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  • May the Fourth be with you!

    Sunday 1st May 2016

    EMERGENCY DEMO! NHS BURSARIES: VOTE IN THE HOUSE OF COMMONS on Wednesday 4 May

    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:

    IF YOU CANNOT ATTEND THE DEMO PLEASE LOBBY YOUR MPs TODAY!

    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.

    JUNIOR DOCTORS, TEACHERS, PUBLIC SECTOR WORKERS AND EVERYONE ELSE - WE NEED YOU. TOGETHER WE CAN WIN THIS.

    And don't forget

    4th JUNE IS OUR BIG MARCH

    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 (www.healthcampaignstogether.com) 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.

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BCM London Health Emergency • London WC1N 3XX • Copyright © 2016 London Health Emergency