant patient areas and deep clean them properly.

    "Instead they have had a bit of a spring clean around the beds and that is not what we were promised.

    "Deep cleaning a hospital environment means decanting patients to another ward, sealing the area and fogging it with a deep cleaning agent that kills off the superbugs wherever they are located.

    "We fear that financial pressures and demand for beds has meant that in many areas the deep clean has been a cursory exercise, ticking boxes rather than doing the job required."


    Wednesday 19th March 2008

    Pressure group London Health Emergency warned today that the full scale of the Capital's NHS financial crisis has been hidden from public view and is likely to blow open as we head towards the end of the current financial year with dire consequences for patient care.

    The warning comes after a hidden financial deficit at the Brent Primary Care Trust of £25 million was blown open following an independent investigation. Measures to claw back the debt have resulted in major cuts to frontline services for children and older people.

    LHE are warning that Brent is not the only area where health chiefs have attempted to play down the scale of their debt and have called on auditors to launch similar investigations into parts of South West London, outer North East London, the whole of South East London and outer West London.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "We have repeatedly warned that the rosy financial picture painted by London's health chiefs is at odds with the harsh reality on the ground where multi-million pound deficits and the constant threat of real cuts in services are still the order of the day.

    "We have also warned that the financial crisis facing London's NHS would wreck any plans to re-organise and modernise services which might come out of the Darzi review into London's health services.

    "In South East London alone the accumulated debt is well north of £100 million and rising and harsh cuts are on the agenda. Londoners are right to demand to know the real picture on health service finance in the capital."


    Sunday 2nd March 2008

    The Chief Executive at the centre of the C Diff outbreak at Stoke Mandeville Hospital in 2006, in which 33 people died, is back working in the NHS as a management consultant on a short term contract worth £52,000 to draw up plans to close the maternity and childrens services at Epsom Hospital in Surrey.

    Ruth Harrison was the senior manager at Stoke Mandeville at the time of the C Diff scandal. She left her £130,000 post in 2006 with a £140,000 payoff just before the publication of a damning Healthcare Commission report which condemned her trust for compromising "the safety of patients by failing to make the right decisions" and which slammed "failings on the part of the leadership at the trust".

    Geoff Martin, Health Emergency Head of Campaigns and a leading figure in the campaign to save Epsom Hospital, said:

    "Failed top brass in the NHS are on a jobs merry-go-round at taxpayers expense where they can jump from one highly paid post to the next reagrdless of the wreckage they have left behind. It's a disgrace.

    "We are demanding that Epsom Hospital halt the plans to bring in Ruth Harrison to draw up the closure plans for services at Epsom. This is a shoddy and ill-conceived decision which must be reversed."


    Sunday 17th February 2008

    Campaign group Health Emergency warned today that Londoners are sleepwalking into the most major changes to the Capital's health services in a generation.

    The Darzi proposals for reconfiguration of London's NHS are currently out to public consulation. With the consultation period ending in three weeks, and with £15 million spent on the exercise, campaigners are warning that it has hardly registered on the radar of the vast majority of the London public.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "It defies belief that the biggest package of changes to London's NHS in decades has failed to grab the attention of the public and makes you wonder where the £15 million on this exercise has been spent.

    "We know that Londoners care deeply about their health care services but most of them have no idea that this massive reform plan is up for debate.

    "We are sounding the alarm bells to Londoners to have their say now before time runs out. There are rumours that only a few hundred have responded so far, and that would totally discredit the Darzi plans."


    Sunday 17th February 2008

    Campaigners today called for a full public inquiry into the management of the privately-financed Princess Royal Hospital in Bromley after it was revealed today that a patient was left with a swab inside her after a Caesarean just weeks after hygiene standards at the hospital had been slammed by the Health Commission.

    Bromley Hospitals Trust, which runs the Princess Royal, has the highest deficit of any NHS Trust in the country of just short of £100 million. Much of the debt has been accumulated through the charges resulting from the PFI scheme at the Princess Royal.

    Geoff Martin, Health Emergency Head of Campaigns, said;

    "There is now an overwhelming case for a full public inquiry into the management of the Princess Royal, we're not prepared to be fobbed off with an internal investigation.

    There is clearly something wrong at this hospital and our suspicion is that corners are being cut with the quality of patient care in order to claw back the £100 million deficit and to pay off the private finance charges."


    Friday 18th January 2008

    Campaigners today blasted the current consultation over the long term future of NHS services in London as "an expensive shambles which is failing miserably to engage Londoners in a proper debate over the future of health care services in the capital."

    NHS London embarked on a public consultation over the future of London's NHS - known as the Darzi Review and drawn up by government-minister Lord Darzi - at the back end of last year and the consultation is due to conclude in early March. £15 million of taxpayers money has been thrown at the consultation exercise which campaigners say has completely failed to engage Londoners despite the high level of public interest in the future of the NHS.

    Geoff Martin, London Health Emergency Head of Campaigns, said:

    "The public consultation over the Darzi review of London's NHS has been a total failure. Despite chucking £15 million at private companies and pollsters to conduct this exercise it has failed to hit the radar and most Londoners have no idea it's going on.

    "The £15 million being spent on this glorious failure to engage Londoners in a debate about an issue that's close to their hearts, the future of the NHS, would have been far better spent on taking some of the pressure off patient care budgets. It would have injected nearly half a million pounds into each of London's 31 Primary Care Trusts - easing the pressure on front-line services."


    Monday 7th January 2008

    Campaigners claimed today that the combined winter pressures of the norovirus and flu have seriously exposed the shortage of bed capacity and have thrown Gorden Brown's pledge to deep clean every hospital from top to bottom by the end of March into chaos.

    Campaign group Health Emergency have kept a running total of bed lost and staff cuts in the NHS over the past eighteen months. Over that period nearly 3000 front line bed losses have been announced with the latest coming on Friday in Cumbria where 144 beds at the West Cumbria Hospital in Whitehaven have been lined up for closure.

    At the Labour Conference last year Gordon Brown announced that every hospital in the country would be deep cleaned from top to bottom by the end of March. Logistically that would mean decanting patients from one area to another but campaigners now say that the pressure on dwindling bed capacity from norovirus and flu make it impossible to deliver in many areas.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    " We are calling on the Government to take emergency measures to allow hospitals under serious pressure to re-open closed beds without the fear of financial penalty just to get through the next few weeks.

    "It's impossible to see how the deep-clean targets to tackle MRSA and CDiff can be met by the end of March with the level of demand and the widespread ward closures currently hitting the NHS across the UK."


    Wednesday 2nd January 2008

    Campaigners warned today that cash-driven moves to push responsibility for a range of home-based procedures onto patients would raise serious safety issues and could destroy what is left of the district nursing service.

    District nurses have been heavily hit by localised NHS cuts in recent years - despite the Government's stated policy of providing more personalised care in the home. A drive to force patients to manage their own blood pressure, pain control and a range of other procedures would open to the door to an all-out assault on district and community nursing budgets.

    Campaign group Health Emergency are forecasting that 2008 will be a year of heavy pressure on health budgets as growth money dries up while demand continues to rise.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "The move towards DIY NHS care in the home is a straw in the wind. We expect 2008 to be a year of heavy pressure on health budgets and we will see more cash-led cuts to services as the months roll on.

    " If the Government really want to save money they could start by pulling back from the costly fiasco of the Private Finance Initiative, cutting the billions wasted on management consultants and external advisers and ending the re-organisation mania that has led to an explosion in NHS bureaucracy."


    Monday 31st December 2007

    Campaigners today announced the winners of the Meanest Hospital in Britain title for 2007 with the award going to the Epsom and St Helier NHS Trust in South London.

    Epsom and St Helier landed the title for repeated acts of stinginess throughout the year but their winning effort came from the decision to remove one in three lightbulbs back in February 2007. The Trust also scrapped hot meals for patients at lunchtime, asked staff to do their own cleaning in some areas and attempted to ban the issuing of pyjamas and nighties. Epsom and St Helier also boasts one of the highest hourly rates for car parking in the country.

    Epsom and St Helier had to beat off stiff competition and the runners up this year are the Maidstone and Tunbridge Wells Trust. Maidstone was plunged into the worst NHS scandal in many years back in October when a report revealed that 90 patients had died from a C Diff outbreak. The Trust was caught out trying to smuggle Chief Executive Rose Gibb out through the back door with a massive pay off - a move later blocked by the Government.

    However, only a few months earlier Rose Gibb had asked nurses and other staff to come in and work for free on their days off and to give up their annual leave to help the hospital managers balance the books. Just a few days after issuing the memo Gibb departed on a family holiday to Lanzarote.

    Other contenders in this years Meanest Hospital award were:

    * Royal Hampshire County Hospital - fingered in a major report on food hygiene standards and put on special measures with six-monthly inspections.

    * Southampton University Hospital - top of the league for hospital car parking profiteering with an annual take of £2.414 million followed closely by Cambridge University Hospitals at £2.263 million.

    * Derby Hospitals NHS Trust - planning to downgrade and cut the wages of 100 nurses and 70 health care assistants as part of a "re-organisation".

    * The Department of Health and the Government - a special mention for their efforts to "stage" the NHS pay award this year to squeeze a few extra quid out of the pay packets of nurses and the rest of the health care team.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "Millions of pounds is being wasted in the NHS on bureaucrats and management consultants who charge us a fortune to come up with barmy, penny piching measures like removing light bulbs and asking nurses to work for nothing. Front line care and basic standards are compromised while the men in suits with their clipboards patrol the wards cooking up dangerous, cash-saving scams.

    "Health Emergency will continue to shine a light into the murky corners on NHS finance and management throughout 2008 and any Trust which thinks that they can get away with hacking away at the fabric of the National Health Service would be wise to think again."


    Monday 24th December 2007

    With the news that local health agencies have effectively lost the medical records of 168,000 people, campaign group Health Emergency warned today that pressure to cut costs is forcing NHS Trusts to axe medical secretary jobs and send the most personal of information overseas to private agencies for processing - adding a global dimension to the security risk.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "It's a shocking failure of very senior management in the NHS that 168,000 patient records can simply disappear. It confirms our suspicion that time that should be spent on basic management is instead being wasted on permanent re-organisation of services, responding to central diktat and eyeing up grandiose private schemes. It's the same poisonous cocktail that led to over 90 deaths at Maidstone and Tunbridge Wells.

    We are deeply concerned that the pressure on budgets is forcing Trusts to axe medical secretaries - a vital cog in the NHS machine - and outsource their highly-sensitive work overseas to save cash. That creates a security nightmare and patients are right to be worried about just who is gaining access to their personal details."


    Thursday 29th November 2007

    Campaigners warned today that the Darzi plan for the future of health services in London, due to be released for public consultation tomorrow, is in danger of degenerating into nothing more than a smokescreen for another wave of hospital closures, service cuts and privatisation of key facilities.

    The consultation document has been gutted of any specific recommendations on local service changes but it is crystal clear that the thrust is to reduce the number of district general hospitals in London and that the whole package is overshadowed by a massive financial crisis at the sharp end of the capital's NHS which has been deliberately covered-up in official statistics.

    London Health Emergency pointed to the example of new figures issued today which claim that the NHS in London has a surplus of £300 million but which ignores historical levels of debt. For example, todays statistics claim that Bromley only has a deficit of £9 million when the true figure is £99 million. The same bogus figures have been applied across the city.

    Dr John Lister, London Health Emergency Information Director, said:

    "Rather than the serious attempt to address the health inequalities in London which we hoped for, debate over aspects of the Darzi report looks like degenerating into an expensive smokescreen for a fresh wave of cuts and closures which would be an absolute disaster for staff and patients in the capital.

    "We are also alarmed that Lord Darzi, who since his initial report been elevated to a straight political position as a Minister in the New Labour Government, has been having top level meetings with American private health giants like United Health.

    "£15 million is being spent on this consulation which is being run through pollsters Ipsos Mori and we fear that the real views of Londoners will be engineered out of the picture giving the management consultants and bureaucrats a clear run to target hospitals for cuts and closures.

    "Along with the patient forums and staff, we will be fighting to make sure that the real views of Londoners on the future shape of services that we really need are heard loud and clear."


    Friday 23rd November 2007

    The winter vomiting bug, norovirus, has forced the West Suffolk Hospital in Bury St Edmunds to declare a "black alert" and close it's doors to patients with wards at other affected hospitals being closed down up and down the country.

    Although the Government provide no proper tracking of norovirus, pressure group Health Emergency revealed today that a number of key hospitals have been hit hard in the past couple of days:

    * West Suffolk Hospital, Bury St Edmunds - declared a black alert last night, the highest form of crisis, and has been turning away ambulances.

    * Bradford Royal Infirmary - has closed four wards as norovirus gets a grip

    * Hinchingbrooke Hospital in Huntingdon - six wards closed

    Geoff Martin , Head of Campaigns at Health Emergency, said:

    "We warned that the bed and staffing cuts forced through over the last 18 months have left the NHS dangerously short of capacity. Our fears of a meltdown as the winter pressures build up over the next few months appear to be coming true as the norovirus gets a grip on the wards."


    Wednesday 21st November 2007

    Senior NHS bureaucrats from across London will gather today to rubber stamp proposals that will lead to a massive shake up of health care services across the Capital.

    Top brass from all of the London Primary Care Trusts will meet this afternoon to endorse the finalised version of the London Darzi Review which will then go out to formal public consultation at the end of next week.

    The Darzi London plans have been overshadowed in recent weeks by growing evdidence that the extent of the cash crisis facing London's hospitals was deliberately covered up in the run up to the phoney election.

    The latest example is Bromley where a combination of historical debt and the punishing costs of an expensive PFI development have plunged the local NHS nearly £100 million into the red with massive cuts in the pipeline. A similar picture has emerged across the rest of South East London, where cumulative debts were estimated at £180m in July.

    Meanwhile, in West London tens of million of debt has been racked up and is dominating discussions of the new five borough PCT consortium covering the area.

    In Kingston the PCT, one of the smallest in London, is pushing through nearly £10 million of cuts, including axing a ward for Alzheimers patients.

    Geoff Martin, London Health Emergency Head of Campaigns, said:

    "In the run up to the phoney election NHS London was telling us that the capital's health service had balanced the books. Those figures have now turned out to be wholly bogus and it is clear that massive cuts are in the pipeline right across the City.

    "We always warned that Darzi could degenerate into just another mechanism for bundling through cuts and closures rather than the modern, strategic approach to tackling health inequalities that we favour. Our worst fears appear to be coming true.

    "We are also alarmed that the consultation process is going to be controlled by spin doctors, pollsters and focus groups rather than seriously reaching out to Londoners. We will be making sure that the voice from the streets and from the wards is heard loud and clear."

  • Darzi Plan a “Trojan Horse for privatisation”

    Monday 19th November 2007

    NHS London has today been publicly challenged by pressure group London Health Emergency to give a guarantee to Londoners that the controversial Darzi Plan for reorganising health care in the capital is not simply a means to smuggle through a massive new privatisation of GP and hospital services.

    A consultation based loosely on Lord Darzi’s July document A Framework for Action is due to launch on November 30 and run until mid March 2008. NHS London, the Strategic Health Authority covering the capital’s 7.5 million population, has agreed to spend £15 million on consultation and implementation of Darzi’s proposals which include a wholesale reorganisation of hospital services and the establishment of a network of “Polyclinics” at a cost of £3.1 billion.

    LHE’s challenge came after a the publication of Lord Darzi’s interim report on the NHS in England early last month specifically endorsed the use of private sector providers for GP services and providinbg large-scale GP premises as well as and elective hospital treatment, and series of further revelations linking Lord Darzi and his proposals with the private sector:

    Kingston Hospital is pressing ahead with plans to hand over its entire elective surgical operation to the private sector, arguing that this policy is in line with the Darzi proposals. NHS London has not officially denied the claim, or intervened to prevent this new escalation of privatisation in the NHS.

    One the senior US managers of UnitedHealth, the biggest and most profitable of the US health insurers, is Simon Stevens, a former health advisor to Tony Blair – who told the Observer on November 11 he had met Lord Darzi, who was ‘one of his big admirers’. UnitedHealth has been included on a list of 14 corporations approved by ministers to bid for contracts advising Primary Care Trusts on how to spend £75 billion a year in “commissioning” services.

    Heart of Birmingham Primary Care Trust has drawn up a “bold and ambitious” plan to franchise its primary care services to companies including Virgin, Asda and Tesco. These proposals turn out to follow meetings between Lord Darzi and retail chains aimed at forging a new provider role in primary care.

    Challenged repeatedly from the platform of a BMA conference on the Darzi report in London on October 25 to promise Londoners that no plans for privatisation would flow out of the Darzi consultation, leading representatives of NHS London refused to respond.

    LHE’s Information Director John Lister, author of a detailed response to the Darzi Report, said:

    “All the signs so far point in one direction. It is beginning to look as if the positive and progressive proposals in Darzi’s London report are simply a smokescreen for an agenda of service cuts and privatisation.

    “The report is effectively a Trojan Horse, drawing the public into a false and irrelevant discussion on various issues of genuine concern – while behind the scenes the plans for a new wave of privatisation and for the axing of local hospital services take shape.

    “If NHS London really wants a consultation and a debate on Darzi to be taken seriously they must give an assurance now to the people of London that they are not being treated like idiots.

    "That means announcing a moratorium on cuts, a halt to the privatisation in Kingston, and a commitment that the Darzi plan will not lead to privatisation of primary and elective services.”


    Thursday 8th November 2007

    Campaigners warned today that the companies exposed in the new Michael Moore movie Sicko are being lined up to take over the NHS's newest surgical centre.

    Just two weeks ago Health Secretary Alan Johnson opened the brand new surgical centre at Kingston Hospital in South West London. But pressure group Health Emergency can reveal today that managers at the Kingston Hospital Trust are finalising highly secretive plans that could see one of the big US private health corporations fingered in the movie Sicko taking over the management of the new centre.

    The move by Kingston Hospital would be an unprecedented experiment in privatisation and would take the use of private companies deeper into the heart of the NHS than ever before.

    The Trust management are refusing to name the preferred companies on the grounds of "commercial confidentiality" but campaigners are warning that at least one of the US giants is likely to be in the frame.

    Geoff Martin, Health Emergency Head of Campaigns, said on November 7:

    "The Government are sitting back while hospital chiefs are working up plans that could bring the nightmare of Sicko right into the heart of our NHS.

    "Anyone who thought that the brakes had been slammed on to NHS privatisation should take a long hard look at what's going on behind closed doors at Kingston Hospital in south London today.

    "These faceless NHS bureaucrats should be stopped in their tracks before they wreck what's left of the NHS with their profit driven schemes."

  • Reinstate Karen Reissmann!
    Sacking of UNISON activist diverts from chronic Trust failure

    Tuesday 6th November 2007

    London Health Emergency has condemned the decision by management of Manchester Mental Health and Social Care Trust to sack UNISON health activist Karen Reissmann, and urged support for the strike action to be waged in her defence.

    Karen was finally dismissed yesterday (November 5) after a protracted six day disciplinary hearing, on a trumped up charge of bringing the Manchester Mental Health and Social Care Trust into disrepute.

    Karen, who is chair of UNISON's Manchester Community & Mental Health Branch, was suspended 4 months ago, and her colleagues believe she is being victimised for her trade union activity. 700 UNISON members in mental heath have already taken 11 days strike action in her defence.

    UNISON had already decided that if the decision went this way 160 members working in community mental health teams and crisis resolution services would begin all-out strike action from Thursday November 8, demanding her reinstatement.

    Karen, a community psychiatric nurse, based at North Manchester General Hospital, was suspended in June after she was quoted in a Manchester-based magazine called Enterprising, criticising the government policy of transferring some health services to the voluntary sector.

    The Trust's decision to press ahead with the sacking amounts to a frontal challenge to trade union organization and the right of trade unionists to speak out against the government's policies of privatization and fragmenting the NHS.

    The victimisation of a leading and outspoken union member also serves to divert attention from those who have genuinely brought the Trust into disrepute: the managers themselves through years of incompetence that have reduced the Trust to 173rd out of a league table of 175 mental health Trusts.

    Beds have been axed, resulting in bed occupancy rates currently standing at over 120%. Meanwhile the Trust is paying out four times the normal NHS rate to lease beds in the PFI-funded Wythenshawe hospital.

    Changes in community and mental health teams, implemented despite warnings from staff and trade unions that they would not work, have left patients without vital key workers and held up the establishment of crisis response teams.

    Respite services and an elderly care ward have been closed as the Trust struggles with a chronic financial crisis, with another £5m cuts this year, while its record on human resources management has been a disaster.

    Supporting UNISON's continuing campaign to reinstate Karen Reissmann, Dr John Lister of Health Emergency said:

    "This Trust management has brought itself and its services into disrepute after years of cuts, policy blunders, under-resourcing and downright incompetence.

    "Karen Reissmann has stood up for patients and for quality mental health care, while these managers have shown little concern for either.

    "It is vital that the pressure is stepped up to secure Karen's reinstatement: what patients and staff in Manchester need to restore confidence in mental health care is a regime change at the top of the Trust."

    The branch will need funds to support the ongoing strike action: rush donations payable to Manchester Community and Mental Health UNISON to the union office, Manchester Community and Mental Health UNISON, Chorlton House, 70 Manchester Road, Manchester M21 9UN.

    Invite a speaker to your next meeting: contact the Branch on 07972 120451


    Friday 2nd November 2007

    Campaigners today claimed a major victory after a key NHS Trust was forced to scrap plans to close a maternity unit. At a Board meeting today, the Epsom and St Helier NHS Trust will confirm that a planned consultation on the closure of the maternity unit and childrens services at Epsom Hospital in Surrey, due to start this month, has been abandoned and that the issue will not be reconsidered until next summer.

    Unions and campaigners have been fighting the downgrading of services at Epsom and last year put 5000 people on the streets of the town in opposition to the axing of the busy maternity unit.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "Anyone who thought that public protests achieved nothing should take a look at the success of the campaign at Epsom Hospital. We have forced the NHS Trust into retreat through the sheer power of our arguments and the weight of our numbers. This will be a shot in the arm for NHS campaigners everywhere and comes on the eve of the big London demonstration in support of the health service.

    "We know that we may have to be ready to fight again next summer but no one should underestimate the scale of this victory."


    Friday 2nd November 2007

    On the eve of the national trade union demonstration in defence of the NHS, health campaigners have sent out a blunt warning to the public that the same private American health companies fingered in Michael Moore's new movie Sicko are being lined up by the New Labour Government to plunder the assets of the NHS.

    Last month the Government unveiled a list of 14 approved companies who will be given the green light to take over the commissioning of local health services. The list includes American giants like United Heath, Humana, Aetna and Health Dialog Services.

    United Health feature heavily in Sicko and is the biggest beast in the US health jungle with a turnover of nearly $12 billion. They are run solely for profit and their Chief Executive William McGuire pulled in a salary of $124 million in 2004.

    The company have regularly appeared in court and in recent years have been fined millions of dollars for cheating patients, inflating prices and delaying payments. They have whole teams of staff dedicated to denying patients care. In the UK, United's operation is headed up by former Blair policy adviser Simon Stevens.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "If anyone wants to know where UK health services could end up in ten years time if New Labour ploughs on with its plans to swing in the big US health corporations they should take a look at Sicko. That is what's at stake and that is why we have to step up our defence of the core principles of the NHS. If we don't, we will wake up one morning to find ourselves in the middle of the living healthcare nightmare which is Sicko.

    Nye Bevan, the founder of the NHS, must be spinning in his grave at the idea that a Labour Government would open the door to the worst of the scum ever spewed out by the privatised US health system."


    Friday 2nd November 2007

    Campaigners warned today that health planners are moving to axe key services in areas of the country facing some of the biggest demands from the growth in population.

    Pressure group Health Emergency have identified three areas of London and the Home Counties where hospital closure plans are rolling on despite all the evidence that there will be increasing demand from population growth:

    * Hertfordshire - despite a conservative estimate of population growth of 10% health chiefs are pressing on with plans to axe 20% of beds and key front line services at two hospitals in Hemel Hemptead and Welwyn Garden City.

    * East London - a cosmopolitan part of the City long associated with influxes of migrant workers. Health authorities planning to close the accident and emrgency and maternity departments at the busy King George's Hospital in Ilford.

    * South East London. Another area of major population growth. Cash-led plans have been leaked to close front line services at Queen Mary's Hospital in Sidcup.

    Health Emergency also point to other examples of similar cuts plans that ignore demographic reality on the south coast, in the North West and in Kent.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "Health planners up and down the country are ignoring the demographic realities of population growth and are pressing on with closure plans that will leave many areas unable to cope with demand. In some areas it could lead to a total collapse of key health care infrastructure.

    The NHS has been a beneficiary from migrant labour for well over 50 years and continues to benefit from the new waves of overseas staff. It is extraordinary that health care bureaucrats are unable or unwilling to take note of the population changes that are staring them in the face."


    Monday 15th October 2007

    The hospital at the centre of last week's C Diff scandal spent £3.5 million on external management advisers - at the same time as key ward posts were left vacant - one of the main factors contributing to the deaths of 90 patients.

    While the Maidstone and Tunbridge Wells NHS Trust was grappling with a £17 million deficit, and axing 300 staff posts and freezing vacancies across the hospital sites, the Board of Directors, led by Rose Gibb, were signing off contracts for external management advisers worth £3.5 million.

    Pressure group Health Emergency today demanded that the police and HSE investigations into Maidstone and Tunbridge Wells be widened to include the awarding of contracts to external companies.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "Maidstone and Tunbridge Wells NHS Trust has been one of the biggest spenders on external management consultants and we are demanding to know why, at a time when the Trust was desperately short of staff on the wards, millions was being spent on advisers to Rose Gibb and her highly paid team of senior staff.

    The money spent on management consultants would have been enough to put more than a hundred extra nurses and support staff on to the filthy wards at the hospital -- and that may well have been enough to prevent the chaos that led to dozens of deaths at the Maidstone and Tunbridge Wells NHS Trust."


    Thursday 11th October 2007

    Campaign group Health Emergency today set out and action plan for dealing with the root causes of MRSA and C DIFF in our hospitals in the wake of the Maidstone and Tunbridge Wells scandal:

    * An immediate moratorium on the cuts-driven closure of beds and departments. In the past 18 months nearly 3000 front line beds have been closed across the NHS with many more in the pipeline. Bed occupancy rates are now at unsustainable levels with "hot bedding" rife.

    * A review of staffing levels. 25,000 NHS jobs have been lost in the past 18 months with more planned. Hospitals are still using casual agency nursing staff as an alternative to maintaining their permanent staffing at viable levels.

    * Removal of private sector companies from the provision of cleaning and other hospital support services. Cleaning has been seen as a soft touch for cuts in the NHS for more than two decades. We are now paying the price.

    * An end to the target-led/bonus driven culture of NHS managment. Senior managers get bonuses for ticking boxes rather than delivering patient-led care. Patients are routinely shifted around beds in the early hours of the morning with no cleaning in between as bed capacity is juggled to hit targets.

    Geoff Martin, Health Emergency Head of Campaigns, said today:

    "Maidstone and Tunbridge Wells was a scandal waiting to happen and I have no doubt that a similar disaster could break out in any region of the country at any time. The appalling backdrop to Maidstone still exists in far too many hospitals today through a combination of inept local management and central Government diktat.

    "Hot bedding is rife in the NHS because of a shortage of capacity. Staff barely have time to change sheets let alone clean around beds and yet the Government are driving further reductions in bed capacity to hit financial targets and meet their key objective of centralising services, That has to stop and it has to stop now. You cannot deep clean wards if you have no spare capacity to decant patients into and Gordon Brown needs to understand that.

    "For over two decades hospital cleaning has been seen as a soft touch for cuts and it still is. Cheapskate contractors, paying the lowest wages and cutting every possible corner, have created the conditions for MRSA and CDIff to get a grip on our wards.

    "Successive governments have turned our hsopitals into infectious time bombs. We would welcome corporate manslaugher proceedings against those found to be responsible but it should not stop at the hospital gates."


    Thursday 4th October 2007

    Pressure group Health Emergency have challenged the Government to come clean on whether the Darzi report on the NHS - published today - means an immediate moratorium on service closures and job cuts across the NHS.

    In the past 18 months over 25,000 jobs have been axed from the NHS and a series of regional reviews have identified a raft of maternity units, A&E departments and mental health services for closure.

    Lord Darzi has today indicated that he will now be bringing in his own teams of experts in the Regions to look at services, with the suggestion that the existing finance-led reviews, and their associated cuts and closures, will be put on hold.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "Any genuine attempt to engage staff and patients in reviewing the future pattern of local health services would be a positive move and would be a welcome break from the current top-down approach where bureaucrats bulldoze through cuts and closures in the teeth of staff and public opposition.

    "However, if we're to have any confidence in the brave, new world of Lord Darzi the existing cuts-led reviews have to be stopped and the axe that's hanging over dozens of local hospitals and services must be lifted. We are challenging the Government for a catagoric assurance on that key point."

  • Campaigners challenge NHS London on hospital closure moratorium

    Monday 6th August 2007

    Pressure group London Health Emergency has today written to the Chief Executive of London's Strategic Health Authority to demand clarification on the plans for consultation and public debate over the reconfiguration of hospital and health services in the capital.

    LHE's Information Director John Lister is responding to statements attributed to NHS London last week, seeking to dismiss allegations that hospital services in five Trusts SW, NW, North , NE and SE London are already being downsized or face imminent consultations, despite the recent publication of a London-wide review by Professor Sir Ara Darzi.

    An NHS London spokesperson is reported to have declared that as a result of the review:

    "No hospitals will be named for upgrading, downgrading or creation of new identities until next year."

    In reply, the LHE letter underlines plans already underway for downgrading of services in Epsom & St Helier, NW London Hospitals, Barnet & Chase Farm (with the planned closure of Chase Farm A&E), Barking Havering & Redbridge, and Queen Mary's Hospital, Sidcup. And it challenges NHS London boss Ruth Carnall to clarify the policy:

    "Does NHS London intend to uphold this policy of 'no downgrading' or closures before next year? If so, it seems that you have a major challenge of communicating this to PCTs and Trusts which are implementing cash-driven reviews. In the five cases identified above, you may need to intervene and call local health managers to order, and reverse some cuts already made."

    LHE makes clear that it would welcome any such temporary reprieve for popular local services.

    Publicising the letter, John Lister said:

    "Londoners are sick and tired of seeing their local services undermined by cash-driven cutbacks, while remote bureaucrats from NHS London, accountable to nobody, feed us a lot of bull, claiming that no decisions have been made.

    "We all know that maternity and other services at Epsom are under threat, that A&E services are already being run down at Central Middlesex and King George's Ilford, and face closure at Chase Farm, and that Queen Mary's in Sidcup is the only hospital in the area that could be axed without incurring a massive PFI bill.

    "If NHS London want to freeze these moves until next year, and discuss Darzi's plans that's fine: but if they don't, we will be fighting them all the way - and exposing every cutback as it happens."

    LHE's Letter to Ruth Carnall/NHS London:

    Ruth Carnall

    Chief Executive, NHS London


    105 Victoria Street


    SW1E 6QT

    August 2 2007

    Moratorium on hospital closures and downgrading

    Dear Ms Carnall

    I write in response to the recent statements attributed to NHS London, which appeared last week in icSurreyonline (July 24 "St Helier will not be scrapped, claim NHS"), in which your unnamed spokesperson insists that London Health Emergency is "wildly wrong" to point to on-going plans to run-down and/or close key services at hospitals including Epsom & St Helier, Chase Farm, Central Middlesex, Queen Mary's, Sidcup and King George's in Ilford.

    NHS London is reported to have argued that our predictions of service closures at these hospitals are "not worth the paper they are written on", with your spokesperson insisting that, in order to allow time to debate the Darzi Report and its implications,

    "No hospitals will be named for upgrading, downgrading or creation of new identities until next year."

    Perhaps your team is not aware of the continuing moves that are taking place at local level: the closure of Chase Farm A&E is out to consultation (which was discussed by NHS London in June); the closure of maternity services at Epsom is due to go to consultation in a few weeks; trauma cases are already being diverted away from A&E units at both Central Middlesex and King George's in advance of any consultation; and plans for wholesale downgrading of Queen Mary's Sidcup are a poorly-kept secret, and have already been widely reported and subject of a major seminar discussion at the King's Fund.

    Does NHS London intend to uphold this policy of 'no downgrading' or closures before next year?

    If so, it seems that you have a major challenge of communicating this to PCTs and Trusts which are implementing cash-driven reviews. In the five cases identified above, you may need to intervene and call local health managers to order, and reverse some cuts already made.

    If this is your intention, we would of course welcome the reprieve for popular local services, which are threatened by the NHS financial regime and by the longer-term implications of the Darzi Report.

    If you do not intend to intervene, it would be helpful if your representatives would refrain from denying the obvious, and lying to the public over cutbacks which are as unwise as they are unpopular. I await your reply with interest.

    Yours sincerely

    Dr John Lister, Information Director, London Health Emergency


    Monday 6th August 2007

    Pressure group London Health Emergency today called on Health Secretary Alan Johnson to intervene after they revealed that the Kingston Hospital NHS Trust is planning to privatise all of its planned surgical work - contrary to assurances from Gordon Brown and Alan Johnson that they are easing off the pace of private sector involvement in the NHS.

    Documents obtained by London Health Emergency show that early next year Kingston Hospital in south west London plans to bring in a private company to carry out all it's elective surgery - an unprecedented experiment in NHS privatisation which would take commercial firms further deeper into the heart of the NHS than has ever been considered before.

    Kingston Hospital also claim that their move is in line with the findings of Professor Ara Darzi's report into London's NHS even though Drazi made no reference to wholesale privatisation of elective surgery. LHE are seeking urgent talks with NHS London to clarify the position.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "The plans by Kingston Hospital to bring a commercial, profit-driven company right into the heart of the NHS to run all routine surgery is unprecedented and would give that company enormous leverage to launch a takeover bid to run the whole hospital. This is NHS privatisation on a scale we have never seen before.

    It would appear that the Trust Board have cooked this plan up themselves and it will be a huge embarassment to the Government at a time when they are signalling that the pace of private companies involvement in the NHS is being pulled back. It will also be a shock to NHS London that Kingston Hospital are using the Darzi report as grounds to rush headlong into this privatisation experiment right at the sharp end of the service.

    We are demanding the urgent intervention of Alan Johnson to block the privatisation plans at Kingston Hospital."


    Monday 6th August 2007

    Campaign group London Health Emergency today accused local health bosses in the capital of ploughing on with a hospital closure programme by stealth before Londoners have had a chance to comment on Professor Darzi's report on the future of NHS services across the city.

    LHE have flagged up five examples across London of Trust's and PCT's using Darzi as an excuse to jump the gun:

    * Chase Farm in Enfield - where proposals to downgrade services are already out to consultattion.

    * Epsom and St Helier - where the proposed closure of maternity services at Epsom is due to go out for consultation after the summer holidays.

    * Queen Mary's Sidcup - where a leaked internal memo points to an imminent consultation on the downgrade of A&E and maternity services.

    * Central Middlesex Hospital in Park Royal - where changes to trauma care hours have already been bundled through with no consultation.

    * King Georges in Ilford - another downgrade target where trauma cases are already being diverted to neighbouring hospitals.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "Before the ink is even dry on the Darzi report local health chiefs are using it as an excuse to plough on with closure plans and in some cases hospitals targetted for downgrade and closure of key facilities are being undermined by stealth. That shows complete contempt for the principle of public consultation and the promise that the NHS would listen to Londoners.

    We warned that Darzi was cash led cuts dressed up as a rational planning process. The evidence shows that we were right to sound the alarm."


    Monday 6th August 2007

    Consultant medical staff have come out in almost unanimous support for the medical secretaries at the cash-strapped Epsom and St Helier NHS Trust who have been told that over 50% of their jobs will be axed as part of cash-saving, privatisation measure which would send their work overseas.

    Consultants have joined with NHS union UNISON in warning that the penny-pinching proposals, aimed at saving £600,000 and recommended by a hit squad from management consultants KPMG, will cause chaos and would have potentially lethal implications for patients if documents are mis-transcribed on their journey around the world.

    UNISON have put the proposals into formal dispute and the medical secretaries have voted to ballot for industrial action if the plans are not withdrawn.

    Dr Ian Wilson, Deputy Chairman of the BMA's Consultants Committee, said:

    "Medical secretaries have a hugely important role in running medical services in hospitals yet their work is often under-valued. They are highly trained to assist doctors in their care of patients; reducing this critical support to services risks making consultants less available to provide high quality care to patients. Cutting back in this area is a false economy; we should be investing in the staff we have working here rather than shipping work out to other countries."

    Geoff Martin. Health Emergency Head of Campaigns, said:

    "Where medical secretarial services have been privatised and sent overseas on a computerised system in other Trusts it has been a disaster. This is all about money. The medical secretaries are the glue that holds the relationship between the consultant and the patient together. Hacking it apart, in the way that Epsom and St Helier are proposing, would have potentially lethal consequences."


    Monday 6th August 2007

    Health services across England face another battering from cutbacks and closures as Patricia Hewitt unveils a massive unspent pot of cash that could have spared misery for patients and staff. The thumping surplus, expected to be as high as £500 million, delivered in most of England’s Strategic Health Authorities follows months of painful belt-tightening, with bed and ward closures, job losses, frozen vacancies and deliberately lengthened waiting times, with many Primary Care Trusts insisting on a 5-month “minimum wait” for non-urgent care.

    Pressure group Health Emergency has pieced together a snap-shot view of some of the key cuts still under way as ministers crack open the champagne to celebrate the millions unspent – while insisting the crisis-hit services must meet tight cash limits this year and even tighter constraints from 2008.

    North Yorkshire and York PCT is carrying through a second year of cutbacks having axed 200 jobs and 90 beds last year.

    In the North West Westmoreland General Hospital still faces swingeing cuts and closures, while NW Pennines Acute Trust is planning to axe 10% of its beds in Oldham, Rochdale, Fairfield and North Manchester, and East Lancashire acute is seeking to cut 127 jobs to slash its wage bill by £4m.

    In the North East the County Durham and Darlington Foundation Trust is seeking to axe 700 staff as part of a £40 million cuts drive to balance its books.

    In the West Midlands, Coventry’s brand new £400m Wallsgrave Hospital has announced a third reduction in bed numbers and a job freeze as it wrestles with a £15m deficit.

    In the East of England, Huntingdon’s Hinchingbrooke Trust faces a “rescue” package which amounts to a 2-year stay of execution, with a loss of 25% of its caseload, as Cambridgeshire PCT struggles with a £51m deficit. In Norfolk, after a year of cuts and cash savings, the merged PCT also faces a £50m deficit, and plans involve cuts in mental health and closure of 40 community beds. In Suffolk, Ipswich Hospital after a traumatic year of short-sighted cuts, must make further savings.

    In the West of England hospital services in Weston Super Mare and minor injuries units throughout Wiltshire are among a series of targets for cutbacks.

    Cuts are looming in Surrey and Suffolk, despite repeated delays in the consultation process. Sussex faces a loss of services in either Eastbourne or Hastings, while services in Worthing, Brighton and Haywards Heath are also under threat.

    In London, a major acute services review has been postponed, but it is clear that services are under threat in north London with the plans to close A&E at Enfield’s Chase Farm hospital, NE London with the sword hanging over services at King George’s Hospital, Ilford, major cuts aimed at slashing a massive £41m from spending at Epsom & St Helier in SW London, and a review pending in SE London, with Queen Mary’s Hospital, Sidcup the likely victim of cutbacks to tackle a local £65m deficit.

    Commenting on the ongoing cutbacks, Health Emergency Information Director Dr John Lister said:

    “The cuts we have uncovered are all ongoing and upcoming, drawn from press coverage since April 1: we know these are only the tip of the iceberg as Trusts and PCTs come under pressure to slash back their budgets this year, in advance of tighter times to come – effectively stockpiling cuts. Many cutbacks decided last year are still taking effect, and many areas – such as Hertfordshire – are awaiting the outcome of controversial reviews.

    “Patients are waiting needlessly, newly qualified nursing and other staff are being turned away from the NHS, and morale among existing NHS staff remains at rock-bottom.

    “What’s worse is that while these cuts are ripping in to the public sector provision, hundreds of millions are being squandered on pointless and over-priced contracts with the private sector.

    “If ministers do not change course, Gordon Brown will go down as the Prime Minister who in his first year in office did the most irreparable damage to the NHS through excessive cuts to front line services and through plundering patient care budgets to fund the costs of his PFI schemes.”


    Tuesday 12th June 2007

    Campaigners claimed today that the Central Middlesex Hospital in Park Royal - the nearest major hospital to the new Wembley Stadium - is beginning long-awaited moves to run down its 24 hour Accident and Emergency Department.

    Trust managers have confirmed to staff unions that they are moving a large chunk of the out of hours emergency work to Northwick Park Hospital in Harrow leaving the future of the main casualty unit on the Central Middlesex site hanging in the balance.

    There has been speculation for the past year that a review of services by the North West London Hospitals NHS Trust would lead to the downgrading of core services at Central Middlesex as they grapple with a multi-million pound deficit. Campaigners and unions, who have been waiting for a formal consultation document on the proposals for Central Mid, today accused the Trust of bundling through the closure by stealth.

    Geoff Martin, London Health Emergency Head of Campaigns, said today:

    "Not only is Central Mid the main critical care unit serving the busy, new Wembley Stadium complex but it is also strategically placed by the A40 and close to the North Circular and right next to Park Royal Ambulance Station. Running down key emergency work to a nine to five service just to save money at such an important London hospital defies belief and we have no doubt that lives will be put at risk."


    Saturday 2nd June 2007

    News today that 6000 staff at the County Durham and Darlington NHS Trust have been offered voluntary redundancy as part of a plan to save £40 million and axe 700 staff posts over the next 3 years has nailed the lie that NHS cuts are over.

    Earlier this week figures suggested that the NHS was £500 million in surplus and raised the prospect that the national programme of cuts would come to an end. Pressure group Health Emergency claimed today that many areas of the country and still facing on-going service and job reductions as cash surpluses are stockpiled to bail out an in-coming Brown Government when financial pressures bit again later this year.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "Anyone who thought that the projected NHS financial suplus would draw a line under the cuts to jobs and services should take a look at what's happening in Durham and Darlington today.

    "The cuts are still on the agenda in many parts of the country as cash supluses are stockpiled to bail out Gordon Brown and his government when a new wave of financial pressures hit home later this year."


    Monday 7th May 2007

    A cash-strapped south London hospital, where nurses have been threatened with redundancy, has spent £18,000 on photographs of its buildings to brighten up the walls of its new, privately financed wing.

    In a leaked email between senior managers, which has been passed to pressure group London Health Emergency, it is confirmed that the Trust has set up an "Arts Group" of senior managers including a "Photographic Commission". That group has agreed to spend £18,000 on photographs of its buildings which will come straight out of the patient care budget.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "Kingston Hospital has been facing a multi-million pound debt over the past year and nurses and other staff have been warned that they could face redundancy. To be blowing the best part of 20 grand on arty snaps of their building against that background is a disgrace.

    "This "art commission" would have kept a key member of staff in work for a year and I wonder what senior managers think they are doing sitting around discussing the artistic merit of a bunch of poncy photos, when they should be getting on with running the hospital."


    Tuesday 17th April 2007

    Campaigners and unions have reacted angrily to news that the crisis-torn Epsom and St Helier NHS Trust has seen its cuts target rocket from £24 million to £41 million and are warning of massive cuts in jobs and services over the next two years as the Trust attempts to balance the books and pay back money borrowed from the Government.

    The news of the deterioration in the Trusts financial position came at a Board meeting on friday - Epsom and St Helier will have to axe £21 million of spending this year and a further £20 million in 2008/2009 to comply with Government targets.

    The Trust - branded the "Meanest Hospital in Britain" after it removed lightbulbs and scrapped hot lunches for patients to save money - have also confirmed that a planned new hospital to replace Epsom Hospital in Surrey and St Helier in Sutton, is now in serious doubt.

    Board members confirmed on Friday that the new unit will have a catchment of just 350,000 and falls below the Government's minimum of 500,000 which they say is required to siupport an accident and emergency department.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "This is chaos. We were told that Epsom and St Helier needed to save £24 million in 2006 and it now appears that not only have they failed to do that but that the total cuts have shot up to £41 million as they now have to pay back money borrowed to balance the books last year. You cannot save these kind of sums of money without having a devastating impact on front line services.

    It also appears that the plans for even a scaled down new hospital to replace Epsom and St Helier are in serious doubt as the catchment population has been whittled down to a level well below that required to justify an accident and emergency department. It seems certain that St Helier is being set up for a merger with St George's and that Epsom is being hung out to dry by the Surrey PCT. This is no way to run front line hospital services for the growing population in Merton, Sutton and mid-Surrey."

    Kevin O'Brien, UNISON Branch Secretary, said:

    "The news that the cuts target has shot up yet again is a bitter blow to staff who have lived with a year of uncertainty and who are now being told that we are facing cuts right up to 2009. We know that key groups of staff like the housekeepers and emergency pathway teams are already facing the axe and many more key jobs across the local NHS are now on the line. The staff unions will continue to fight these cuts."




    Tuesday 27th March 2007

    Campaigners today slammed moves by the Epsom and St Helier NHS Trust, branded as the "meanest hospital in Britain", to axe 11 key, frontline staff centrally involved in infection control as a "potentially lethal act of mismanagement that will send cross infection levels through the roof."

    The staff involved are the housekeepers on the south London and Surrey Trust's most critical wards. They were introduced four years ago in response to the NHS Plan and co-ordinate cleaning, catering and a range of support services to patients.

    The posts are being lined up for the axe in order to save £300,000 and campaigners and unions warn that the cash-raising measure will put dozens of lives at risk.

    The Trust, facing a combined cash deficit of over £24 million is planning to axe nearly 500 staff in total and to close nearly a quarter of it's beds.

    In the past few months the Trust has also:

    * Axed hot lunches for patients, including the elderly, offering them a sandwich instead

    * Told staff in non-clinical areas to do their own cleaning

    * Cut cleaning frequencies at weekends even though the Trust has a serious C DIff and MRSA problem.

    * Stopped issuing nighties and pyjamas to patients

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "Epsom and St Helier is the meanest hospital in Britain and is an example of everything that's wrong in the Patricia Hewitt's NHS.

    This is a trust with a serious MRSA and C Diff problem and to be cutting back on the staff who co-ordinate cleaning and infection control at ward level will have potentially lethal implications and will put dozens of patients lives at risk. These staff fulfil the role of the "modern matrons" that the government has promised us and yet here they are facing the sack.

    Staff morale is at rock bottom and the Trust is being run by management consultants getting paid a fat fee for dreaming up the most outrageous penny-pinching cuts. Is this what Tony Blair means by "modernising health care"?.


    Thursday 15th March 2007

    Staff renting accomodation at the Epsom and St Helier NHS Trust - branded "The Meanest Hospital in Britain" after they started removing lightbulbs, cancelling hot meals and cutting cleaning frequencies to save money - have been told that rents for staff living on site are to be jacked up by a massive 10%.

    Staff accomodation costs will go up from an average of just under £300 a month for a single room with shared facilities to £330. The Epsom and St Helier Trust is making cuts of £24 million this year and is axing nearly 500 jobs and a quarter of their beds. The Trust is mired in an on-going scandal with rumours circulating that a former Chief Executive, who left suddenly just before Christmas, got a pay off of more than £500,000.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "This is just another kick in the teeth for staff who are already reeling at this years pay cut and the threat of redundancies across the NHS. It's no wonder that morale is at rock bottom when staff are subjected to these repeated penny piching cuts."


    Wednesday 14th February 2007

    Campaigners today branded the Epsom and St Helier NHS Trust as the "meanest hospital in Britain" after news broke that NHS bosses had instructed staff to remove lightbulbs in a bid to save cash.

    The Trust, facing a combined cash deficit of over £24 million is also planning to axe nearly 500 staff and to close nearly a quarter of it's beds.

    In the past few months the Trust has also:

    * Axed hot lunches for patients, including the elderly, offering them a sandwich instead

    * Told staff in non-clinical areas to do their own cleaning

    * Cut cleaning frequencies at weekends even though the Trust has a serious C DIff and MRSA problem.

    * Stopped issuing nighties and pyjamas to patients - even those rushed into hospital as emergency cases

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "Epsom and St Helier is the meanest hospital in Britain and is an example of everything that's wrong in the Patricia Hewitt's NHS.

    Staff morale is at rock bottom and the Trust is being run by management consultants getting paid a fat fee for dreaming up the most outrageous penny-pinching cuts. Is this what Tony Blair means by "modernising health care"?.

  • Campaigners denounce "sell-out" on Public Health

    Monday 29th January 2007

    Campaigners have today accused the Association of Directors Public Health of a "gross betrayal" of public health ideals, after the ADPH issued a call for the imposition of charges for non-emergency operations.

    The Association claims to represent the public health directors of Primary Care Trusts across the UK, but has only now began to argue that the NHS should scrap its founding principle of delivering care free at point of use, funded from taxation.

    ADPH president Dr Tim Crayford, calling for a system of charges, actually said:

    "What is wrong with asking people to contribute for some care which is not life-saving much as we do with dentistry?" He went on to call for charges to be imposed on hip operations, surgery for varicose veins and cataract treatment.

    Responding, Dr John Lister of pressure group Health Emergency said:

    "This new policy is a fundamental betrayal of everything the Public Health medicine is supposed to be about, as well as the basic principle that with the NHS patients are entitled to a full range of care on the basis of clinical need rather than their ability to pay.

    "Public Health is above all about prevention, and tackling the causes of ill-health - of which one of the most obvious is poverty, especially among older people. It is about equitable treatment and equitable allocation of resources.

    "The experience of imposing charges for health care is that always and everywhere, around the world, it deters the poorest from accessing the treatment they need, while doing nothing to reduce ill-health.

    "The rich of course will always be able to afford to pay for their own care - but the most efficient and economical system of funding and provision is the NHS system of universal cover, into which we all pay through taxes.

    "For The ADPH to use dentistry as an example of the way things should be done is just bare-faced cheek: dental services are a classic illustration of the collapse of NHS services and wholesale privatisation which has lumbered tens of thousands of people with a "choice" of paying massive bills for treatment or doing without.

    "If these doctors don't believe in public health any more, and don't believe in the principles of the NHS, they should get out now, and not encourage a government that is already racing down the road of privatisation to step harder on the accelerator."


    Monday 29th January 2007

    Pressure group Health Emergency today slammed the Government for deliberately misrepresenting the views of older people in their drive to push through the closure or downgrading of up to 70 district general hospitals up and down the country.

    In a report due to be published tomorrow, the Government's "older people's tsar" Professor Ian Philp, will claim that pensioners are happy to travel greater distances to remote critical care centres to access care - a claim which flies in the face of all the evidence from the protests against hospital closures in the UK wher pensioners have formed the bedrock of opposition.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "The claim that older people support the closure of local hospitals is an insult and a gross distortion that flies in the face of all of the evidence. Pensioners have been amongst the most vociferous opponents of hospital closures up and down the country and have been out on the streets in their thousands. It's an insult to claim that they would be happy to travel miles away from their friends and families to access front line hospital care."

    LHE's Information Director John Lister added:

    "The new policy also turns the previous policy completely on its head. We always argued that the policy of "care closer to home" was a hollow fraud in the light of the hospital closures being forced through around the country.

    "Now the "tsar" himself has abandoned that policy -- and concluded that the best policy is care a long way away from home -- or minimal care in your own home.

    "It is also a fraud to claim that most older people requiring emergency admission need the high-tech facilities of a specialist trauma centre: figures show that only 3 percent of A&E attenders require the most specialised emergency medicine, while most of the other 97% are older people requiring medical rather than surgical treatment.

    "What they really need is prompt attention at a hospital close to home, where they can be supported by friends and relatives and discharged with minimal complications."

  • Get your MP to sign this!

    Sunday 21st January 2007

    House of Commons Early Day Motion 655




    That this House notes with concern the current proposals for reductions in NHS hospital beds and NHS staff and the threats of closure of accident and emergency departments, maternity units and mental health services which are being brought forward across the country and which are causing instability, uncertainty and damage to staff morale and undermining confidence in the community; and calls on the Government to introduce a moratorium on the implementation of these proposals pending an independent review of the NHS funding model, the outsourcing of services and the long-term strategy for critical care services, engaging with frontline healthcare staff, patients groups and local communities.

    2 signatures: McDonnell, John, Russell, Bob


    Saturday 20th January 2007

    Pressure group London Health Emergency and NHS trade union UNISON have launched a campaign to stop a second wave of cutbacks to mental health care in south London which would axe key services to some of the most vulnerable members of the community.

    The South London and Maudsley NHS Trust - which provides mental health care services across south east London - is looking at a second tranche of multi-million pound cuts this year as it comes under pressure to slash budgets from the Lambeth and Southwark Primary Care Trusts.

    Amongst the targets for closure is the Felix Post Unit at the Maudsley Hospital - a specialist service providing support for older people with mental health needs in Southwark and Lambeth, enabling patients to access care and support while living in their own homes.

    This innovative and highly-commended unit meets all the Government's criteria for providing care in a community setting and yet is facing the threat of closure purely as a short-term, cash-saving exercise that will have dire consequences for patients and will simply shift responsibilty onto social services. Staff fear that some people will simply slip through the gaps and end up requiring an expensive acute admission to hospital - costing more in the long run and depriving patients of the continuity of care that they need.

    A petition against the closure of the Felix Post Unit has been launched and campaigners and unions are appealing for support from the community, from pensioners and mental health organisations and from MP's and local councillors.

    Meanwhile, the South London and Maudsley Trust are pressing on with plans to axe the Emergency Clinic service at the Maudsley. Staff in the unit have been given notice that the clinic, a unique London-wide service, will be closed even though the statutory consultation hasn't been completed and the proposal has been opposed by local MPs, including two Cabinet members, Tessa Jowell and Harriet Harman.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "It's a scandal that, despite opposition that goes right up to the cabinet table, the South London and Maudsley Trust are pressing on with ill-conceived cuts plans that will have dire consequences for mental health services across south London. These cuts fly in the face of national mental health care policy.

    "These are purely cash led cuts that will rip apart brilliant and innovative services like the Felix Post Unit and the Emergency Clinic and which may well end up costing us all more in the long run as people end up being admitted to acute wards rather than getting the early and continuing care that they need.

    "UNISON and London Health Emergency intend to fight these plans all the way and we are calling for community and political support right across the board."

  • Campaign launched for moratorium on NHS cuts

    Thursday 18th January 2007

    Despite increased funding, the NHS is making swingeing cuts across the country, with proposed closures to units and to thousands of jobs and beds.

    In conjunction with Health Emergency, John McDonnell MP has launched the ‘Campaign for a Moratorium on Health Service Cuts’, which will be formally launched with a public meeting at the House of Commons on Tuesday 27th February (details below).

    John McDonnell MP , who is a candidate for the Labour leadership when Blair steps down, said:

    "The current wave of cuts to NHS services are now having a critical effect upon A&E units, maternity and mental health services, across the country. Unless the Government listens now to the growing anger and dismay within our communities and amongst health service staff we will face electoral disaster in the local elcetions in May."

    “I am calling for an immediate moratorium to the programme of cuts and closures and an independent review of the NHS funding model so that we have a chance to fully re-evaluate the Government’s health service policy, and ensure that these policies do not cost lives.”

    Geoff Martin, Head of Campaigns at Health Emergency, said:

    “Today’s survey by the British Medical Association exposes the dire consequences of the Government’s cuts and closures policy to healthcare services.

    “With John McDonnell’s motion calling for a moratorium, we now have a real opportunity to build public and trade union support for a concrete demand that will put the Government right on the spot.”


    Tuesday 9th January 2007

    Pressure group Health Emergency today warned New Labour that they risk electoral meltdown in the Capital in the 2008 local elections and the next general election if they press on with plans that would see up to nine major hospitals in and around London closed or downgraded with the loss of thousands of hospital beds.

    The warning comes after New Labour think tank the IPPR called on the government at the weekend to press on with their closure programme - holding up London as an example of an area where they claim there is major over-provision of hospital capacity.

    Health Emergency have identified the potential closure targets as:

    * Epsom and St Helier NHS Trust - covering Merton, Sutton and North Surrey

    * Chase Farm in Enfield

    * St Peter's Hospital in Chertsey or the Royal Surrey County Hospital in Guildford

    * King George's Hospital in Ilford or Whipps Cross in Walthamstow

    * Queen Mary's Hospital in Sidcup

    * Central Middelsex Hospital in Park Royal or Northwick Park Hospital in Harrow

    * The Royal Free in Hampstead or the Whittington in Islington.

    * Hammersmith Hospital

    * West Middlesex Hospital in Hounslow

    Mental health services, notably at the South London and Maudsley Trust which covers south east London, are also under continuing pressure.

    However, campaigners have managed to seriously delay reports from review teams looking at the closure of services suggesting that the political realities of embarking upon such a programme are coming home to roost.

    Geoff Martin, Health Emergency Head of Campaigns said:

    "If New Labour listens to the IPPR and presses on with the hospital cuts and closure programme in London they will face electoral meltdown in the 2008 local elections and at any snap general election that Gordon Brown may be considering.

    "The fact that all of the service reviews paving the way for closures have been delayed and disrupted by public campaigning suggests that the message is getting through to the powers that be. The heat map of NHS campaigning is running hot in the capital and across the south east and we intend to keep up that pressure."


    Sunday 7th January 2007

    Pressure group Health Emergency this morning hit back at claims by New Labour think tank that thousands of hospital beds across the UK could be safely closed down in the name of improving efficiency.

    Health Emergency research has shown that nearly 3000 hospital beds were closed in 2006 with thousands more facing the axe this year as hospitals come under central government pressure to balance the books.

    But community services and primary care are also facing a squeeze, and with consistent year on year increases in attenders at A&E and emergency admissions to hospital there is no sign of the new model of care which governments have been promising since 1991.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "Let's be clear, the IPPR are outriders for New Labour, and what they are proposing today is likely to become government policy tomorrow.

    "The hospitals bed closures carnage in the NHS has already been allowed to rip with thousands more beds facing the axe in the run up to the end of the financial year.

    "In many areas of the country services are already dangerously short of capacity and any extra pressure from flu or a cold snap would tip them on to red alert with disastrous consequences.

    "The IPPR have got the brass neck to slag off those campaigns up and down the country who have had the guts to stand up and fight for their local hospital services and against the sacking of NHS staff.

    "Their patronising claim that our efforts are detrimental to the NHS turns logic on its head, and will simply spur on thousands more to join the fight for the future of the NHS."


    Friday 5th January 2007

    NHS pressure group Health Emergency said today that a massive planning failure at both national and local level had created a situation where private GP locum agencies across the UK are able to hold the NHS to ransom for the provision of out of hours cover - bleeding huge sums of money away from patient care and adding to the financial crisis hammering Primary Care Trust budgets up and down the country.

    In the past week there have been a number of highly publicised cases of private agencies hiring doctors "on the lump" to the NHS at huge cost to the taxpayer but Health Emergency believe that the individual cases attracting attention are simply the tip of the iceberg of a national failure to meet a key element of local health care provision.

    Health Emergency will be working with MP's over the weekend to formulate a series of questions to the Health Secretary aimed at establishing just how much the private locum agencies are creaming off from the NHS budget in each Primary Care Trust across the country - the figure is expected to run into millions of pounds.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "It defies belief that a government that repeatedly lectures us on the need to provide health services in the community and in peoples homes has allowed the out of hours GP service to collapse into such a state of chaos that private locum agencies can effectively hold the NHS to ransom.

    "We want to know how much money is being bled away from front line patient care in fees to these agencies - money that could be used to stop redundancies and bed closures at the sharp end of the service.

    "A decade ago we campaigned to stop the nursing agencies ripping off the NHS by charging fat fees to the hospitals and exploiting staff shortages. We're going back into battle with the locum agencies and will be lining up political support for this campaign over the weekend."

  • Hospital Trust boss departs as deeper cuts take shape

    Monday 1st January 2007

    The Chief Exec of one of the NHS Trusts facing the most severe cuts anywhere in the countryhas stood down from her post with effect from Sunday 31st December 2006.

    Epsom and St Helier has racked up debts of £24 million and is currently trying to bundle through cuts in staffing of 480 posts and cuts in beds of 208 - nearly a quarter of their current total - in the teeth of major public and staff opposition which has seen thousands protesting on the streets of Epsom and Sutton in 2006.

    The Trust is also looking to downgrade maternity services at Epsom in the new year and is one of the targets on the government's list for closing services and moving to centralised care.

    A plan to build a new crtical care hospital to replace Epsom and St Helier is now in doubt and has been called in for further review by Health Secretary Patricia Hewitt. Campaigners fear that the Chief Exec's departure, the architect of the new hospital plan, will pave the way for the schame to be ditched in the new year.

    Geoff Martin, Health Emergency head of campaigns, said:

    ""The sudden departure of Lorraine Clifton clears the decks for the scrapping of her 'Better Healthcare Closer to Home' policy and the new critical care hospital to replace Epsom and St Helier.

    "That was Ms Clifton's policy and now that she has gone the Trust are likely to dump it early in the new year.

    "This is ominous news for local people. The path is now clear for the new Trust management to run down services at both Epsom and St Helier and we expect consultation to begin early in 2007. This is yet another example of crisis management stitching up services for local people behidn closed doors.

    "Epsom and St Helier Trust is being run like a bankrupt, lower- league football club where managers come and go like ships in the night, the board have lost any control and the local supporters of the hospitals are treated with total contempt. "We need to be prepared for a long, hard fight to defend services in 2007."


    Thursday 28th December 2006

    Health campaigners today blasted cabinet minister Hazel Blears for "rank hypocisy" after she joined protesters fighting the closure of the maternity unit at Hope Hospital in her Salford constituency - one of 29 acute hospitals facing closure or downgrading up and down the country as a direct result of central government policy.

    Blears - Labour Party Chairwoman - was involved earlier this year in the infamous "NHS Heat Map" briefing with Health Secretary Patricia Hewitt where the political fall out of the cuts and closure programme in Labour-held seats was assessed.

    Back in the spring Dr John Reid joined protesters outside the gates of Monklands Hospital in his Airdrie constituency opposing the closure of the A&E department.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "Here we have cabinet ministers, totally bound up in the Government's hospital cuts and closure programme, riding on the backs of anti-cuts campaigns in their own constituencies in a bid to save their own political skins. Frankly, it stinks.

    "There are 29 hospitals up and down the country facing the immediate threat of cuts and closure to key services in 2007. Will Hazel Blears be joining demonstrators on the streets in each of those areas or is this just a classic case of "not in my back yard"?

    "If the closure of maternity services is wrong in Salford it is wong in all those other parts of the country as well and Blears should be piling on pressure to ditch the cuts policy -- or she sould resign."


    Friday 22nd December 2006

    One of the main hospitals expected to serve the central Olympics site in 2012 - King George's in Ilford - is being set up for closure of its front line emergency services as part of a £16 million cuts package being driven through by the Barking, Havering and Redbridge Hospitals Trust.

    As part of a "Fit for the Future" review, health chiefs in North East London have been examining a range of cuts options to claw back their multi-million pound deficit. Documents leaked this week reveal that King George's, which is a new hospital that only opened its doors in 1993, is the favoured target for downgrading with loss of A&E, maternity and trauma services.

    If the closure is bulldozed through the services will be transferred over to the new, privately- financed Queens Hospital in Romford. Journey times will increase and there are serious questions over whether the Queens will have the capacity to mop up the fall out from the closure of one of the busiest and most modern A&E departments in London.

    King George's is one of up to nine front line hospitals in and around London facing closure. The others are Chase Farm in Enfied, Queen Mary's in Sidcup, Central Middlesex in Park Royal, Epsom and St Helier, The Royal Free , St Peter's in Chertsey, West Middlesex in Hounslow and Hammersmith Hospital.

    A raft of closure plans across the capital are expected to be unveiled early in the new year as London's hospitals try to claw back a combined deficit of more than £300 million.

    Geoff Martin, London Health Emergency Head of Campaigns, said:

    "It defies belief that one of the most modern hospitals in London, and one of the units that would provide essential support to the London Olympics in 2012, could be targetted for closure. That underlines the depth of the financial crisis facing London's NHS and the desperate measures health chiefs are cooking up behind closed doors to balance the books.

    In 2007 we can expect a rush of announcements on health care cuts and closures in and around London and we need to be gearing up a wave of public protest that can hold off this assault on our essential services."


    Thursday 7th December 2006

    Campaign group Health Emergency today challenged the Government to identify a single one of the 29 major acute hospitals facing early closure or downgrading where the axing of key services isn't being driven by a major deficit in the local NHS budget.

    The challenge has come the day after Tony Blair and the New Labour think-tank the IPPR claimed that the closure of A&E, maternity, intensive care and trauma services at local hospitals was about long-term planning and not money. Health Emergency are counter-claiming that every single one of the currently threatened casualty and maternity closures being resisted by local communities is being cash-led.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "For the government to claim that the current wave of service closures and job losses ripping thorugh the NHS this winter isn't being driven by a cash crisis is ridiculous. The planned cuts to casualty services across the country, that will be finalised in the new year, have nothing to do with modern, rational planning of health services and everything to do with simple, old-fashioned cuts."

    Health Emergency also hit back at claims by the IPPR that local campaigns to fight A&E closures will leave a thousand patients dead on the streets:

    "The IPPR are nothing more than cheer-leaders for the New Labour government. Their attempt to smear and insult the tens of thousands of nurses, NHS support staff and members of the public who are out on the streets in their tens of thousands every weekend fighting for their local hospitals is a disgrace. It will simply spur more people on to join the campaigns to save A&E and maternity services."


    Thursday 30th November 2006

    In a move that will have repercussions for the government's NHS cuts and closures programme across the country this winter, the Health Overview and Scrutiny Committee of Surrey County Council have slammed the brakes on plans to axe over 200 beds and nearly 500 jobs over the coming months at the Epsom and St Helier NHS Trust.

    The Committee have used their statutory powers under the NHS Act to demand that the cuts, aimed at slashing spending by £24 million, be subject to formal public consultation.

    Unions and campaigns have received assurances from the leader of Sutton Council that his Borough's Health Scrutiny Committee will follow suit effectively blocking the bed and staff reduction plans for months until the public have had their say.

    Health Scrutiny Committees have the power to demand public consultation on any plans that they consider represent a "significant change in service". In the past this has been narrowly defined as a closure of a whole service or unit but Surrey Council have set an important trend by identifying cuts in beds and staffing numbers as a "significant change."

    Pressure group Health Emergency, who along with UNISON presented key evidence to the Surrey Scrutiny Committee, will now be rushing out guidance to health campaigns across the country on how to submit "expert witness" to local Scrutiny Committee's within the scope of their statutory powers.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "The decision of Surrey County Council to pull in the bed cuts and staff losses at Epsom and St Helier for full public consultation is fantastic news and will be shot in the arm for health campaigns across the country this winter.

    It shows that the wave of panic cuts being bulldozed through our hospitals as NHS Trusts fight to balance the books by next March to save Patricia Hewitt's job can be stopped – and the public can be given a say.

  • NHS consultation slammed as a "sham" as cuts are bulldozed through to dodge media spotlight

    Friday 24th November 2006

    Health campaigners have condemned a major NHS consultation exercise in Kent and Medway as a sham – and they say a leaked document proves health bosses are out to bamboozle the public. There are plans to demonstrate about it at a Strategic Health Authority "health summit" next week.

    Under the slogan "Creating an NHS Fit for the Future", local NHS managers are conducting the most far-reaching review of health services in Kent since the NHS began, in 1948. They are gearing up to propose drastic changes that will determine the shape of the local NHS for many years to come – possibly including the closure of at least one hospital.

    But campaign group Health Emergency says:

    • NHS bosses are not telling the whole truth about the reasons for the review or what will actually happen to local services;

    • the review is being rushed through with indecent haste to avoid a genuine public debate and is driven by a cash crisis;

    • the NHS bodies charged with running the review are themselves in chaos and struggling to cope with it.

    • the door will be opened to more private health companies draining more cash away from the NHS

    Not telling the whole truth

    In late October, the local NHS published a very thin (eight-page) "Fit for the Future" discussion document. It claims that the review is being carried out primarily to modernise services and make them better for patients. And it talks in vague, general terms about modern ways of delivering healthcare – especially the idea of more "care in the community". With the document comes a highly leading questionnaire, clearly designed to get the responses that NHS bosses want.

    The document talks about "overspending" and the need to achieve "best value". But it does not spell out the massive financial pressures that are being felt by Primary Care Trusts and acute hospital Trusts across Kent and Medway – as a result, not of "overspending", but of government policy.

    The document contains not one word about the government’s policy of privatising and marketising the NHS at breakneck speed – which is what really lies behind this review. These policies mean that huge private (often American) healthcare corporations are increasingly "cherry-picking" the easy, profitable work within the new NHS "market". As a result, NHS hospitals are to be drastically restructured to make them fit for market. District general hospitals, providing local services for local people, will be replaced by more centralised services – with many people forced to travel long distances for facilities such as Accident & Emergency, and women’s and children’s services.

    Behind the scenes, private consultancy firm McKinsey, who act as the shock troops of the Department of Health, have already been at work to begin identifying which hospital services in Kent and Medway must be lost. But NHS bosses are saying nothing publicly about this work – or how much McKinsey were paid for it.

    We are promised more services that will be delivered, somehow or other, "in the community" – yet cottage hospitals and other community services are actually being cut as a result of the financial turmoil in the NHS.

    Indecent haste

    An identical "Fit for the Future" review in Surrey and Sussex has provoked an unprecedented storm of controversy, with many thousands of people marching, signing petitions and forming campaign groups to save their local services. This has been dragging on since May – and publication of detailed proposals for service changes, previously scheduled for November and then December, has now been put back to the New Year.

    NHS bosses are desperate to avoid getting bogged down in similar public-relations trench-warfare on a second front, in Kent and Medway. So this time they are going for Blitzkrieg tactics – rushing "Fit for the Future" through in just a few weeks, including Xmas.

    A leaked internal NHS document about their plans spells out exactly why they want to hold "deliberative" meetings (with a few invited members of the public) in a huge hurry:

    It is urgent to complete these [meetings] before the engagement process leads to heavy media coverage or any active campaigning so that it is relevantly [sic] easy to recruit a representative sample of the population who have not been affected by any previous public discourse. Therefore it is intended to hold these events in mid-November.

    In other words – NHS bosses want the meetings over and done with before the cat is out of the bag that this is really about taking an axe to local services, and local communities begin protesting.

    Since that document was written, in October, it has been decided to hold just one "deliberative" meeting for the whole of Kent and Medway, to be held sometime in November – although, to date, details of this meeting still have yet to be revealed.

    The plan is apparently then to hold "co-design" meetings for "stakeholders" (invited audiences of clinicians, politicians and others) in December. NHS bosses will then, over Xmas and the New Year, cook up firm plans for actual changes to services. If they decide that there needs to be public consultation on these plans – incredibly, it seems they are actually contemplating the possibility of not consulting! – this is currently scheduled to begin in late January.

    Primary Care Trusts are struggling to cope

    The official NHS line is that "Fit for the Future" is being driven from below by local NHS Primary Care Trusts. But the truth is clearly that the impetus is coming from the very top of the Department of Health, through the South East Coast Strategic Health Authority. The PCTs are actually struggling desperately to keep up with the impossible timetable to which these drastic reforms are expected to run.

    The three PCTs in Kent and Medway only came into existence on 1 October, replacing the nine PCTs that previously covered the county – and they are not yet properly up and running. They are struggling to rationalise nine organisations into three – which includes identifying job losses in their own offices, in order to realise the massive savings the government is demanding from these mergers. On top of this, they are having to address difficult financial problems, and the destabilising impact of government privatisation and marketisation policies. The current rush to push through "Fit for the Future" has come as the final straw for long-suffering PCT staff.


    Health campaigners from across Kent, Surrey and Sussex will be demonstrating against "Fit for the Future" next week at a "health summit" organised by the South East Coast Strategic Health Authority. Campaigners believe the meeting will be an "orgy of spin", designed to portray cuts, closures and drastic reconfigurations of health services as "modernisation".

    The meeting takes place on Wednesday 29 November at the Hilton Brighton Metropole Hotel and demonstrators will be assembling outside from Midday to 2pm.

    Geoff Martin, Head of Campaigns at Health Emergency, said

    "This isn't anything to do with making the NHS fit for the future - it's an old fashioned fit-up based on cash-led cuts and a phoney consultation. Key services will be lost and the door will be opened to more private operators like Casualty Plus."


    The official Kent and Medway NHS "Fit for the Future" website, which includes the discussion document, is as follows:

    For more information about the demonstration in Brighton on 29 November, please contact Zena Dodgson:

    Mobile: 07788 550577


    Geoff Martin

    07831 465 103

  • Danger of NHS melt-down as London’s deficits top £300 million

    Wednesday 22nd November 2006

    Detailed analysis of Department of Health figures by pressure group London Health Emergency shows that the projected deficits for London’s NHS Trusts and Primary Care Trusts now stack up to a massive £303 million this financial year - money that must be clawed back by next March.

    Almost a quarter of the 69 Trusts and PCTs face a worse financial problem than last year, and several face monumental deficits involving a very large chunk of their budgets:

    Bromley Hospitals Trust faces an 8.6% shortfall:

    Kingston PCT is expecting to be 9.7% adrift;

    Lewisham Hospital 9.8%;

    North West London Hospitals 11.5%;

    Whipps Cross Hospital 18.4%;

    Hillingdon PCT 26.9%

    and the PFI-funded Queen Elizabeth Hospital in Woolwich is technically bankrupt with a staggering 32.3% shortfall.

    Some of the figures published in this latest Department of Health round-up appear to be overly optimistic, and it seems likely that further deficits will be reported in the final half of the year, posing huge problems for Trusts trying to rein in spending while facing the usual winter pressures and tough government targets for performance.

    Commenting on the figures Dr John Lister of London Health Emergency said:

    “This is a real old-fashioned winter cash crisis. And the figures still do not tell us the whole truth. The Department’s habit of adding together the possible surpluses of a small minority of Trusts and PCTs with the deficits seems to make the problem appear more manageable than it is. However, no NHS trust has been offered a bail out from a central pot - they are are all being told to got it alone.

    Trusts like Epsom and St Helier, where the deficit is just short of £10 million this year and a further £14 million in 2007, will be making panic cuts on a huge scale this winter and staff have been warned to expect redundancy notices just before Christmas.

    These huge deficits can only be resolved two ways: massive and damaging cuts that will devastate services, or government action to rescue the NHS in parts of London and many other parts of the country from the danger of melt-down.”


    Wednesday 22nd November 2006

    Campaigners from pressure group London Health Emergency and public services trade union UNISON said today that they expected thousands on the streets of south London this coming saturday in protest at plans to close and downgrade services at St Helier Hospital in Carshalton.

    In what is expected to be the biggest NHS protest in London in years, the public and staff will be joining forces in a show of anger at plans by the Epsom and St Helier NHS Trust to close over 200 beds across its two sites and axe 480 jobs as part of a £24 million cuts drive.

    This Saturday's demo - marching from Sutton to the St Helier Hospital site in Carshalton - follows on from a similar protest at the Epsom side of the Trust at the end of September which put 5000 on the streets. Since then it has become clear that both the Epsom and St Helier sites are being lined up for downgrading, losing A&E and maternity services, as part of the governments rationalisation plan for hospital services in London and Surrey.

    Geoff Martin, Head of Campaigns at pressure group Health Emergency, said today:

    "We have worked with local MP's Tom Brake and Paul Burstow to build the maximum community support for the campaign at Epsom and St Helier and we know how angry people are at the secret plans to downgrade their hospital. We are going to drag Patricia Hewitt and her officials kicking and screaming out into the open and force them to tell us what their plans are for our local hospitals.

    Across London up to 11 acute units could be downgraded or closed as part of the government's NHS carve up and in Surrey at least two units - including Epsom and Guildford - are up for the chop. Thousands of jobs and beds are on the line in a cash-driven hospital clampdown that we haven't seen the likes of in 20 years."

    Karen Jennings, UNISON National Head of Health, stated:

    “I am grateful to the nursing and support staff and the hospital for continuing to provide a first class service for patients during this difficult time when many face the very real threat of redundancy or closure of their services”.



    March assembles at 10.30am at Sutton Junior Tennis Centre, Rose Hill recreation ground on Rose Hill in Sutton on Saturday 25th November before marching to St Helier Hospital on Green Wrythe Lane Carshalton for a rally from appox 11.15am with Karen Jennings, Tom Brake, Paul Burstow and Geoff Martin.


    Monday 6th November 2006

    Pressure group Health Emergency warned today that cuts to beds and jobs throughout the NHS since the start of the year will leave services seriously exposed this winter with red alerts likely in many areas as the cuts start to bite.

    Campaigners have verified information which shows that 2,468 beds have been cut from the NHS this year and that 21,885 jobs have been deleted, including compulsory redundancies.

    However, campaigners are also warning that many of the Trusts with the largest deficits are still working up their cuts plans and are likely to be shedding jobs in the run up to Christmas and the busy winter period.

    Last week Watford General declared a two day "red alert" where cases are diverted away from casualty and surgery is cancelled due to a lack of beds. Reports are coming in from other parts of the country that similar pressures are building up and that any additional demand from flu cases or a severe cold snap would tip front-line hospital services into crisis.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "The Government are ignoring the hard reality of the pressures that are building up at the sharp end of the NHS following a year of job losses and bed cuts. We fear that last week's red alert in Watford is really just a taste of what's to come across the country this winter.

    "Many hospitals will be driving through their cuts in beds and staff numbers in the run up to Christmas in a mad dash to hit government spending targets by next March.

    "Cutting hospital capacity in the run up to the busiest time for the NHS is like an ice cream factory winding down production in July - it makse no sense at all and will leave services seriously exposed over the coming months."


    Saturday 28th October 2006

    NHS pressure group Health Emergency today slammed the government for deliberately setting out to insult NHS staff over the 21,000 jobs that have been deleted across the country since February this year and for failing to understand the impact that blanket recruitment freezes are having on front-line patient care.

    Health Emergency, which keeps a running dossier of the axed NHS posts, are pointing at three recent examples of where the job reduction programmes have hit front line services:

    * St George's Hospital Tooting - Five neo-natal intensive care cots left moth-balled as the Trust cannot afford to recruit specialist nurses to run them. The Trust is looking to cut £29 million.

    * The Royal Free Hospital in Hampstead - 480 posts deleted leaving staff so short on the wards that they don't have time to assist elderly patients with their meals, running the risk of malnutrition. The Trust is cutting £25 million this year.

    * Epsom and St Helier Trust - Staff in non-clinical areas told to do their own cleaning so that the number of cleaners can be reduced. Risk of MRSA, C Diff and other superbugs breeding in non-clinical areas and being spread to the wards. The Truts is cutting £24 million over the next 18 months

    In the latest wave of job losses this week 95 staff at Kingston Hospital in Surrey, including nurses and consultants, were warned to expect to receive redundancy notices on the 11th December - two weeks before Christmas.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "It's easy for Tony Blair and his health ministers to be cavalier about the job losses in the NHS because it's not their livelihoods on the block. It's not just about compulsary redundancies. Many Trusts across the country have blanket recruitment freezes in place and are deleting vacant posts. That means not enough staff are left to run key services with dire consequences for patient care.

    The government seem determined to provoke and insult over a million health care staff who are trying to hold the service together in the teeth of cuts, privatisation and mis-management and waste of resources which goes right to the top of the Department of Health. It's no wonder they are angry."


    Sunday 8th October 2006

    In a statement to the BBC, senior health bosses have confirmed that both Epsom and St Helier Hospitals are likely to be reduced to the status of local "care" hospitals, losing their accident and emergency and critical care services.

    The bombshell announcement confirms the worst fears of health campaigners, the public and staff and came in a written statement to todays Politics Show on the BBC.

    The news comes as the Epsom and St Helier Trust, which runs both hospitals, have confirmed to staff unions that 200 beds will be closed over the next 18 months as part of a £20 million cuts package. Those cuts will now be seen as a staging post to the closure of both units as major acute hospitals.

    Government think-tank the IPPR confirmed last week that two hospitals should be closed in South West London. It is now clear that the two units that will be axed are St Helier in Carshalton and Epsom which is just over the south London boundary in Surrey.

    Geoff Martin, Health Emergency Head of Campaigns, said today:

    "The truth is now out and it confirms the worst fears of staff and patients - both Epsom and St Helier are to lose their main front line services as part of the carve up of hospital services in South West London and North Surrey.

    "The public who use these hospitals have been repeatedly lied to, deceived and sold down the line by health chiefs who have denied the closure plans while all along they've been cooking up this wholesale axing of services behind closed doors.

    "The Epsom and St Helier Trust Board have been implicated in a massive act of betrayal and the whole lot of them should do the decent thing and resign. Hundreds of health workers jobs are on the block but you can bet your boots that the senior managers will swan off to highly paid posts elsewhere once they've nailed the closed signs on the casualty department doors at both Epsom and St Helier.

    "We're going to up the fightback right now and we'll put thousands on the streets in a life or death battle to save these vital services."


    Friday 22nd September 2006

    On the eve of the Labour Party conference, campaigners have branded Home Secretary Dr John Reid as a hypocrite for fighting to save a casualty department in his constituency from closure while backing his Cabinet colleague Patricia Hewitt in her plans to close up to 60 hospital A&E units in England.

    John Reid has been a vocal opponent of plans to close the A&E department at Monklands Hospital in his Airdrie constituency and has joined protests outside the hospital. At the same time he has been backing government plans to axe 60 similar departments right across England.

    Geoff Martin, Head of Campaigns at pressure group Health Emergency, said:

    "The hypocrisy of John Reid over hospital casualty closures is breathtaking. One day he's outside Monklands Hospital in his constituency fighting the closure and the next he's sitting in Westminster with his Cabinet colleague supporting identical plans for up to 60 hospitals the length and breadth of England.

    This is Nimbyism at it's most extreme and most cynical and will have hospital campaigners in England spitting blood. The government are in free fall in their poll ratings on health and John Reid's rank hypocrisy will fire up campaigners to fight even harder to defend their local hospitals."


    Tuesday 19th September 2006

    With Health Secretary Patricia Hewitt due to defend her policies on hospital closures and privatisation today, campaigners have promised to "turn up the heat" against her plans in every town, city and village up and down the country facing the prospect of losing health care facilities in what is the biggest single attack on the NHS since the Lawson cuts in 1983.

    Campaign groups have already mobilised tens of thousands against the threat to hospital, primary care and mental health services from Glasgow to Cornwall and more new campaigns are springing up by the day in what is a growing public mood of resistance to Government health policy.

    Department of Health staff have been told by Labour Party officials to draw up "heat maps" of where the public anger against Government policy is at it's strongest. Campaign group Health Emergency are warning Hewitt that the mood right across the country is running hot and will boil over when the Strategic Health Authorities rack up another raft of hospital closure targets this autumn.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "The Government are running scared over their health policy blunders on hospital closures and privatisation but if they think the political temperature's running warm now they haven't seen anything yet. It's set to boil over this autumn and winter when we find out where the 60 main hospitals targetted for closure or downgrading are located.

    If Patricia Hewitt gives us another one of her nannying and patronising speeches at the IPPR today about how marvellous her cuts and privatisation policies are it will simply act as a recruiting sergeant for the NHS defence movement.

    We know that Labour backbenchers are terrified at the impact that the Government's health policies are having on core Labour voters and they are right to be alarmed. However, the Strategic Health Authorites are steaming on and are expected to announce plans over the next few months that will cut a swathe through health care provision across the country. This going to be the big domestic political issue and no amount of gerrymandering, spin and warm words will keep out of the news."


    Monday 18th September 2006

    Pressure group Health Emergency warned today that the confirmation that the Government are set to close or downgrade up to 60 major hospitals will speed up the moves to reduce services at a number of key units in London and the South East.

    Hospitals under immediate threat of losing accident and emergency services include the Royal Surrey County Hospital in Guildford and both Epsom and St Helier Hospitals where the government recently vetoed plans for a new hospital to replace the existing facilities.

    Demonstrators will be taking to the streets of Epsom on Saturday 30th September to fight moves to close services at the local hospital. Last week the Epsom and St Helier NHS Trust announced that they were closing a ward at both hospitals as part of an on-going £20 million cuts programme.

    Other London units under threat include:

    * West Middlesex Hospital in Hounslow

    * Central Middlesex Hospital in Park Royal

    * Queen Mary's Hospital in Sidcup

    * Whipps Cross Hospital in Waltham Forest

    * Chase Farm Hospital in Enfield

    Major reviews of services - aimed at clawing back multi-million pound deficits - are underway in Kent, Sussex, Essex and Hertfordshire with a raft of A&E and maternity closures expected.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "All of the potential hospital closures that we have identified in London and the South East are being driven by cuts. To suggest that this is all part of some rational planning process is nonsense. The BMA would do well to have a long, hard look at what's really forcing the pace of the cuts before they give a green light to more carnage on the wards.

    In the areas of the biggest projected population growth we are facing the heaviest duty cuts in health care services. So much for the government's promises of joined-up Government.

    What we are looking at is a cash-driven avalanche of panic cuts and closures which will have deadly impact on patient care. That's why we are jacking up the fightback and we are promising an autumn of widespread resistance."


    Friday 15th September 2006

    Pressure group Health Emergency today announced that it will be stepping up the national co-ordination of resistance to Government plans to close accident and emergency and maternity services following a new wave of cuts announcements this week.

    Across the country tens of thousands of people have been mobilised to fight local closure plans. Health Emergency are working with local organisers and trade unions to break the isolation of individual campaigns and expose the government's health plans for what they are - the biggest assault on the NHS since the Nigel Lawson cuts back in 1983.

    This week a raft of cuts announcements have been made hitting front-line hospital services in Rochdale, Sussex, Hertfordshire and Cambridge. Campaigns to oppose these latest cuts will be organised and will link up with on-going fights in areas across the UK as diverse as Grantham, Airdrie, Surrey, Cornwall and North London.

    In addition to the acute hospitals, campaigns have also been launched to stop cuts to mental health and primary care services.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "On top of the cuts to services more jobs are being slashed. Yesterday we learnt of another hundred health worker posts being axed in Sunderland on top of the 21,000 already lost in the NHS since the start of the year.

    "The cuts programme to NHS jobs and services will escalate this autumn as Trusts come under heavy duty pressure to balance the books. We now know that the £1.2 billion deficit in the NHS can only be squared by hitting front-line services and hitting them hard.

    "Meanwhile external consultants on £1200 a day are prowling the corridors of hospitals up and down the country drawing up hit lists of services to cut and nurses to sack. That's the sickening reality of the NHS today and it's no wonder that people are angry and are out there fighting back and we will be working to co-ordinate the local resistance on a national level to maximise the impact."


    Friday 15th September 2006

    On the day that the Liberal Democrats revealed new research identifying the 16 most cash-strapped NHS Trusts, pressure group Health Emergency warned that "turn-around teams" are working behind closed doors up and down the country to draw up the biggest wave of hospital cuts and closures since the infamous "Lawson Cuts" more than two decades ago.

    Although a number of Trusts have confirmed their jobs cuts and service clousures many more are still grappling with the scale of the deficits they need to claw back over the next six months if they are to meet the Government's target of balancing the books by March next year. Many Trusts are also now confirming the scale of the cuts sthat they will be forced to find in 2007/2008 as a result of the new funding system for the NHS.

    Highly-secretive reviews of services have been set up by Strategic Health Authorities with PR-friendly titles like "Fit For The Future". Management consultants and accountants have been engaged at massive cost to the taxpayer to draw up the hitlists.

    The new NHS Chief Executive has confirmed this week that there will be a wave of closures of major services over the next few years giving the green light to the Strategic Health Authorities to let the cuts rip this autumn.

    Meanwhile, a wave of local protests against the closures of accident and emergency and maternity services at hospitals across the country has sprung up and tens of thousands have taken to the streets in defence of health care services. Campaigners have mobilised to fight severe cuts to mental health services and the privatisation of GP services. The strike at NHS Logistics will add an important dimension to the fightback against cuts and privatisation.

    Geoff Martin, Health Emergency Head of Campaigns, said today:

    "Our organisation was set up to fight Nigel Lawson's cuts to health care services back in 1983. We are now staring down the barrel of the biggest wave of cuts since the Tories weilded the axe 23 years ago, and all this under a Labour Government.

    We've been up and down the country over the past few months speaking at rallies and meetings and the anger amongst health workers and the public at these cuts to health care services is running hot.

    Labour MP's worried about losing their seats should cast their eyes beyond Westminster and the Blair/Brown soap-opera and have a word with the people marching down High Streets up and down the country in protest at New Labour's carve up of our hospitals."


    Monday 11th September 2006

    Pressure group Health Emergency today slammed the Government over a total failure to get to grips with the MRSA crisis in the NHS and warned that the cuts in bed numbers and staffing levels currently ripping through the UK's hospitals will lead to even more hospital aquired infections as corners are cut to try and keep up with Government targets.

    The attack from Health Emergency on the Government's failure on MRSA comes on the day that new research shows that nearly 150 babies and children last year suffered potentially fatal blood infections after contracting the superbug - double previous estimates.

    Geoff Martin, Health Emergency Head of Campaigns, said today:

    "The Government and the Department of Health have been promising decisive action over MRSA for years but these shocking figures on the rate of infection amongst babies and young children show that they are failing miserably.

    The latest wave of cuts in staff and bed numbers hitting hospitals across the country will create new breeding grounds for MRSA and the the other superbugs. Patient throughput will be sped up, corners will be cut and there simply won't be enough time or money to maintain hygiene standards. That's the poisonous cocktail that MRSA thrives on."


    Friday 8th September 2006

    On the eve of the TUC Congress campaign groups Health Emergency and Public Services not Private Profit have issued a stark warning to the Government that their cuts and privatisation programme for the NHS is alienating core Labour voters in their thousands and is a major factor in the collapse of the Labour Party's national opinion poll ratings - a collapse which kicked off the bitter row over the timing of the Prime Ministers departure.

    The impact of the health cuts has sparked off a new wave of protest campaigns up and down the country with local marches bringing tens of thousands of angry people out onto the streets. More action is planned over the autumn as health providers come under Government pressure to balance the books by next March or risk further, punitive cuts in their budgets.

    Pressure group Health Emergency have been keeping a running total of job losses in the NHS since the start of the year and the number of axed posts now tops 20,000 with many more in the pipeline.

    John McDonnell MP, Chair of the Public Services Not Private Profit campaign, said:

    "I know just how angry health workers are at the continuing attacks on their services from the twin evils of cuts and privatisation. These public servants are core Labour supporters who are sick to the back teeth of being told that slashing jobs, and opening up the NHS to the profiteers of the private sector, is some kind of "modernisation".

    " It defies all logic that the money-making racket which is the Private Finance Initiatve is still being pursued by the Government despite a mountain of evidence that it bleeds huge sums of money away from patient care and into the pockets of the speculators.

    " I am backing our health workers to the hilt. If they ballot for strike action against the job cuts then I'll be on the picket lines with them. You can't talk about "renewing" the Labour Party when our own Government is systematically giving a kicking to the very people who have backed us through thick and thin and who provided the springboard for our electoral success."

    Geoff Martin, Head of Campaigns at Health Emergency, said:

    "The anger at the health cuts programme is bubbling over. It is now clear that the new Payment by Results system of NHS funding has been a disaster and panic cuts are being driven through across the country in a mid-year bout of blood letting. Thousands of health workers facing redundancy are bitterly angry that all the focus is on just one job - Tony Blair's.

    "The government appear to be on a suicide-mission to alienate core Labour supporters and that's why they are dropping like a stone in the polls. We are determined to drive a proper, public debate about the consequences of Government health policy onto the national agenda."


    Friday 8th September 2006

    Campaigners fighting to save the services at Epsom Hospital in Surrey today predicted the biggest demonstration the town has ever seen when the public take to the streets on Saturday the 30th September.

    The protest will assemble at Epsom Clock Tower at 10.30am on the Saturday 30th and will march to Epsom Hospital where a letter of protest will be handed in against the run down of maternity, paediatric, trauma and accident and emergency services. There will then be a rally in Rosebery Park where speakers will include local MP Chris Grayling, Kevin O'Brien from UNISON and Geoff Martin from Health Emergency.

    The campaign to save services at Epsom Hospital became even more urgent this week after the Epsom and St Helier NHS Trust confirmed that they are looking at cutting another £20 million from their budgets over the next 18 months leading to fears that those cuts will be targetted at Epsom, speeding up the closure of the Hospital.

    The hit squad from accountants KPMG who have been brought in to make the £20 million cuts are fresh from a similar exercise in Surrey and Sussex NHS Trust where they recommended getting rid of over 400 jobs and charged the NHS £750,000 for their time.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "We are getting a fantastic response from people who are pledging to support the march on the 30th September. They will be coming in from all over Surrey to show their support for Epsom Hospital. People are rightly angry at what they see as a betrayal of a fantastic local facility.

    "I know what's at stake. When I was born 44 years ago at Epsom Hospital, premature and jaundiced, they saved my life. A few years later Epsom Hospital saved my dad's life when his duodenal ulcer ruptured and he suffered massive internal bleeing. Only last year they gave my mum a new hip which has made an unbelievable difference to her. This is deeply personal for me and I will fight the NHS bureaucrats who want to run down Epsom Hospital every step of the way."

    Kevin O'Brien, Unison Secretary at Epsom and St Helier, added:

    "Staff and the public will join forces on the streets of Epsom on Saturday the 30th to stand up for our local hospital. We know that the £20 million of cuts announced this week will put jobs and beds on the line and that the hit squad from KPMG who have been brought in to swing the axe will only be looking at the bottom line. That could well speed up the closure plans for Epsom."


    Friday 8th September 2006

    Campaigners today accused the Kingston Hospital NHS Trust of keeping staff and the public in the dark on their plans to cut £7.5 from their budget and have issued a challenge to them to come clean on just where the axe will fall.

    Earlier this week London Health Emergency released an internal Trust memo which had been circulated to staff confirming that £7.5 million will have to be cut by next March and warning that wards, theatres and hundreds of jobs were all on the line.

    However, the Trust are refusing to confirm exactly where the bulk of the cuts will fall. To date, 26 bed closures and a similar number of job losses have been confirmed in women's health and orthopaedics but that only saves £500,000. The other £7 million of cuts are being kept under wraps.

    Local Councillors and MP's have joined London Health Emergency and UNISON in demanding to know which services the Kingston Hospital Trust is planning to slash.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "It is a scandal that the cuts in front-line services at Kingston Hospital are being cooked up behind closed doors and that staff and the public are being kept in the dark.

    We know that the cuts on the scale being proposed will lead to ward and theatre closures and hundreds of jobs being axed.

    This will mean major reductions in services and we have called on the Health Scrutiny Committee of Kingston Council to trigger a full public consultation on the changes which they have the power to do under the NHS Act.

    We will be mobilising a full public campaign against the cuts plans at Kingston. The Trust know that and maybe that's why they are keeping the plans secret."


    Thursday 7th September 2006

    Pressure group Health Emergency warned today that the 20,000 NHS job losses announced since the start of the year are now starting to have an impact on some of the most vulnerable users of health care services - children, the elderly and people with mental health problems.

    Health Emergency are pointing to four recent examples of where the job cuts are hitting front line services:

    * City and Sandwell Hospitals in the West Midlands where 800 jobs have been slashed. Paediatric beds regularly being closed down as the Trust is not recruiting to vacant posts and as a result cannot provide an adequate number of nurses.

    * Royal Free Hospital in north London where 480 jobs have been axed. Whistleblowing nurses have warned that they simply don't have enough staff to cope at meal times leaving elderly patients at risk of malnutrition. Health Emergency have triggered a Health Commission investigation.

    * Buckinghamsire community health services where 56 jobs have been axed so far. Not enough staff left to run the out of hours district nursing service with elderly and other vulnerable patients told to get themselves to accident and emergency. Community beds and school nursing services also cut.

    * South London and Maudsley mental health trust where up to 200 posts are being cut. Cuts to staff and the skill mix are having a widespead impact on mental health services in south London including the closure of a 9-bed "crisis centre" for women, Dove House in Streatham, which only opened two years ago.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "These four examples of just how the job cuts in the NHS are hitting vital front line services nails the government lie that the financial squeeze on the health service is merely an adminstrative matter. These are real cuts and hitting real services for some of the most vulnerable members of our communities.

    "Those MPs squabbling amongst themselves in a desperate bid to save their own skins would be well advised to take a look at what's going on in the health services in their constituencies. The crisis in the NHS is part of the Blair legacy that has an impact on lives well away from the Westminster village.

    " Our campaign, along with Keep Our NHS Public and the unions, will be bringing that message loud and clear to the party conference in two weeks time."


    Monday 4th September 2006

    Health campaigners and unions warned today of further massive cuts to front line hospital services in south west London and Surrey as the Kingston Hospital Trust announced that they will be closing theatres, beds and axing jobs in a raft of panic cuts aimed at clawing back a massive £7.5 million deficit over the next six months.

    The Kingston cuts come on top of news that Health Secretary Patricia Hewitt has effectively torpedoed plans for a new hospital to replace Epsom and St Heliers with her officials citing the financial crisis in the Kingtson, Merton and Sutton PCT's as grounds for ditching the proposed new critical care hospital.

    Kingston Hospital, which has balanced it's books for the past three years, is now plunged into a massive of package of panic cuts half way through the financial year to bail out the £9 million deficit which has been run up by Kingston PCT.

    The hospital has not yet confirmed how many beds, theatres and jobs will be scrapped but London Health Emergency, and health union UNISON, are warning that the cuts will be major and will have a severe impact on patient services. Unions and campaigners are planning to fight the cuts and will be looking to enlist support from the public, MP's and Councillors.

    A march has been organised in Epsom on Saturday 30th September assembling at 10.30 am at the Clock Tower in Epsom High Street which will now become a focal point for opposition to the run down of services at Epsom Hospital and the wider assault on health services in the surrounding area.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "The carnage of cuts and closures to hospital services in south London and Surrey has escalated today with the news that Kingston Hospital is looking to slash £7.5 million from it's budget over the next six months. You can't save those sort of sums of money without having a disastrous impact on front line patient care.

    This area is now at the eye of the storm in terms of the Government's health cuts policy. It's vitally important that the people who rely on the services of the hospitals under attack join us on the streets of Epsom on Saturday the 30th September to ram home our opposition to the cuts and closure plans."


    Tuesday 22nd August 2006

    Health campaigners today called on the Board of the Epsom and St Helier NHS Trust to resign after it was confirmed by the Department of Health that the plans for a new critical care hospital to replace Epsom Hospital and St Helier Hospital have been effectively scrapped on the grounds of cost.

    The Trust Board have wasted millions of pounds pursuing the scheme, known as Better Healthcare Closer to Home, and have promised a network of new community hospitals across south west London and north Surrey backed by a single critical care hospital.

    Now, Health Secretary Patricia Hewitt has turned the plans on their head, teliing the Trust that they are not to pursue the redevelopment of the St Helier site and that they are to go back to the drawing board. She also points out that the financial crisis facing the NHS in the area makes the funding of a new hospital virtually impossible.

    Meanwhile, plans to run down services at Epsom Hospital are gathering pace after being given the green light by Surrey County Council. The services will be transferred into the crumbling and condemned buildings at St Helier as an interim measure before both hospitals are downgraded and closed as major acute units as part of the Government's shake out of major hospitals in and around Surrey.

    Campaigners have pledged to step up the fight against the axing of services across the area with a major demo in Epsom on Saturday the 30th September assembling at 10.30am at the Clock Tower in Epsom High Street.

    Geoff Martin, Head of Campaigns at Health Emergency, said today:

    "The Board of Epsom and St Helier have presided over the collapse of a health strategy that will have an impact on hundreds of thousands of people and they should do the decent thing and resign. They have not a single shred of credibility left and the sooner they go the better.

    "The collapse of the hospital plan for south west London and north Surrey has been an expensive and damaging farce from start to finish and I have no doubt that the end result will be that we are left with nothing. Last weeks leak of news that the Government plans to cut the number of hospitals in and around Surrey is no coincidence.

    "All that we have left now is the power of protest. That's why it's vital that people from across the area join us on the streets of Epsom on saturday the 30th September. We have to mobilise and harness the anger of the public at this betrayal of their hospital services."


    Monday 21st August 2006

    Pressure group London Health Emergency warned today that plans to axe 26 beds and 25 full-time posts at Kingston Hospital are the first wave of a cuts process which could bite deep into patient services.

    Kingston Hospital has been caught in the crossfire of a financial crisis in the Kingston Primary Care Trust and the chaos over the Government's new funding system for the NHS and will be looking at cuts which could be as high as £7 million this year.

    The shock cuts news, confirmed by the Trust today, has come out of the blue as Trust recently reported that they balanced the books for the past three years.

    The first wave of cuts - now out to consultation - would see the closure of 5 women's health beds on Isabella Ward and 21 orthopaedic beds. Over 25 whole time equivalent posts are set to be deleted from the workforce.

    The Kingston Primary Care Trust, facing a deficit of over £9 million this year, are also demading a range of other savings:

    * The specialist Royal Eye Unit is under threat with the PCT demanding that patients with emergency eye problems attend Kingston's general A&E.

    * Beds will be closed at Tolworth Hospital, including some of the beds only recently shifted there from Surbiton. The long-term future of the Tolworth site has been called into question.

    * Pain management services provided by both Kingston Hospital and local GP's will be reduced.

    * GP referrals will be restricted with cases vetted on an independent basis by an independent panel.

    Pressure group London Health Emergency and health union UNISON have vowed to campaign against the cuts and are warning the public that there is worse to come.

    Geoff Martin, Health Emergency Head of Campaigns, said today:

    "Here we have another London NHS trust which has managed to balance the books left facing multi-million pound cuts in front-line patient services. It underlines once again just what a shambles health care funding has become.

    We have no doubt that these cuts at Kingston are just the first wave and that there wil be more to come. Slashing budgets for pain services is a cruel blow for hundred of people who will be left in agony."


    Wednesday 2nd August 2006

    The day after it was revealed that the Wembley Stadium development has been delayed again, health campaigners have raised new doubts over the viability of the Stadium's emergeny plans in light of the possible closure of the casualty unit at Central Middlesex Hospital in Park Royal - the nearest hospital to the stadium.

    London Health Emergency have been trying to obtain a copy of the multi-agency emergeny plan for the new Wembley but have been told that it is "restricted access."

    However, in an email from Brent Council LHE have been told that the emergency plans have not yet been finalised, let alone agreed by the wide range of agencies involved in the process.

    Geoff Martin, Health Emergency Head of Campaigns, said today:

    "Clearly there is something seriously wrong if the Wembley emergency plans have not yet been finalised. The consultation process with the various agencies involved will take months and frankly there is something seriously wrong here. We would have expected robust, tried and tested plans to be in place by now.

    We suspect that the Council - who are co-ordinating the emergeny plan - have not been informed of the possibility that the nearest casualty unit to the stadium could be closed or downgraded by the North West London Hospitals NHS Trust as part of a £23 million cuts programme. A consultation document on the closure is due out this autumn.

    In the event of a major incident at Wembley there could be hundreds of casualties and Central Middlesex is the hospital that we would expect to be in the front line. If it's casualty unit is closed or downgraded it would seriously compromise emergency plans for the new Stadium.

    We will now be submiiting a Freedom of Information request to gain access to the plans."


    Sunday 23rd July 2006

    A Kent branch of the Keep Our NHS Public campaign was launched last week as campaigners released a new dossier setting out the full scale of the privatisation plans for the county's health care services.

    Pressure group Health Emergency - part of the Keep Our NHS Public campaign - have been monitoring the cuts and privatisation crisis in Kent. The dossier is attached.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    " Kent is a perfect example of everything that's wrong with government health policy. On the one hand a combination of mismanagement and underfunding has left the county facing £100 million of cuts this year. On the other hand private companies are being allowed to cherry-pick lucrative areas of the service in the knowledge that they'll get paid regardless of their abysmal performance.

    This poisonous cocktail of cuts and privatisation results in the obscenity of student nuses being shown the door when they finish their training because their's no money to pay them while the private companies bleed millions away in profits. The public are right to be angry at this waste of resouces while the private sector is given the green light to rip off taxpayers money by the barrow load."


    Sunday 23rd July 2006

    As a group of MPs released a scathing report on the system of NHS charges in the UK, pressure group Health Emergency warned that the scale of charging is set to escalate under New Labour's market-driven NHS reforms.

    Health Emergency claimed that the Foundation Trusts, run as quasi-commercial businesses, are almost under obligation to squeeze every penny that they can out of patients and relatives when they are on the hospital site. The increasing involvement of private companies in the NHS means that they will bring their "maximum profit" practices into our hospitals and health centres.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "We welcome today's report but with the government's NHS reforms being driven by the private sector it's no surprise that Trust's are bringing in the same commercial methods designed to screw every possible penny out of patients and visitors that you'd expect on a trip to Asda.

    The Foundation Trusts will be even more aggressive in exploiting every commercial opportunity to the full. All hospitals are supposed to become Foundation Trusts by 2008 and we can expect to see the range of support services subject to charges expanded as the drive for profit takes over.

    When Tony Blair met with the heads of Tesco's and Sainsbury's earlier this year to discuss their involvement in his NHS reforms we warned that it would lead to wholesale commercialisation of the NHS. Today's report shows that we are well on the way."


    Sunday 23rd July 2006

    Campaigners fighting health cuts in north west London, which could see the closure or downgrading of the nearest accident and emergency department to the new Wembley Stadium at Central Middlesex Hospital, have been denied access to the Wembley emergency plans which would show the strategic importance of Central Mid in the event of a major incident at the stadium.

    Brent Council have told campaigners that the plan is "restricted access" and not available for scrutiny. Pressure group Health Emergency will now be tabling a Freedom of Information request to try and gain access to the section of the report on casualty flows to Central Middlesex as a consequence of a major incident on the Wembley site.

    Geoff Martin, Health Emergency Head of Campaigns, said today:

    "We have no doubt that any move to close or downgrade the casualty unit at Central Middlesex, with it's close proximity to Wembley and excellent road links, would have a major impact on emergency incident plans for Wembley Stadium.

    As part of a £23 million cuts programme North West London Hospitals are considering centralising the Central Mid emergency and trauma services up at Northwick Park Hospital in Harrow. A consultation document on the plans is due out this autumn but it would be impossible to run a serious public consulation without access to information on the impact on Wembley Stadium and it's major incident plans."

  • Kent County Crisis: NHS torn apart by cuts and privatisation

    Wednesday 12th July 2006

    Hospital and health services throughout Kent are face cuts totalling over £100m this year, with front-line NHS services, beds and jobs at risk in Dartford, Gillingham, Maidstone and Canterbury: but private sector providers, investors and management consultants are scooping up fat profits, and expanding as the NHS declines.

    These are the shock conclusions from ‘On the Critical List’: a new detailed round-up published today by health watchdog Health Emergency (attached). It identifies the cash shortfalls hitting hospital Trusts (Dartford and Gravesham £6m; Medway £12m; Maidstone and Tunbridge Wells £34m; East Kent £35m) and Primary Care Trusts (five of which have deficits totalling £20.7m).

    But it also points the finger firmly at the private sector, draining funds from patient care through the inflated overhead costs of the Private Finance Initiative hospital at Dartford (where PFI charges consume 20 percent of the Trust’s budget) and threatening even heavier costs in the proposed £428m new PFI hospital in Pembury for the Maidstone and Tunbridge Wells Trust.

    More cash is also being siphoned out of NHS Trust budgets into “Independent Sector Treatment Centres” (ISTCs), with one in Gillingham picking up guaranteed payments despite falling around 40% short of its target (and therefore collecting full funding for 2,500 operations it has not performed) while the local Medway NHS Trust makes cuts to balance the books.

    Another ISTC is to be built in the grounds of Maidstone Hospital, resulting in a loss of £11m income to the Trust, while NHS staff will be seconded to work in the new unit, delivering profit to shareholders.

    The report sets the scene for the launch on July 19 of a Kent-wide campaign to “Keep Our NHS Public”, aiming to link health workers and professionals with patients, trade unionists, pensioners, community groups and campaigners and anyone in the wider public who recognises the chaos that is emerging as a result of the government’s market-style “reforms” in the NHS.

    Kent Keep Our NHS Public

    Wednesday 19 July 2006

    7:30pm at Sessions House, County Hall, Maidstone

    Launching the report, Health Emergency’s Information Director Dr John Lister said:

    “This report, which is fully documented, makes grim reading. Patients and public of Kent have a stark choice. They can watch their local NHS hospitals being dismantled, with the profitable bits hived off to private profiteers and the emergency services “centralised” to one or two hospitals meaning long journeys for those most serious ill – or they can join the campaign to stop the rot.

    “That’s why Health Emergency welcomes the launch of Keep Our NHS Public in Kent. The privatisation and cutbacks are running hand in hand at rapid pace. There is no time to lose.”


    Wednesday 12th July 2006

    Health campaigners warned today that the threat of closure hanging over the accident and emergency department at Central Middlesex Hospital in Park Royal could seriously undermine the emergency incident plans for the new Wembley Stadium.

    The North West London Hospitals NHS Trust, which runs Central Middlesex Hospital, is looking at axing £23 million from its budget this year. One of the plans under consideration is closing or downgrading the casualty unit at Central Middlesex Hospital and merging it into a single unit on the Northwick Park Hospital site in Harrow.

    A formal consultation document of the plans is due out in November.

    Geoff Martin, Health Emergency Head of Campaigns, said today

    "This week the British Association for Emergency Medicine warned that hospital casualty units are being closed down to save money regardless of the consequences. Any plan to close A&E at Central Mid would provide concrete evidence to back their case.

    The Central Mid A&E is a brand new unit, strategically placed in North West London close to the main road newtork and the closest casualty department to the new Wembley Stadium. Any thoughts of closing it are dangerous nonsense.

    We want to see a copy of the major incident plans for the new Wembley. We'd be amazed if they didn't rely heavily on the services at Central Middlsex Hospital but now there is a real possibly that those services could be axed soon after the new Wembley opens. We are calling on the Government to rule out any closure of the main A&E unit at Central Middlesex Hospital."


    Monday 10th July 2006

    Health campaigners today promised Health Secretary Patricia Hewitt an "all out war" over her plans to privatise primary health care services after she revaled today that government plans to offer private companies the opportunity to run GP and other services are back on track.

    Geoff Martin, Health Emergency Head of Campaigns, said today:

    "The government have confirmed today that their plans to bring in private companies to run primary care services are back on track and we are promising them a long, hot summer of resistance.

    The Department of Health were rumbled over their dodgy advert in the European Journal but they are now looking for a new form of words that will offer the giant US health care corporations the same thing - the right to bleed a fat profit out of the NHS.

    The public will be appalled and these plans will be fought every step of the way."


    Tuesday 4th July 2006

    Pressure group Health Emergency revealed today that nursing numbers at ward level are being cut within the Epsom and St Helier NHS Trust as part of a £10 million cuts drive.

    An internal memo to staff working on one of the wards says:

    "On 15/05/06 I sent all staff an urgent memo informing you that the wards establishment of staff has been reduced on the late shift (to 3 RGN's). Unfortunately this has been reviewed further and on 18/05/06 I was informed we also have to reduce the number of trained staff on the early shift. This will come into effect on Monday 22nd May.

    Therefore as of this date we will now only have 4 trained nurses on the early shift. The untrained staff will remain the same (2 on an early and a late).

    I have expressed my concerns to the appropriate people, but the reality is this has to be done to prevent redundancies."

    The memo, circulated by a senior member of nursing staff, was passed to Health Emergency at the weekend.

    Kevin O'Brien, UNISON Epsom and St Helier Branch Secretary, said:

    "It's a scandal that the Trust are cutting staffing levels on the wards without any consultation with the trade unions. It flys in the face of our negotiating procedures and our members are extremely angry that the changes have been bounced on them this way. We are taking the issue up with the Trust and we are prepared to take action to maintain safe staffing levels"

    Geoff Martin, Health Emergency head of campaigns said,

    " We know that the Trust is looking at £10 million of cuts this year and we feared that they would start cutting staffing levels to balance the books. It appears that the cuts are well under way by stealth and that Epsom and St Helier is joining the ranks of hospitals across the country axing nursing posts under government pressure to break even."

    Meanwhile, staff at the North West London Hospitals Trust - which includes Central Middlesex and Northwick Park - have taken to the streets in protest at 422 job losses as part of a £23 million cuts package which could see the closure of the casualty department at Central Middlesex Hospital, the nearest A&E to the new Wembley Stadium.


    Sunday 2nd July 2006

    Health campaigners today promised to "turn up the heat" on the government over their NHS privatisation plans after Health Secretary Patricia Hewitt was forced to back off on plans to advertise for a private sector takeover of primary health care services in the European Journal.

    Hewitt has been forced onto the defensive over health care privatisation and Health Emergency said today that they will use the Government disarray as an opportunity to jack up campaigning against local health privatisation plans across the country.

    Health Emergency have already successfully ambushed and derailed a plan to sell off the South West London Elective Orthopaedic Centre (SWLEOC) to an American health care provider and are promising to wheel out the same tactics in other areas of the UK.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "The Government were caught out bang to rights over the European Journal advert and their claims that they are not privatising health care will come back to haunt them. Those words will be slung back in their faces as they try to smuggle through their privatisation plans by stealth away from the glare of publicity.

    From the private elective treatment centres, through to the invitation to the big American corporations to take over GP services and on to the debt-ridden consequences of the Private Finance Initiative -privatisation of health care is top of the new Labour agenda. Why else was Tony Blair having breakfast meetings with companies like Tesco and Sainsburys on health care policy?

    The shambles over the advert for private bidders for primary care services is the biggest shot in the arm the NHS defence campaign has had in years. We have every intention of making the most of it."


    Sunday 25th June 2006

    NHS pressure group Health Emergency revealed today that nurses in Oxfordshire have been reduced to tears on the wards as the human cost of the redundancy programme in the health service hits home.

    The Radcliffe NHS Trust, which covers Oxfordshire, is axing 600 jobs as part of a £33 million cuts programme. Health Emergency have compiled figures which show that the total number of jobs lost in the health service since February this year is over 16,000 with the prospect of worse to come as health chiefs come under pressure from the Government to close the £1.2 million deficit in local NHS budgets this year.

    There are reports from across the country of the disastrous impact on staff morale that the threat of redundancy is having across the NHS. With more job losses set to be announced the crisis in staff morale will deepen with disastrous consequences for patient care.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    “I am sure that the vast majority of people will share our disgust that the Government’s orders to slash health spending have reduced nurses and other members of the health care team to tears. That’s the human cost of letting over-paid accountants and management consultants take over the running of our health services and it stinks.

    The NHS runs on the good will of its staff and relies on a highly-motivated workforce who feel that they are valued. All of that is being ripped to shreds.

    There are growing campaigns up and down the country taking to the streets, uniting the public and the NHS staff, in a fightback against the health cuts that are slicing through many areas of the UK.

    The government ignore the anger of the public and health care workers at their peril.”


    Wednesday 21st June 2006

    Pressure group Health Emergency said today that tens of thousands of people up and down the country have taken to the streets over recent weeks in protest at cuts to health care services and jobs and predicted a "long, hot summer" of action as more local groups organise to fight off attacks on the NHS.

    A snapshot of recent protests shows:

    a.. 5000 people in Oxfordshire protesting against £33 million of cuts which would see the downgrading of front-line services at the Horton Hospital in Banbury.

    b.. 6000 on the march in the Forest of Dean and 4000 in Stroud against a wave of local hospital closures and job cuts as part of a £45 million cuts package in Gloucester.

    c.. 1000 staff on the streets of Manchester in protest at £21 million of cuts which will lead to the axing of 800 jobs.

    d.. Hundreds of NHS staff outside the gates of Whipps Cross Hospital in Waltham Forest for a lunchtime rally against 400 job cuts.

    e.. Reports in the local press that staff in Wolverhampton are to be balloted for industrial action in response to £20 million of cuts which will see 300 job losses, including 119 nurses, the majority through compulsory redundancy.

    f.. 5000 staff and patients marching through Stoke in protest at one of the biggest job-loss packages of nearly 1000 posts designed to claw back a £15 million deficit.

    g.. There have been a wave of angry protests against closures of local community, cottage hospitals and maternity services in areas across the country as diverse as Shropshire, Cumbria, Surrey and Sussex, Bristol and Derbyshire.

    h.. A number of protests are planned over the next fortnight including major events in Maidstone, Birmingham and Leicester.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "There is growing anger up and down the country at the cuts that are being forced through to try and square the NHS's national deficit of £1.2 billion. With more cuts in the pipeline we are predicting a long, hot summer of action that the Government ignore at their peril.

    Labour's poll ratings on health are in free fall, NHS protest candidates are scoring victories in local elections and many Labour backbenchers are feeling the heat. This grassroots NHS protest movement will continue to grow up and down the country and will keep health right at the top of the political agenda."


    Tuesday 20th June 2006

    Pressure group Health Emergency said today that 16,125 jobs have been axed in the NHS since February and predicted much worse to come as health trusts come under government pressure to wipe out £1.2 billion of deficits by March of next year.

    Health Emergency have been keeping a running total of NHS job losses since the first cuts were announced earlier this year and the latest update includes the 1100 job losses announced in Yorkshire last week – the biggest single hit unleashed so far.

    The campaign is warning that further major reductions in jobs and services are on the cards as half of the Trusts with the biggest deficits, where government-appointed hit squads are carving their way through the accounts, have yet to announce their cuts.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    “We’ve already seen staff and patients mobilising campaigns against the cuts in areas as diverse as Gloucestershire, Waltham Forest, Stoke and Surrey & Sussex and there is a growing mood of anger building up across the country. Health Emergency is working with the local campaigns to maximise national pressure on the government to call a halt to the cuts.

    "If the government are serious about stripping £1.2 billion out of the NHS budget by the end of this financial year that would mean the job loss total pushing up towards 50,000 with major reductions in services up and down the country.

    "Sacking nurses and closing hospitals is political suicide and we will be working with Labour backbenchers and others to shove that message down the government’s throat.”


    Wednesday 14th June 2006

    NHS campaign group Health Emergency have today seized on comments by NHS supremo Sir Ian Carruthers in this mornings Guardian, in which he admits for the first time that acute hospitals may have to close to square the NHS deficit of £1.2 billion, as evidence that the health service faces a year of job losses and service closures that will hammer patient services up and down the country.

    Health Emergency have compiled figures which show that over 16,000 jobs have been axed to save £200 million since February this year. Far worse cuts will have to be made to claw back the £1.2 billion owed by Trusts by the Governments own figures and that means whole hospitals going to the wall.

    Epsom Hospital in Surrey, where moves to downgrade maternity and children's services are underway, could be the first to go. Queen Elizabeth Hospital in Woolwich, one of the first PFI units, admitted earlier this year that it is "technically bankrupt" and the nearby Queen Mary's in Sidcup has accepted that its financial pressures are so dire it could close.

    Health Emergency have pointed to Yorkshire, the South West, Essex and East Anglia as other areas that could see cash-driven hospital closures.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "The NHS are softening us up for some major cuts and closures later this year. This is the first time that NHS Chief Executive has accepted that whole hospitals may be left to go bust. For staff, this means that the axe of redundancy is hanging over thousands of heads - for patients it means serious questions over whether their local hospital will be one of the winners or losers under New Labour's death or glory health policy."


    Friday 19th May 2006

    Yesterday’s announcement that St George’s Hospital in Tooting are to axe a minimum of 150 staff posts as part of a drive to save £29 million takes the total number of jobs stripped out of the NHS to over 15,000 since the cull began in February.

    St George’s – a massive teaching hospital providing health care services to a large area of south London – have been given instructions by the Government to speed up their cuts programme and to balance their books by the end of the financial year regardless of the consequences.

    The Trust have warned that if their proposed cuts package fails to deliver, far greater job losses could be required later in the year.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    “Coming on top of the Leeds, Gloucester and Nottingham job cuts earlier this week, and the axing of nearly 1000 staff at NHS Direct, the total number of health care posts lost since February is now over 15,000 with this announcement from St George’s.

    St George’s have made it clear in their statement that these cuts are being forced on them by the Department of Health – they are following central Government diktat. There is no doubt that more jobs, and more beds and services, will be stripped out of the NHS up and down the country over the coming months with severe consequences for patient care.”


    Friday 19th May 2006

    Pressure group Health Emergency said today that the confirmation the NHS Direct is to cut 1000 posts will devastate the service and pile more pressure on GP and Accident and Emergency services at a time when they are struggling to cope.

    Health Emergency have calculated that the Health Direct cuts, added to the recent announcements of job losses in Leeds and Gloucester, take the total number of NHS posts axed since February to nearly 15,000.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    “The Health Direct cuts will devastate the service and the public will find it much harder to get through for the advice they need. Many will simply opt to head for A&E or the GP centre, piling pressure on the same services that Health Direct was set up to support.

    This is health care planning on the hoof, dominated by crisis management and panic cuts. The Health Direct cuts make a mockery of new Labour’s “joined up Government” and will cause confusion and fear for thousands of people who find it impossible to access the service.”

    Tuesday 16th May 2006


    Wednesday 10th May 2006

    Pressure group Health Emergency said today that the tide of job losses in the NHS has risen to 11,525 with the prospect of far bigger cuts in jobs and services to come as the year drags on.

    The trail of job losses since February this year - detailed below - has caused misery and uncertainty across the NHS with devestating consequences for staff morale.

    However, campaigners are warning that there is far worse to come for three reasons:

    1. Some of the NHS Trusts with the biggest deficits, and where the government hit-squads are still working through the books, have yet to announce their cuts.

    2. Many Trusts have not yet been able to agree a budget for this current financial year, a fact recognised by Patricia Hewitt today, because they cannot predict the outcome of the new "payment by results" funding system and the tariff imposed by the government at the last minute.

    3. Cuts in the Primary Care Trust budgets for this year, particularly in London, have yet to filter through.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "The Government have sat on their hands while the morale of health staff has been ripped to shreds by this growing tide of panic cuts in jobs and services right across the country.

    NHS finance is out of control as a result of poor management from both the government and local Trusts and the result is that our front line health services are being crisis-managed on the hoof. Many Trusts have no idea what their income and expenditure position is for this current year and as a result a lot of them are heading for meltdown by the autumn as more panic cuts are hammered home.

    This is a scandal cooked up in Whitehall and served up at your local NHS hospital - Hewitt has not only lost control of the situation but has lost the confidence of the public, NHS staff and a growing number of Labour MP's."


    Tuesday 9th May 2006

    Research from NHS pressure group Health Emergency published today reveals that the private companies behind current and planned Private Finance Initiatives in the health service stand to make windfall profits of £3.3 billion – money that will stripped straight out of patient care budgets.

    Health Emergency have looked at the costs of PFI in light of the inquiry into the financing of Norwich and Norfolk PFI which, through a series of re-financing moves, saw the private sector scooping a bonus payout of £95 million – 60% of the total cost of the new building.

    Health Emergency calculate that re-financing bonuses at that level will be difficult to achieve now but that a 20% windfall return could still be achieved. The £3.3 million stacks up as follows:

    * Current NHS PFI schemes are worth £4.6 billion. A 20% windfall to the private companies averaged out across the current schemes would add up to £920 million.

    * The three most recently approved PFI schemes (Barts, Birmingham and St Helens) are worth £2.2 billion adding a potential windfall profit of £440 million.

    * There are a further £10 billion worth of NHS PFI’s in the pipeline with a whacking £2 billion worth of bonus payouts up for grabs.

    Geoff Martin, Head of Campaigns at Health Emergency, said today:

    “If taxpayers want to know why the NHS is in financial crisis, despite the Government’s extra funding, they should look at the sums that the private consortia and their shareholders are bleeding out of the Private Finance Initiative. The scandal at the Norwich and Norfolk NHS Trust is the tip of the iceberg.

    If the Kray twins were alive and well in East London today they wouldn’t be extorting money from the snooker halls of Whitechapel, they’d be sniffing around the Barts and Royal London PFI where the profits are higher and it’s all legal.

    When Tony Blair talks about modernising the NHS what he means is more PFI and bigger and fatter profits for the shareholders of the private companies involved, and all at taxpayers expense.

    That’s why more beds will be closed and more nurses will be sacked. There should be a national inquiry into the real cost of PFI.”


    Tuesday 9th May 2006


    NHS pressure group Health Emergency said today that the announcement of nearly 10,000 NHS job cuts in the run up to yesterdays local elections had been a major factor in the collapse of the Labour vote and warned that there would be much worse to come for the government if they continue to press on with their privatisation and cuts agenda for the health service.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "There is no doubt at all that Tony Blair and Patricia Hewitt have alienated health workers, and other traditional Labour voters who value the core principles of the NHS, through their slash and burn approach to health service reform.

    They have also managed to play into the hands of the extreme right BNP. In Barking, just before polling day, the local NHS Trust announced that it was axing 650 staff posts - a gift that the BNP gladly exploited.

    New Labour have created a divisive, dog-eat-dog model of health care funding that pitches nurse against nurse and doctor against doctor. Patricia Hewitt has admitted that some hospitals will go bust this year under her market-driven health care model.

    Thousands more staff will end up on the scrap heap and more beds and casualty departments will be closed if the Government don't back off.

    They should start taking note of what the voters are telling them sharpish. Labour voters don't expect to see a Labour Government sacking nurses and hiving off the lucrative parts of the health service to their big business buddies."

  • "Ostrich" Blair drags NHS "back to the future"

    Tuesday 18th April 2006

    TONY BLAIR’s “ostrich-like approach” to reforms which threaten to drag the NHS back to the chaos that existed before 1948 has been sharply criticised by London Health Emergency.

    Blair’s speech today to the pro-market “New Health network” is expected to make no reference to the current crisis taking shape within the NHS, in which tens of thousands of health workers stand to lose their jobs and NHS hospitals face controversial cuts and closures, driven by government reforms.

    Blair is also expected to :

    • Endorse “practice-based commissioning” which claims to put GPs in control of health budgets – while in the real world the NHS is even now introducing new “referral management schemes” intended to limit numbers of patients referred by GPs for hospital care: in London NHS bureaucrats are demanding referral rates be cut arbitrarily to the lowest 10% in England, regardless of clinical need.

    • Endorse the controversial “payment by results” system – which ensures that every £1m spent by the NHS on private treatment means £1m slashed from NHS budgets, and which stands to force a fresh round of cuts and job losses. The same system will now penalise hospitals that treat any increase in numbers of emergencies – creating real dangers patients will be turned away.

    • Endorse the extension of “patient choice” – while he and health ministers urge Trust bosses to take “tough” decisions to close down popular local general hospitals, regardless of patients’ needs or wishes

    LHE's Information Director Dr John Lister said:

    “Mr Blair may choose the ostrich tactic and stick his head in the sand to ignore the crisis his policies have created, but no such luxury is available to the NHS managers and front line NHS staff who have to deal with the problems every day.

    “He may talk of shaping an NHS for 2008 rather than 1948, but his policies are headed in the opposite direction, dragging us backwards rather than forward.

    “Every policy from Blair and his ministers serves to undermine cost-effective public sector services while strengthening a costly and parasitic private sector. They are recreating a new chaotic mish-mash of private, voluntary, charitable, municipal and government-funded services -- just like the mess Nye Bevan swept away in his radical modernising reform that set up the NHS.

    “Any genuine modernisation would build on that radical reform, rather than reverse it. That’s why we support the campaign to Keep Our NHS Public.”

  • 10 percent or more of NHS jobs in England face axe in “sacrifice to market”

    Wednesday 12th April 2006

    The recent wave of redundancies in NHS Hospitals is just the tip of the iceberg of cutbacks to come as ministers deliberately destabilise hospital Trusts and Primary Care Trusts, warns pressure group Health Emergency. Over 100,000 jobs could go – many of them nurses and professional staff vital for effective and quality patient care.

    Already almost 8,000 redundancies have been announced in English hospitals as Trust bosses wrestle with multi-million deficits carried over from last year. But tens of thousands more cutbacks are on the way throughout England, driven by government policies, which aim to scale down public sector health care to make more space for a new private sector.

    • Many of the most indebted Trusts have yet to announce their plans to axe jobs and scale down services

    • But the cutbacks will not be restricted to indebted Trusts: many that were not overspent last year will also have to make cuts to balance the books in 2006-7

    • Many PCTs are also facing massive deficits, driving a reduction in referrals to hospital and forcing many to contemplate scaling down or hiving off the services they provide

    • Government six “priorities” for PCTs omit care for older people and mental health – which will face more cuts and job losses not yet announced

    • A new round of cuts is being driven by the policy of “top-slicing” up to 3% of Primary Care Trust budgets this year to create a reserve to cover deficits

    • The forced reorganisation and merger of PCTs is predicted to axe at least 3,500 jobs:

    • More jobs are certain to be axed in “reorganisation” and rationalisation of hospitals, including up to 1,200 jobs in the merger of Nottingham City Hospital and the Queen's Medical Centre

    • The controversial new system of “payment by results” will force hospitals and departments all over England to slash their costs (staff) or close down, while tens of millions of funding is diverted OUT of the NHS and in to new “independent sector treatment centres” (ISTCs).

    Health Emergency’s Information Director Dr John Lister said:

    “These job cuts and closures are no accident. This is a man-made and avoidable crisis.

    “A £1 billion shortfall – equivalent to just a few days’ health care spending – has been used as a lever to force through drastic changes which will have a massive impact on patient care.

    “A new market system is being created to make room for a new private sector that will carve out a growing share of the NHS budget.

    “This is a triumph of ideology over evidence and is generating not productivity but an increase in bureaucracy in the NHS while guaranteeing profit margins for private treatment centres.”


    Wednesday 12th April 2006

    Hospital bosses at the Epsom and St Helier NHS Trust have announced that they are looking to speed up the closure of key front line services on the Epsom Hospital site in Surrey as they struggle to claw back a cash deficit which they have admitted could rise as high as £67 million as a result of changes to the NHS funding formula.

    Services due to be axed at the strategically important Epsom Hospital site close to the M25 include:

    * Paediatric accident and emergency - downgraded to minor injuries

    * In-patient paediatric beds

    * The main maternity unit

    * All trauma surgery

    The Trust are laying down plans for an immediate £10 million of cuts this year - 5% of their no-capital expenditure - and have not ruled out redundancies. However, they admit that they cannot forecast the consequences of the new funding formual where money follows the patient and they also have failed to agree contracts for this year with their cash-strapped local Primary Care Trusts. Adverse movement on these income streams could see the cash gap rise to £67 million over the next few years.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "The scale of the looming financial crisis at Epsom and St Helier, a Trust which balanced its books this year, exposes the chaos of the government's new funding formula for the NHS and will rip a hole in services covering a large area of the South East. The knock on effect will ripple out from south London all the way down to Sussex.

    The speeding up of the Epsom closure plans will see key services crammed into the crumbling buildings of St Helier Hospital - a unit condemned as unfit for the provision of modern health care services a decade ago and where plans for redevelopment have been put back at least another seven years. It's a shambles and there is no doubt that patients will suffer as a result."


    Tuesday 4th April 2006

    Campaign group Health Emergency today forecast that the announcement that the Government's NHS hit squad have imposed over £20 million of cuts, with 400 job losses, on the Surrey and Sussex Healthcare NHS Trust will have severe service implications across a whole swathe of South East England.

    Geoff Martin, Health Emergency Head of Campaigns, said:

    "Patients and staff are paying the price for years of management incompetence and Government inertia which have stored up the biggest single deficit of any health care trust in the country at £58.2 million in Surrey and Sussex.

    The idea that you can slash these sort of sums from the budget of a single trust without hammering patient services and staffing levels is nonsense.

    There will be severe consequences for patients which will reach from South London down to Brighton. The government have left this Trust to hang out to dry as an example to others and there will be a heavy price to pay."


    Monday 20th March 2006

    Research released today by pressure group London Health Emergency shows that London’s primary health care trusts face cuts of over £400 million this year with dire consequences for patient services across the capital and thousands of possible redundancies.

    Two weeks ago a leaked letter from the government’s London NHS chief told the PCT’s that they must slash 3% from their planned budgets in 2006/2007 in a hard-line drive to balance the books.

    LHE have examined the budget allocations for each London PCT and have calculated that the total 3% budget cut stacks up to just over £320 million across the city.

    The hardest hit are:

    Lambeth - £14.03 million

    Sutton and Merton - £13.79 million

    Ealing - £13.34 million

    Barnet - £12.77 million

    Newham - £12.45 million

    LHE have learnt that some of the cuts will be loaded to poorer areas like Hackney – where the cuts will be over £14 million – in order to bail out wealthier areas like Kensington and Chelsea. One PCT, Kingston, have already confirmed that they will be shedding 13% of their staff.

    The 3% cuts of £320 million come on top of existing London PCT deficits of nearly £80 million which will also have to be clawed back this year. The worst deficits are:

    Hillingdon - £27 million

    Kensington and Chelsea - £20 million

    Hounslow - £8.8 million

    Kingston - £7.9 million

    Geoff Martin, LHE Head of Campaigns, said:

    “These proposed cuts in London’s front line health care services will devastate patient care. You can’t slash £400 million from London’s PCTs without unleashing total chaos. Some of these cuts will be passed on to London’s cash-strapped acute hospitals. Waiting lists will rise, staff will be sacked, patients will find it hard to access services and it makes a total mockery of the Government’s NHS priorities.”


    Wednesday 8th March 2006

    Consultants fighting plans to close the accident and emergency department at Epsom Hospital in Surrey have warned that talks are taking place behind closed doors which could see the closure of A&E services at the Royal Surrey County Hospital in Guildford and their relocation to Frimley Park Hospital on the Surrey/Hampshire border.

    The bombshell revelation came at a review meeting examining plans for the Epsom closure and the transfer of services to St Helier Hospital in Carshalton – a process being politically driven by Health Secretary Patricia Hewitt.

    Consultants from Epsom told the hearing that patient flows across Surrey would end up in chaos if their hospital closed and then let it slip that the situation would be even worse if secret discussions to close emergency services at the Royal Surrey County in Guildford were followed through.

    Geoff Martin, Head of Campaigns at pressure group Health Emergency who have led the fight to save Epsom Hospital, said:

    “The news that there are discussions underway which could see the closure of emergency services at Guildford and their transfer to Frimley Park has come as a real bombshell. We don’t know how far the discussions have progressed but the fact that consultants at Epsom Hospital are aware of it suggests that the move is under serious consideration.

    Accident and Emergency services across Surrey, Sussex and outer south London are already in chaos following the closures at Haywards Heath, Crawley, Ashford and Queen Mary’s in Roehampton. Any move to axe services in Guildford would cause carnage. We are challenging the health authorities to nail the rumours of this plan without delay and to give a cast iron assurance that the emergency department at the Royal Surrey will not be closed under any circumstances.”


    further information


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    Tuesday 7th February 2006

    Pressure group London Health Emergency warned today that government plans to bring the private sector into the provision of GP services will be expensive and divisive and will end up with family doctors offering the same kind of patchy, two-tier service currently available from NHS dentists.

    The government have already begun the process of bringing the private sector into GP and other primary care services and big American outfits like United Healthcare are queuing up to bring their style of US provision to Britain's NHS family doctors. Business analysts predict that there will be huge profits to be made out of the sick.

    The recent opening of the GP walk-in centre at Liverpool Street station was branded as the "thin end of the privatisation wedge" by LHE. Dozens of similar centres, where the well-off can pay on the door for quick access to services, are expected to open in wealthier parts of London and commuter centres over the next two years.

    Geoff Martin, LHE Head of Campaigns, said:

    "If the Government follow through their plans to open up primary care and GP services to the private sector then there is no question that they will end up in the same mess that NHS dentistry services have collapsed into in the past 15 years.

    What we'll have is a limited range of care and treatments available from a dwindling number of NHS GP's where people have to queue up to register - you just try registering with an NHS Dentist in many parts of London today and you'll see what we mean.

    On the other side of the coin, if you can afford to pay you will get swift access to high quality care and the private companies will make a packet. This will widen the health inequality gap and turn back the clock to pre-NHS days. Backbench Labour MP's need to wise up to what's being done in their name and take swift action to slam the brakes on it."


    Wednesday 1st February 2006

    Plans to reorganise hospital services used by nearly three quarters of a million people in South London and North Surrey have sparked a bitter war of words between medical staff at the two main hospitals covering the area.

    Under plans recently approved by the Government, all front line services at Epsom Hospital in Surrey will be closed down and centralised at St Helier Hospital in Carshalton. It is thought that the plans, which are being strongly resisted by patients and unions, will take seven years to develop.

    However, two members of the medical team at St Helier, Dr Jones and Dr Stockwell, have claimed that a range of services at Epsom, including critical care and maternity, are unsafe and have sparked a review which could see the early closure of the main front line services at Epsom and the their interim transfer into the crumbling and overcrowded buildings at St Helier before any new hospital is built.

    This has sparked a furious response from staff at Epsom. Orthopaedic consultant Will Burgoyne has written a detailed letter to the Trust Board demolishing line by line the argument that services at Epsom are unsafe and questioning the whole basis of the service review.

    LHE Head of Campaigns Geoff Martin said today:

    "Health planning for three quarters of a million people in South London and Surrey has descended into chaos. A service review which could close vital maternity, intensive care and accident and emergency services has been shown to be completely spurious. The Trust board have succeeded in pitching consultant against consultant and nurse against nurse through their sheer ineptitude.

    The Trust board meets this Friday and I will be there to demand their resignation. They have no credibility amongst either health staff or local patients, they have made a mess of health care planning locally and have left the service providers angry and demoralised. It's time for them to go."


  • UNISON slams NHS “system failure” at stricken Trust

    Sunday 29th January 2006

    A hard-hitting report analysing the rapid plunge into crisis of a previously stable and expanding NHS Trust has been published by UNISON, just days after Health Secretary Patricia Hewitt named the University Hospitals of North Staffordshire Trust as one of the 18 worst Trusts in England.

    UNISON’s report ‘System Failure’ (drafted by Dr John Lister of London Health Emergency) rejects the notion that the Trust’s £18m financial shortfall, which has brought the departure of two chief executives, a finance director, the Trust chair and all of its non-executive directors, can be dismissed as the result of failures by local management.

    It shows how a combination of ambitious government targets to reduce waiting times, under-funded pay settlements, contradictory guidelines on prescribing, and soaraway inflation from the pharmaceutical industry and private sector providers has forced busy, successful Trusts such as UHNS into crisis.

    The problem in North Staffordshire and many financially-challenged Trusts and PCTs can be tracked back to the period in the run-up to last year’s general election, when NHS managers around the country were being tacitly urged to avoid making cuts to balance their books. UHNS managers were also preparing their case to win support for a £400 million project for a new hospital to be funded under the controversial Private Finance Initiative (PFI).

    In seeking to minimise the apparent financial difficulties of the Trust, Trust managers were doing exactly what ministers wanted them to do. UNISON is convinced that the UHNS crisis – coming after six previous years in which the Trust achieved balanced budgets – is the primarily result not of individual management incompetence, but of a systems failure within the NHS as a whole.

    It concludes that as long as they have to operate within the same financial constraints and contradictory policy framework, there are no grounds to believe that the new replacement directors, or the government-appointed ‘hit squads’ of management consultants who are now being wheeled in by the Strategic Health Authority and the Department of Health, will be any more successful at delivering the necessary level of services within an inadequate budget.

    UNISON’s UHNS Branch Secretary Pat Powell said:

    “UNISON commissioned this report because we want everyone to see that the crisis in our Trust is one generated by government policies and by problems affecting the whole NHS. Hundreds of jobs are at risk if the government tries to bring in a new bunch of managers to force through cuts without regard to the causes of the problem.”

    Report author Dr John Lister of London Health Emergency said:

    “If ministers delude themselves that they can sort out the problems at this Trust by sending in a team of accountants to sack some staff and order others to work harder, they run the risk of destroying all the hard work that has been done in developing a high performance and forward-looking Trust. It’s a systems failure, and they must repair the system they have screwed up, rather than undermine the health care for patients in North Staffordshire.”


    Sunday 29th January 2006

    Pressure group London Health Emergency revealed today that casualty patients, identfied as high MRSA risk, have been dumped in beds on a maternity ward at a major Surrey hospital in order to comply with government NHS targets on casualty waiting times.

    A letter from Will Burgoyne, a consultant orthopaedic surgeon at Epsom Hospital in Surrey, has been passed to LHE and says:

    "....four patients were admitted dierctly from casualty on to Simon Stewart Ward [maternity ward], including one long term resident of a nursing home and another patient who incipient sacral pressure sore. Both patients were high MRSA risk and should never have been placedin such a ward. The fact that this occured only weeks after the tragic death of Luke Day, an infant born at Heath Road Hospital in Ipswich, from MRSA acquired on a maternity ward suggests that the Trust Management place patient safety a poor second to meeting Government Targets.

    Over the January 15/16 weekend this year, two high-risk post surgical patients were transferred onto the maternity ward to allow admissions from casualty, increasing the risk to mothers and vulnerable neonates of contracting a hospital acquired infection, the protests of the midwifery staff being overruled by a (non clinically trained) manager."

    Epsom Hospital is being targetted for closure as part of a cash-led reorganisation of hospital services and LHE, trade unions and consultants believe that it is being starved of resources in order to undermine the unit and set it up for the axe.

    Geoff Martin, LHE Campaigns Organiser, said today;

    "The news that high risk casualty and surgical patients are being dumped into beds on a maternity ward, with potentially ethal consequences exposes the governments plans to eliminate MRSA as a sham and reveals the target-led NHS to be rotten to the core.

    Managers have overridden protests from midwives and other clinicians in order to tick boxes on a form. It's a disrgace and we are demanding an inquiry into how widespread this practice has become."


    Tuesday 24th January 2006

    Pressure group London Health Emergency said today that the opening of two privatised GP walk-in centres at railway stations in London and Manchester will speed up moves towards a two-tier health care service and is a kick in the teeth for thousands of people who will be phoning desperately for a GP appointment this morning only to be told they will have to wait 24 hours.

    Geoff Martin, LHE Chair, said today:

    "We are all for expanding NHS GP services but a couple of privatised walk in centres is nothing more than a New Labour government stunt when thousands will be struggling to book a routine GP appointment at home. We see GP services going the same way as dental services, a nice little earner for some, expensive but easily accessible for the few and damned hard to access for the rest.

    Today's glitzy unveiling of these privatised units is another step down the road to a two-tier, part-privatised health care service."


    Monday 16th January 2006

    Pressure group London Health Emergency today called on the government to use the traditional public funding route to save the Barts Hospital development after it became clear that the plan has been halted after ministers realised the costs of financing the proposed private finance scheme had shot out of control.

    This PFI crisis follows a similar shambles at the planned redevelopment of St Mary’s in the Paddington Basin. That PFI scheme also collapsed when the private sector charges went through the roof.

    Meanwhile, the PFI hospital at UCH in Tottenham Court Road is already looking at closing beds that opened just six months ago as the costs of servicing the private debt charges have eaten into patient care costs.

    Geoff Martin, LHE Chair, said today:

    “Barts and the London are heading the same way as the Paddington Basin development as the same cost pressures kick in. The massive profits demanded by the private sector are simply incompatible with this kind of hospital building project and the government have to face up to that. The only solution is a return to the public funding route that’s served the NHS well for the past sixty years.

    There’s a common misconception that the cost of the Barts and the London PFI scheme is just over £1 billion when in fact it’s over £2 billion. It’s the finance charges on that debt that have caused this crisis.”


    Wednesday 23rd November 2005

    Pressure group London Health Emergency and NHS trade union UNISON today launched an aggressive public campaign aimed at defeating one of the government’s NHS privatisation pilot schemes at the South West London Elective Orthopaedic Centre based at Epsom Hospital in Surrey.

    The campaign has been backed with national funding from UNISON and also has the support of the newly-launched Keep Our NHS Public Campaign – an initiative co-founded by former Health Secretary Frank Dobson.

    The South West London Orthopaedic Centre (SWLEOC) has been earmarked for a fast-track transfer to a New York based outfit called HSS which would be the first NHS treatment centre privatisation of it’s kind. The Government have agreed to ignore the usual procurement rules and fund all legal and professional costs in order to push the privatisation through swiftly.

    Campaigners blocked an attempt to force the plans through at the October meeting of the Epsom and St Helier NHS Trust but it will be back on the agenda at the next meeting on the 2nd December.

    Geoff Martin, Chair of NHS Pressure Group London Health Emergency, said today:

    “We have exposed the government’s plans to fast track SWLEOC into the private sector and have delayed them in the first round through a high-profile public campaign. We now have the resources from UNISON to jack up the campaign.

    We are talking here about a well-run, top-quality NHS facility that would be hijacked by New Labour and their venture capitalist friends from the USA at grave risk to local NHS patients. We’ll be fighting them all of the way in what is very much a national test case on the future of the NHS.”

  • Top Commons committee slams Norfolk & Norwich PFI scheme

    Wednesday 23rd November 2005

    The Norfolk & Norwich Hospital PFI deal has been branded as "the unacceptable face of capitalism" by the Tory chair of the Commons Public Accounts Committee (PAC).

    The PAC began a meeting by looking into the Norfolk and Norwich University Hospital PFI deal, but wound up with calls for compensation to be paid to the Norfolk health economy.

    During the heated debate officials from the Department of Health and the Trust itself were questioned by the seven man committee and several aspects of the scheme were severely criticised.

    The refinancing in 2003 came in for particular criticism. The deal saw the Trust take a 30% share of the refinancing cost spread over the duration of the project, whilst Octagon, the PFI operator took its share in a one-off cash payment.

    The report by the PAC, to be published in the new year, is expected to be scathing in its conclusion with the scheme being described as a 'cash machine' and a 'financial debacle' during the two hour meeting.

    The Norfolk & Norwich Trust's Chief Executive Paul Forden claimed that whilst the financial returns to Octagon had exceeded what might have originally been expected, the operator had also delivered a service that he described as 'very good'.

    The meeting culminated in a statement by the PAC chairman, Edward Leigh that he never again wanted to see officials defending the 'unacceptable face of capitalism'.

    Immediately after the meeting, Mr Richard Bacon MP (South Norfolk) called for compensation to be paid in light of the fact that the schemes 'pathfinder' status had led to more problems than subsequent schemes that had benefited from the lessons learned.

    He added that the blame for the deal should focused on the poor guidance from the DoH, not at a private sector organisation seeking to maximise profit. North Norfolk MP, Norman Lamb, who campaigned against the terms of the PFI deal, called for a 'one-off payment' to be made to the Norfolk health economy.

  • Health trusts head for £23m overspend

    Friday 28th October 2005

    Birmingham Post

    Oct 24 2005

    By Jonathan Walker, Political Editor

    Health trusts in Birmingham and the Black Country are set to go £23 million over budget.

    Figures presented to the board of the Strategic Health Authority show that hospitals, primary care trusts and the ambulance service will run up the deficit between them.

    The figures show that Royal Wolverhampton Hospitals NHS Trust, which runs New Cross Hospital in Wolverhampton, is expected to run up a deficit of £12.8 million.

    Good Hope Hospital has a projected deficit of £4.5 million, while Sandwell and West Birmingham NHS Trust, which runs City Hospital in Birmingham, has a projected deficit of £5.1 million.

    Worcestershire Acute Hospitals NHS Trust has unveiled plans to downgrade the Alexandra Hospital, Redditch, as part of a package designed to save £20 million a year.

    University Hospitals Coventry and Warwickshire NHS Trust revealed earlier this month it was to shut down a ward at Walsgrave Hospital, in Coventry, as part of a £7.8 million packaged of costcutting measures.

    Sandwell and West Birmingham NHS Trust and Good Hope Hospital have imposed a recruitment freeze on nursing staff in a bid to save money.

    Full article available at tm_objectid=16287746%26method=full%26siteid=50002-name_page.html

  • Job cuts threatened as Shrewsbury Trust plunges £29m into the red

    Friday 28th October 2005

    By Emma Brady, Health Reporter

    Birmingham Post

    Hospital bosses admitted that they will have to make job cuts in order to help tackle their £10.1 million debt.

    Shrewsbury and Telford Hospital NHS Trust employs 5,500 staff at the Royal Shrewsbury Hospital and Telford's Princess Royal Hospital.

    Last night Tom Taylor, the trust's chief executive, would not be drawn on how many jobs would go or which departments would be affected.

    An independent inquiry, commissioned by Shropshire and Staffordshire Strategic Health Authority, revealed the trust's reported financial position "had very little correlation with reality".

    During 2004/05 the trust had planned to break even, until it forecast a £3 million deficit.

    But an external audit by KPMG revealed the actual shortfall was £10.1 million.

    Coupled with historic debts totalling £19 million, the trust now has a deficit of more than £29 million.

    Remainder of story available at

  • Health care trust announces community hospitals have been saved

    Thursday 27th October 2005

    New Forest Primary Care Trust have announced today that five threatened community hospitals have been saved.

    Trust chiefs say that they have listened to the public outcry, which included a 40,000-signature petition and a 2,000 strong rally backed by the Daily Echo, and have had a major rethink as a result.

    The hospitals are at Hythe, Fordingbridge, Milford on Sea, the Fenwick Hospital at Lyndhurst, and Romsey. None will now be closed this financial year. Some form of treatment will be provided from them. However the PCT would not say what services they will offer in the future.

    Campaigners fighting to save hospital beds in Hampshire are concerned that these latest promises by health chiefs are worthless - and will act as no more than a stay of execution.

    Full article by Sarah Jones from Southern Daily Echo

    on This is Southampton website

  • Now Primary Care Trust commissioning faces privatisation. Thames Valley SHA rubber-stamps "procurement" of commissioning role for new Oxfordshire PCT

    Wednesday 12th October 2005

    By December 2008 Primary Care Trusts around the country are scheduled to end their role in providing primary care [district nursing, health visiting and community

    hospitals] and other services and become commissioning agencies. 250,000 staff across the country will be affected.

    Who will provide the services?

    No one knows.

    The government suggests it might be private companies, charities, even a cottage industry of workers' co-ops competing against giant health care multinationals in the new health market.

    But on top of this something extra is being planned for the new single PCT that is planned to take over from the country's existing PCTs and cover the whole of Oxfordshire.

    On October 12 Thames Valley Strategic Health Authority voted through proposals that would remove the PCTs' senior staff from April 2006 and replace them - most likely by managers from a big corporation. The new, outsourced, PCT commissioners will buy in services from the private sector, Foundation Trusts and the NHS for the people of Oxfordshire at the same time as preparing to shed those services currently provided by the PCT.

    The SHA has made no attempt to seek or consider the public's view of the these latest 'reforms'. The announcement was buried in Board Paper 62-05 on page 9:

    "The SHA proposes to procure the provision of management services to the Oxfordshire PCT(s)".

    Staff of the existing PCTs heard about this plan just two days before the proposals came into the public arena. Having rubber stamped the "procurement" process, TVSHA has indicated that there will be no further consultation with staff or public on this issue.

    And it has been made clear that while the size and configuration of other Thames Valley PCTs is up for consultation, Oxfordshire's privatised PCT isn't.

    Its believed that the Primary Care Trust inc (as it has been called by staff) might be put out to tender in the Official Journal of the European Commission (OJEC) in late November, and by April 06 may be up and running with new staff.

    The Department of Health, it is said, views Oxfordshire as a pilot site, and if successful would like to put all PCTs out to tender.

    And the reaction of staff?

    'Shock and dismay' said UNISON PCT Convenor Mark Ladbrooke, adding: "but we are going to be the 'guinea pig that roared. This is a huge acceleration in the privatisation of the NHS, with the private sector invited to control the process of buying in health services from the private and public sector."

    "Today anti-privatisation petitions were drawn up by staff in our community hospital, and they are circulating different workplaces. Despite the short notice we managed to have a good turn out for the lobby of the Health Authority."

    Mark also reported that PCT union stewards are getting messages of support from staff in NHS Trusts across Oxfordshire, because they realise that with privatised commissioning they are likely to face a ferocious round of cuts next year.

  • Health Authorities, Trusts and PCTs face massive cuts £1.6 billion cash crisis hits England's NHS

    Wednesday 7th September 2005

    Despite record levels of funding at national level, the National Health Service is facing a drastic autumn round of local cutbacks and economies throughout England as Trusts, Primary Care Trusts (PCTs) and Strategic Health Authorities (SHAs) attempt to deliver a balanced budget for the current financial year.

    16 SHAs have projected deficits in 2005-6, while four have projected end of year deficits in excess of £70m for local NHS organisations.

    A snapshot estimate of the available figures suggests a total shortfall of more than £1.6 billion across 22 SHAs: the 51 most financially challenged NHS Trusts face deficits and savings targets totalling almost £650 million.

    A survey of SHA, Trust and PCT papers and local press websites has revealed that tens of millions in deficits carried over from the last financial year are now worsening the plight of hard-pressed Trusts and PCTs as they attempt to stay within spending limits this year, while meeting stiff government performance targets.

    Many Trusts and PCTs are counting on substantial "brokerage" and one-off support payments organised by SHAs as a means to prop up their floundering finances and remain within borrowing limits.

    One Trust, Mid Yorkshire Hospitals, is seeking brokerage this year of £100m, while others are so deep in the red they are having to defer payments on accumulated debts, and hope to clear their deficits over the next three years.

    No fewer than 29 hospital and mental healthTrusts have been identified as facing deficits or savings targets of £10m or more in 2005-6, leaving them just six months to push through far-reaching cuts and changes. At least another 22 Trusts face savings targets or deficits of £5m or more.

    And well over a dozen PCTs face massive deficits across the country, several of them in excess of £10m. While previously published official figures have set last year's deficits against underspends elsewhere within each SHA, resulting in an apparently marginal deficit across the NHS as a whole, it is clear from this recent survey that the sheer scale of the cutbacks required in the overspending Trusts and PCTs must have an impact on patient care.

    Beds, wards and some well-loved smaller hospitals and units are closing, jobs are being axed, and PCTs, which foot the bill for each episode of hospital treatment, are seeking to cut back the use of hospital services and divert patients to primary care or to nursing homes and social services - to balance their books at the expense of yawning deficits for their local provider Trusts.

    Publishing the survey, completed at the end of August using the most current published figures, Dr John Lister, Information Director for pressure group London Health Emergency said:

    "It's hard to tell which figures are the most worrying: the huge sums to be saved through identified spending cuts, or the fact that tens of millions of "savings" assumed by the SHAs have yet to be identified as we head into autumn and another potentially cold winter.

    "Ministers have clearly been adopting the 'ostrich' style of management, taking note only of the carefully laundered and deceptive figures served up by civil servants at the end of a financial year, and ignoring the misery that is taking shape as these cuts start to bite.

    "It seems that the deficits rolled over for years at local level have suddenly become unmanageable without drastic cuts. Local services are paying the price of failed government policies, including:

    ministers' eagerness to tie every last penny of new money to new and tougher targets,

    the introduction of new contracts with more costly private sector providers

    and a new, fiercely competitive market system, in which Trusts will only be paid per item of treatment supplied.

    "To make matters even worse, a new round of "reforms" which will merge many existing PCTs and make the NHS even more remote from the local people it is supposed to serve, is now being forced through at breakneck speed.

    "Ministers need to wake up and take action now to prevent these financial pressures forcing a major dislocation in health services that the electorate will not readily forgive.

    "Patricia Hewitt in May announced £3 billion was available for the NHS to buy in more services from high-cost private hospitals, despite the capacity of the NHS to deliver better value: the money is clearly available to rescue vital services and save our NHS.

    If she refuses to act it will be clear she is happy for NHS organisations to fail."

    Further details: DR JOHN LISTER 07774 264112

  • Britain revealed as "world's health policy guinea pig"

    Tuesday 5th July 2005

    CONTROVERSIAL health policy reforms, including the development of a new, market system involving unfair competition between the NHS and private sector providers, have gone further and faster in Britain than any other country in the world, according to a major new comparative study, published today, the 57th anniversary of the NHS.

    A new book by LHE Director Dr John Lister, Health Policy Reform, Driving the Wrong Way? (Middlesex University Press) looks at changes in over 40 countries, and concludes that there is little or no evidence that the reforms imposed by successive British governments can deliver better, cheaper, more efficient or more accessible services for patients.

    Among the costly policies imposed in Britain without evaluation of their impact or evidence of their effectiveness have been:

    " The separation of purchasers and providers to create a 'market' system - a policy which has massively inflated bureaucracy and management costs in Britain and in every country where it applies

    " The use of private sector providers, despite evidence around the world that these are more expensive than public sector provision, and that the private sector will only "cherry pick" the most profitable treatments, leaving the public sector to carry the costs of emergencies, complex cases and other vital work.

    " Competitive tendering and privatisation of support services such as cleaning and catering, despite evidence that competition on price in these labour-intensive services effectively casualises staff, and reduces quality of cleanliness and patient care

    " Creating Foundation Trusts, and similar moves to enhance "provider autonomy", have proved a costly failure elsewhere, with experiments abandoned in Spain, Sweden, and New Zealand, and early signs that the British experience has brought no real democracy but greater links with the private sector and a 2-tier split between NHS Trusts.

    " The use of the Private Finance Initiative to fund almost all new hospital developments, in which Britain is far and away the world leader, with rocketing costs of schemes now raising huge questions of affordability and value for money.

    Author John Lister said:

    "Five years of research confirms that Britain, and especially England, is being used as a guinea pig in a bizarre experiment in health reform by ministers who have no evidence at all that the policies will work.

    "The pace of reform is increasing. Even since the book went to press, ministers have pressed for the first two NHS hospitals to be privatised as part of the drive to expand private sector provision of NHS-funded treatment.

    "Nowhere in the world do these reforms save money, improve efficiency or enhance access to care: now patients are being denied a choice of publicly-provided services.

    "The British reforms are being introduced as a result of ideological fundamentalism by New Labour politicians obsessed with the private sector and the free market."

    Book launch: TUESDAY JULY 5, 6.15pm, NUJ HQ, Grays Inn Rd WC1

    MORE DETAILS: JOHN LISTER 07774 264112

    Middlesex University Press, 020 8880 4374

  • NHS financial report shows "tip of the iceberg" of cash crisis

    Friday 24th June 2005

    NHS watchdog London Health Emergency today sharply criticised a new report by the National Audit Office and Audit Commission for severely understating the scale of the financial crisis faced by hospital Trusts and Primary Care Trusts across the country.

    "Managers or ministers who take these findings as a measure of today's situation are either seriously deluded, or wilfully sticking their heads in the sand," says LHE's Information Director John Lister.

    "Today's report is based on figures from two years ago, before many of the government's current round of costly and disruptive reforms were introduced, such as Foundation Trusts, and the system of "payment by results" which is being phased in.

    2003-4 was also

    before the costs of the consultants' contract,

    before the new GP contracts which have forced up costs,

    and before the introduction of Agenda for Change, which is also forcing up pay bills for 1 million NHS staff.

    It was before the opening of the first private sector treatment centres which are now beginning to siphon substantial resources out of the NHS and undermine the viability of local NHS departments.

    "It was literally another world from today's NHS," says Dr Lister.

    "To make matters worse, the report adopts the method of adding up end of year surpluses or deficits to arrive at an overall balance sheet for each Strategic Health Authority and across the NHS. These figures are always misleading, because they cover over in-year borrowing and capital to revenue transfers which are used to hide the genuine financial imbalance in many Trusts and PCTs. Today's deficits are larger partly because capital to revenue transfers have been almost halted by a change in government."

    The result is that the NAO/AC report detects an apparent minuscule overall overspend of just £72 million (0.2% of the NHS budget).

    "That figure is the smallest possible tip of the vast and growing iceberg of today's financial problems in the NHS. It offers no recognition of the issues faced by some very indebted Trusts and PCTs.

    "And the fact that our leading financial scrutineers appear to be living in a time-warp and issuing such misleading information and advice helps explain why ministers are also clearly living in denial, perhaps even blissfully unaware of the scale of the problems their policies have compounded. Patricia Hewitt is today putting the boot into desperate NHS financial directors, telling them to make efficiency savings to bridge the gap.

    "It's time she tried a bit of listening to what's really happening around her."

  • Scanning for profit: LHE demands a review

    Friday 10th June 2005

    London Health Emergency is calling for a public review of the working of a controversial contract which will buy over 600,000 MRI (Magnetic Resonance Imaging) scans from private operators Alliance Medical Limited (AML).

    The contract is almost one year old, and has been the subject of a continuing series of complaints by doctors and NHS managers across the country, with some consultants so concerned about the quality of the work that they have refused to accept the reports they have received.

    This week the GMB released a report bringing together a number of the complaints and issues, with the GMB's National Officer Sharon Holder branding the AML contract as "a cock up from start to finish." (

    Ministers have refused to reveal the cost of the five year scheme, although estimates vary from £80m to £95m.

    The contract was centrally negotiated by the Department of Health without consultation with local NHS Trusts and PCTs. Ministers have claimed that the scans work out at half the average cost of an NHS scan, but the contract stipulates that AML will accept only the least complicated cases, and will not cover any specialist work such as that required for neurosurgery.

    Scans are sent out of the country - to Spain, Belgium and South Africa - to be "read" by radiologists, and the results have been taking up to 8 weeks to come back to the consultant who referred the patient.

    Calling for ministers to recognise widespread concern and open up a review of the contract, London Health Emergency's Information Director John Lister said:

    "The AML deal has fallen on at least three counts:

    "1) It is a national deal done without reference to local needs, and without any mechanism to make AML accountable to the local NHS providers they work with.

    "2) It injects new money into private sector provision covering only the most minor cases, while leaving NHS scanners, which cover all the more complex and costly cases, short of staff and funds and often standing idle.

    "3) It is delivering reports of questionable quality, which could potentially put lives at risk if crucial problems are reported very late, or missed altogether.

    "Patricia Hewitt has insisted that she wants to listen as Health Secretary: she should listen to the consultants, managers and health workers who are telling her they have got this wrong, and she should do something to put it right."

  • New round of privatisation hits NHS hospitals

    Friday 10th June 2005

    London health campaigners have condemned the new lurch towards the privatisation of clinical services in the National Health Service, as health chiefs in SW London announced the first NHS unit to be hived off to the private sector.

    An advert has been placed in the official EU Journal inviting private companies to bid to take over the brand new, publicly-funded South West London Elective Orthopaedic Centre (SWLEOC), based at Epsom General Hospital, from Spring 2006.

    A statement from the Epsom & St Helier hospitals NHS Trust which runs SWLEOC links the decision to privatise it directly to the New Labour government's policy of promoting private sector provision of routine operations in preference to expanding NHS capacity.

    Just three days after taking office pledging to act as a "listening Health Secretary", Patricia Hewitt announced a further massive expansion of spending in private sector Treatment Centres, with £3 billion extra spending over the next five years to buy 1.7 million more operations.

    This will effectively double the NHS use of private hospitals: but NHS hospitals like SWLEOC have been forbidden to compete for this work.

    Already NHS-owned Treatment Centres offering modern facilities and short waiting times have been stuck with unused beds and mounting financial problems while contracts signed by the government have diverted NHS patients and funds into new rival private sector units that have cherry-picked the most minor cases.

    In NW London, the state of the art Ravenscourt Park NHS Treatment centre is running a deficit of £12.5 million, while the award winning ACAD treatment centre at Central Middlesex Hospital is also facing empty beds and a cash shortfall.

    It is likely that the NHS Trusts running these units will also be driven to privatising these units along the lines of SWLEOC, to open up the possibility of bidding for a share of the £3 billion of private contracts.

    London Health Emergency's Information Director John Lister said:

    "We are strongly opposed to handing over public assets in this way to private profiteers - while the NHS loses out.

    "This is not modernising the NHS but creating a new health market in which the odds are stacked in favour of the private sector."

  • LHE opposes new powers for Foundation Trusts

    Monday 16th May 2005

    Today's Financial Times warns that ministers are looking to make room in the Queen's Speech for further legislation to widen the powers of Foundation Trusts.

    This follows Health Secretary Patricia Hewitt's hard-line speech to NHS employers at the end of last week, in which she committed the government to a further massive expansion of private sector provision of NHS treatment, and warned that "failing" NHS hospitals, bankrupted by the "modernisation" process, would be closed.

    These moves make it quite clear that the initial promise that the new Blair government in general, and Hewitt in particular, would be "listening" to other views has already been broken. Instead the most controversial and unpopular policies from the last five years are being forced through.

    London Health Emergency's Information Director Dr John Lister today strongly cautioned ministers against extending the powers of Foundation Trusts, which would serve only to widen the gulf emerging in a 2-tier NHS.

    "It appears that ministers are looking to relax the tight controls on borrowing which were imposed on Foundations at Gordon Brown's insistence.

    "But the experience of New Zealand, where the equivalent to Foundations, Crown Health Enterprises, were allowed unrestricted borrowing from the private sector in the early 1990s was that they ran up massive debts, and had to be brought back into line. They are still paying off the deficits now," warns Dr Lister.

    "We don't want that happening here."

    Dr Lister also underlined the extent to which Monitor, the office of the independent regulator charged with overseeing Foundation Trusts, has itself been privatised:

    "According to the Health Service Journal, two thirds of Monitor's £15.5m budget has been spent on private consultancy contracts, flying in American whizz-kids from McKinsey consulting.

    "But we all know that the USA has the most expensive, and most bureaucratic health care system in the world, spending $1 out of every $3 on administration. What lessons have McKinsey got to teach the NHS?

    "This is a shocking waste of NHS and taxpayers' money that can only serve to further undermine the principles of the NHS as a publicly run, publicly funded service," says Dr Lister.

  • LHE slams Hewitt's boost for private sector

    Friday 13th May 2005

    Just days after taking office pledging to act as a "listening Health Secretary", Patricia Hewitt has announced a further massive expansion of spending in private sector Treatment Centres.

    The £3 billion spending over the next five years is expected to buy 1.7 million operations and effectively double the NHS use of private hospitals.

    By the end of this year, Primary Care Trusts have been instructed to ensure that at least 10 percent of elective operations are carried out in the private sector: Hewitt has now set course to increase this still further, towards 15%.

    The tax-funded expansion of the private sector will have a severe knock-on impact on existing NHS Trusts. They will

    * Lose the funding for routine waiting list operations, and have to find ways to deliver other services with reduced budgets.

    * Lose crucial nursing and medical staff, who will increasingly be poached by growing private treatment centres, leaving front-line NHS services struggling to cope.

    * Have to cancel their own plans to expand services to meet tough government targets for reduced waiting times

    * Lose valuable opportunities to train doctors and specialist nursing staff in routine treatments, which will increasingly be carried out in the private sector - which does not train professional staff. Some departments and hospitals face the possible loss of their accreditation to teach doctors and nurses, with severe consequences for future skill shortages in the NHS.

    * Face a more complex and costly caseload of patients the private sector has no interest in attracting. The removal of much routine "bread and butter" work from the NHS will force up the unit costs of the services that remain, and undermine the viability of many Trusts that are currently struggling with large deficits.

    * The government's insistence on transferring NHS patients to the private sector can run counter to their claim to favour "patient choice": what happens when patients choose to get their treatment in an HHS hospital, but have to be sent to private treatment centres to meet targets laid down by ministers?

    The policy of building up a private sector at taxpayers' expense has been denounced not only by health unions, but also by the BMA and professional bodies of surgeons.

    London Health Emergency Information Director Dr john Lister said:

    "Patricia Hewitt has revealed in less than a week that she has no intention of listening to staff or patients, but is doggedly committed to the policies she inherited from John Reid and Alan Milburn.

    "There is no evidence that these policies will do other than undermine and destabilise the NHS, and no evidence that patients have asked for or support this privatisation of health care .

    "The New Labour slogan during the election was "Forward, not back". But the forward step in 1948 was the establishment of the NHS as a publicly funded, publicly provided health service: in 1997 Tony Blair's manifesto promised to scrap the wasteful internal market system in the NHS.

    "Now Hewitt and her colleagues are using billions of taxpayers' money to drag the NHS back towards a market model in which the main beneficiaries are for-profit private hospitals.

    "If Ms Hewitt has £3 billion extra to spend she should invest it in expanding the NHS, not in driving it towards crisis and local collapse."

  • £8.5 million cuts shock hits Lewisham Hospital

    Thursday 5th May 2005

    The Lewisham Hospital Trust has become one of the first to break the unspoken pre-election moratorium on cuts and closures as Trusts and Primary Care Trusts across the country wrestle with massive shortfalls.

    Lewisham's deficit of £8.5m on a budget of £126m in 2004 has triggered the closure of two wards, one surgical ward, and one dealing with the effects of heart attacks, stroke and lung disease. Both tend to contain large numbers of older patients.

    Statements by the Trust defending the cutback insist that the bed cuts will have no impact on patient care: yet it is clear that the reduction in bed numbers will put pressure on hard-pressed A&E staff seeking beds for emergency admissions and reduce the ability to deal with more complex waiting list cases.

    More worrying is the fact that the potential savings from closing just two wards fall far short of the substantial £8.5m savings target - meaning that now the pre-election illusion of tranquillity has been shattered, Lewisham bosses will have many more unpalatable and painful cuts to announce as the summer rolls on.

    "Lewisham Trust is a grim warning to Londoners that the phony war is at an end and the battle of the balance sheets is about to break out." says LHE's Dr John Lister.

    "The round of cuts that is coming is one of the biggest ever, and will hurt patients and staff unless ministers step in to inject new funds into the NHS."

  • Hammersmith Hospitals tipped to close Treatment Centre

    Thursday 5th May 2005

    Facing deficits last estimated at £19m, Hammersmith Hospitals Trust in west London is contemplating a series of desperate options.

    The popular and renowned Charing Cross Hospital in Fulham Palace Road could face closure in the longer term, in a plan that would seek to centralise the Trust's hospital services in or around the current Hammersmith Hospital site, several miles away in Acton.

    Trust executives have already revealed to consultants that extensive planning discussions have taken place, although they have strenuously denied in public that any plans exist. Wards are currently closed at Charing Cross as the Trust wrestles with its deficits.

    The more immediate prospect for closure is the state of the art Treatment Centre at Ravenscourt Park Hospital, the former Royal Masonic Hospital bought by the Trust as part of its bid to secure more NHS contracts for joint replacements.

    Government plans to expand private sector treatment centres, and attract in overseas companies to run them with the lure of generous and guaranteed payments have left NHS Treatment centres under-used, with Ravenscourt Park running at a loss last estimated at £12.5m.

    As the financial strings pull tighter, west London could be one of the first to face a major NHS cutback.

  • Epsom & St Helier braced for closure plan decision

    Thursday 5th May 2005

    Ministers have put the plans to close both Epsom & St Helier hospitals and build a new, smaller Critical Care Hospital in Sutton "on hold" until after the votes are counted in the General Election.

    Merton council had called on the Department of Health to step in and overrule the £350m-plus plan, which would reduce both existing hospitals to rudimentary levels of "intermediate" care, and develop a new hospital on part of the Royal Marsden Hospital site.

    But junior minister Stephen Ladyman revealed at the end of April that any decision would come after May 6.

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