NHS Reinstatement Bill – What is it?

Brief summary of the NHS Bill

In short, the Bill proposes to fully restore the NHS as an accountable public service by reversing 25 years of marketization in the NHS, by abolishing the purchaser-provider split, ending contracting and re-establishing public bodies and public services accountable to local communities.

This is necessary to stop the dismantling of the NHS under the Health and Social Care Act 2012. It is driven by the needs of local communities. Scotland and Wales have already reversed marketization and restored their NHS without massive upheaval. England can too.

The Bill gives flexibility in how it would be implemented, led by local authorities and current bodies.

It would:

  • reinstate the government’s duty to provide the key NHS services throughout England, including hospitals, medical and nursing services, primary care, mental health and community services,
  • integrate health and social care services,
  • declare the NHS to be a “non-economic service of general interest” and “a service supplied in the exercise of governmental authority” so asserting the full competence of Parliament and the devolved bodies to legislate for the NHS without being trumped by EU competition law and the World Trade Organization’s General Agreement on Trade in Services,
  • abolish the NHS Commissioning Board (NHS England) and re-establish it as a Special Health Authority with regional committees,
  • plan and provide services without contracts through Health Boards, which could cover more than one local authority area if there was local support,
  • allow local authorities to lead a ‘bottom up’ process with the assistance of clinical commissioning groups (CCGs), NHS trusts, NHS foundation trusts and NHS England to transfer functions to Health Boards,
  • abolish NHS trusts, NHS foundation trusts and CCGs after the transfer by 1st January 2018,
  • abolish Monitor – the regulator of NHS foundation trusts, commercial companies and voluntary organisations – and repeal the competition and core marketization provisions of the 2012 Act,
  • integrate public health services, and the duty to reduce inequalities, into the NHS,
  • re-establish Community Health Councils to represent the interest of the public in the NHS,
  • stop licence conditions taking effect which have been imposed by Monitor on NHS foundation trusts and that will have the effect of reducing by April 2016 the number of services that they currently have to provide,
  • require national terms and conditions under the NHS Staff Council and Agenda for Change system for relevant NHS staff,
  • centralise NHS debts under the Private Finance Initiative (PFI) in the Treasury, require publication of PFI contracts and also require the Treasury to report to Parliament on reducing NHS PFI debts,
  • abolish the legal provisions passed in 2014 requiring certain immigrants to pay for NHS services
  • declare the UK’s agreement to the proposed Transatlantic Trade and Investment Partnership and other international treaties affecting the NHS to require the prior approval of Parliament and the devolved legislatures,
  • require the government to report annually to Parliament on the effect of treaties on the NHS.

Ten Minute Rule Bill – NHS Reinstatement Bill

On Wednesday, 13th July 2016, immediately after Prime Minister’s Questions around 12.30 p.m, Margaret Greenwood, MP for Wirral West, will try to table the NHS Reinstatement Bill as a cross-party Ten Minute Rule Bill

 

She will have 10 minutes to speak in favour of the Bill, one other MP can speak for 10 minutes against it, and then it will be put to the vote. If the vote is won, it will go forward for a second reading. It will be behind many other Bills and so will not become law in this session of Parliament – but it will help in building support outside Parliament and in keeping the pressure on MPs.

 

The privatisation of the NHS in England will continue until we have a law to stop it, so please ask your MP for them attend the debate and to support the Bill.

 

NB: If your MP doesn’t to support this Bill on the usual grounds that the 2014 Commonwealth Fund found that the NHS was the most effective and efficient health service in the world – that data is almost all from before the stealth-privatising 2012 Health and Social Care Act took effect in 2013.

NHS

NHS cuts, privatisation and fragmentation continue. New legislation is needed to stop and reverse the damage

 

These cuts and changes are being carried out across England under Simon Stevens’ 5 Year Forward View. Where they are further advanced, they are bringing disaster in their wake.

The NHS in England is being dismantled. Only a change to the law can stop the damage.

Now more than ever.

To reverse the damage, the NHS must be reinstated in a civilised form that restores it to full public ownership, management and funding, with a duty on the Secretary of State to provide a comprehensive, universal health service that is free at the point of need and based on patients’ clinical needs.

The BMA reiterates its overwhelming support for the Bill

On Thursday 23rd June 2016, the British Medical Association voted overwhelmingly to continue supporting the Bill. You can watch the debate at its Annual Representative Meeting here (click on ‘Motions Arising From ARM’ in the right hand box, it will start at at 2 hrs 47 mins)

Therefore we urge you to contact your MP and ask them to attend the House of Commons debate on 13th July and support the Bill so it can go forward to a second reading. Please tell them why this is important to you.

There is more related information from the NHS Reinstatement Bill Campaign Group here; and here the Bill’s main author, Professor Allyson Pollock,  analyses the NHS crisis and appropriate responses to it.

Tell your local press and MP

Please use the local press letter and edit to send to your local press and MP.

NHS Bill Letter guide for public and suggested draft local press letter 

If you work in the NHS we have a letter guide NHS employees and suggested draft local press letter for NHS employees

NHS turns 68

Happy Birthday

Today we celebrate the 68th birthday of the National Health Service.

History of the NHS

The NHS was born out of a long-held ideal that good healthcare should be available to all, regardless of wealth. Use this interactive timeline to find out what‘s happened since Aneurin Bevan officially started the National Health Service on July 5 1948.

1948

NHS established

The NHS is born on July 5 1948 out of a long-held ideal that good healthcare should be available to all, regardless of wealth.

When health secretary Aneurin Bevan opens Park Hospital in Manchester it is the climax of a hugely ambitious plan to bring good healthcare to all. For the first time hospitals, doctors, nurses, pharmacists, opticians and dentists are brought together under one umbrella organisation that is free for all at the point of delivery. The central principles are clear: the health service will be available to all and financed entirely from taxation, which means that people pay into it according to their means.

1952

Prescription charges introduced

Charges of one shilling are introduced for prescriptions.

Prescription charges of one shilling (5p) are introduced and a flat rate of a pound for ordinary dental treatment is also brought in on June 1 1952. Prescription charges are abolished in 1965, and prescriptions remain free until June 1968 when the charges are reintroduced.

1953

DNA structure revealed

Crick and Watson, two Cambridge scientists, reveal the structure of DNA in Nature Magazine.

On April 25 James D Watson and Francis Crick, two Cambridge University scientists, describe the structure of a chemical called deoxyribonucleic acid in Nature magazine. DNA is the material that makes up genes which pass hereditary characteristics from parent to child. Crick and Watson begin their article: “We wish to suggest a structure for the salt of deoxyribonucleic acid (DNA). This structure has novel features which are of considerable biological interest.”  DNA allowed the study of disease caused by defective genes.

1954 

Smoking-cancer link established

Sir Richard Doll establishes a clear link between smoking and lung cancer.

In the 1940s, British scientist Doll begins research into lung cancer after incidences of the disease rise alarmingly. He studies lung cancer patients in 20 London hospitals, and he expects to reveal that the cause is fumes from coal fires, car fumes or Tarmac. His findings surprise him and he publishes a study in the British Medical Journal, co-written with Sir Austin Bradford Hill, warning that smokers are far more likely than non-smokers to die of lung cancer. Doll gives up smoking two-thirds of the way through his study and lives to be 92.

1954

Children get daily visits

Daily visits gradually introduced for children who until now had been allowed to see parents only at the weekend.

Until now children in hospital are often only allowed to see their parents for an hour on Saturdays and Sundays and are frequently placed in adult wards, with little attempt to explain to them why they are there or what is going to happen. Paediatricians Sir James Spence in Newcastle and Alan Moncriff at Great Ormond Street are making considerable steps to change this, demonstrating that such separation is traumatic for children. As a result, daily visiting is introduced gradually.

1958

Polio and diphtheria vaccinations

A programme to vaccinate everyone under the age of 15 against polio and diphtheria is launched.

One of the primary aims of the NHS is to promote good health, not simply to treat illness, and the introduction of the polio and diphtheria vaccine is a key part of the NHS’s plans. Before this programme, cases of polio could climb as high as 8,000 in epidemic years, with cases of diphtheria as high as 70,000, leading to 5,000 deaths. This programme sees everyone under the age of 15 vaccinated and will lead to an immediate and dramatic reduction in cases of both diseases.

1960

First kidney transplant

An Edinburgh doctor, Michael Woodruff, performs the first UK transplant involving an identical set of twins.

The first UK transplant takes place at Edinburgh Royal Infirmary on October 30 and involves a set of 49-year-old twins. The procedure is a success, with both donor and recipient living for a further six years before dying of an unrelated illness. Kidney transplants, which for many are a welcome alternative to a lifetime of regular dialysis, now enjoy a high success rate but demand outstrips supply due to an ageing population meaning an increased incidence of renal failure, while the number of donor organs available has fallen.

1961

The Pill made available

The contraceptive pill is made widely available and is hailed as a breakthrough of the 20th Century.

The launch of the contraceptive pill, which suppresses fertility with either progesterone or oestrogen or, more commonly, a combination of both, plays a major role in women’s liberation and contributes to the sexual freedom of the so-called Swinging Sixties. Initially, it is only available to married women, but this is relaxed in 1967. Between 1962 and 1969, the number of women taking the Pill will rise dramatically, from approximately 50,000 to 1m.

1962

The Hospital Plan

Porritt Report is published and results in Enoch Powell’s Hospital Plan.

The medical profession criticises the separation of the NHS into three parts – hospitals, general practice and local health authorities – and calls for unification. The Hospital Plan approves the development of district general hospitals for population areas of about 125,000. The 10-year programme is new territory for the NHS and it soon becomes clear that it has underestimated the cost and time taken to build new hospitals. But with the advent of postgraduate centres, nurses and doctors will be given a better future.

1962

First hip replacement 

First full hip replacement is carried out by Professor John Charnley in Wrightington Hospital.

Charnley begins to devote his energies to developing full hip replacements from 1958 and moves to the Wrightington Hospital where the first full hip replacement takes place. He asks his patients if they mind giving back the hip post-mortem. Apparently 99% of them agree, so his team would regularly collect the replacement hips to check wear and tear, and aid research. He improves his design with a low-friction hip replacement, and in November 1962 the modified Charnley hip replacement becomes a practical reality.

1967

The Salmon Report

This major report makes recommendations for the development of senior nursing staff.

The Salmon Report is published and sets out recommendations for developing the nursing staff structure and the status of the profession in hospital management. The Cogwheel Report considers the organisation of doctors in hospitals and proposes speciality groupings. It also highlights the efforts being made to reduce the disadvantages of the three-part NHS structure – hospitals, general practice and local health authorities – acknowledging the complexity of the NHS and the importance of change to meet future needs.

1967

Abortion Act

The Abortion Act is introduced by Liberal MP David Steel and is passed on a free vote, becoming law on April 27 1968.

This new act makes abortion legal up to 28 weeks if carried out by a registered physician and if two other doctors agree that the termination is in the best mental and physical interests of the woman. In 1990, the time limit is lowered to 24 weeks. The act does not extend to Northern Ireland.

1968 

Sextuplets born 

Sextuplets born after British woman receives fertility treatment.

In the morning of October 2 Sheila Thorns celebrates her birthday by undergoing a caesarean section at Birmingham Maternity Hospital. She gives birth to six children, four boys and two girls, but sadly one of the girls dies shortly afterwards. With 28 medical staff at the delivery, the five surviving babies – Ian, Lynne, Julie, Susan and Roger – are cared for by a specialist team. Doctors say around one birth in 3,000m will result in sextuplets. Mrs Thorns had been treated with the fertility treatment gonadotrophin which contains two hormones known as FSH and LH.

1968

First NHS heart transplant

A 45-year-old man becomes the first Briton to have a heart transplant on 3 May.

Surgeon Donald Ross carries out Britain’s first heart transplant at the National Heart Hospital in Marylebone, London. Ross leads a team of 18 doctors and nurses to operate on the man in the seven-hour procedure. The donor was a 26-year-old labourer called Patrick Ryan. The British operation is the tenth heart transplant to be undertaken in the world since Christiaan Barnard carried out the first in Cape Town, South Africa, in December 1967. The patient dies after 46 days and only six transplants are carried out over the next 10 years.

1972

CT scans introduced

Computer tomography scans start to revolutionise the way doctors examine the body.

These scanners produce 3-D images from a large series of two-dimensional X-rays and the first one is started in 1967 by Godfrey Newbold Hounsfield, with his research reaching fruition now. His concept will go on to win him a Nobel Prize, which he will share with the American Allan McLeod Cormack, who developed the same idea across the Atlantic. Since that initial invention, CT scanners have developed enormously, but the principle remains the same.

1975

Endorphins discovered

The morphine-like chemicals in the brain called endorphins are discovered.

John Hughes and Hans Kosterlitz of Scotland isolate from the brain of a pig what they called enkephalins and will later be termed ‘endorphin’ from an abbreviation of ‘endogenous morphine’. These are polypeptides produced by the pituitary gland and the hypothalamus in vertebrates, and they resemble opiates in their abilities to produce analgesia and a sense of well-being. In other words, they might work as natural pain killers.

1978

First test-tube baby 

Louise Brown is the world’s first baby to be born as a result of in-vitro fertilization.

The world’s first test tube baby is born on July 25. Parents Lesley and John Brown had failed to conceive due to Lesley’s blocked fallopian tubes. This new technique developed by Dr Patrick Steptoe, a gynaecologist at Oldham General Hospital, and Dr Robert Edwards, a physiologist at Cambridge University found a way to fertilize the egg outside the woman’s body before replacing it in the womb.

1979

Bone marrow transplant

The first successful bone marrow transplant on a child takes place.

Professor Roland Levinsky performs the UK’s first successful bone marrow transplant in children with primary immunodeficiency at Great Ormond Street Hospital for Children.

1980s

MRI scans introduced 

Using a combination of magnetism and radio frequency waves, MRI scanners provide information about the body.

Magnetic resonance imaging scanners prove more effective in providing information about soft tissues, such as scans of the brain. The patient lies inside a large cylindrical magnet and extremely strong radio waves are then sent through the body. It provides very detailed pictures, so is particularly useful for finding tumours in the brain; it can also identify conditions such as multiple sclerosis and the extent of damage following a stroke.

1980 

Keyhole surgery

A surgeon uses a telescopic rod with fibre optic cable to remove gallbladder.

This first successful instance of keyhole surgery is the removal of a gallbladder. Technically it’s known as laparoscopic surgery, after the instrument that’s used to perform the surgery, a thin telescopic rod lit with a fibre optic cable and connected to a tiny camera which sends images of the area being operated on to a monitor. The procedure will go on to be one of the most common uses of this kind of surgery. It will also be used for hernia repairs and removal of the colon and the kidney.

1980

Black Report 

Commissioned three years earlier by David Ennals the report aimed to investigate the inequalities of healthcare.

Commissioned three years earlier by David Ennals, then secretary of state, the report aims to investigate the inequality of healthcare that still exists despite the foundation of the NHS i.e. differences between the social classes in the usage of medical services, infant mortality rates and life expectancy. Poor people are still more likely to die earlier than rich ones. The Whitehead Report in 1987 and the Acheson report in 1998 reached the same conclusions as the Black Report.

1981

Improved health of babies

The 1981 Census shows that 11 babies in every 1,000 die before the age of one. In 1900 this figure was 160.

Childhood survival has been revolutionised by vaccination programmes, better sanitation and improved standards of living, resulting in better health of both mother and child. Increased numbers of births in hospital has meant that where unexpected problems do occur, medical help is on hand. Around one baby in eight requires some kind of special care following birth. Twenty years ago, only 20% of babies weighing less than 1,000g (2lbs 2oz) at birth survived. Now that figure is closer to 80%.

1986 

Aids health campaign

The government launches biggest public health campaign in history to educate people about the threat of Aids as a result of HIV.

Following a number of high-profile deaths, the advertising campaign sets out to shock – with images of tombstones and icebergs, followed early in 1987 by a household leaflet, “Don’t die of ignorance”. This was very much in keeping with the NHS’s original concept that it should improve health and prevent disease, rather than just offer treatment.

1987

Heart, lung and liver transplant

First heart, lung, and liver transplant is carried out at Papworth Hospital.

Professor Sir Roy Calne and Professor John Wallwork carry out the world’s first liver, heart and lung transplant at Papworth Hospital in Cambridge. Professor Calne describes the patient as “plucky” and she survives for a further 10 years after the procedure. Her healthy heart is donated to another transplant patient.

1988

Breast screening is introduced

Comprehensive national breast-screening programme introduced.

To reduce breast cancer deaths in women over 50 this project is launched with breast-screening units around the country providing mammograms. A mammogram works by taking an X-ray of each breast, which can show changes in tissue that might be otherwise undetectable. This means that any abnormalities show up as early as possible, making treatment more effective. Screening, together with improved drug therapies will help to cut breast cancer deaths by more than 20%, a trend that looks set to continue.

1990

NHS and Community Care Act

Internal market is introduced, which means health authorities manage their own budgets.

Now health authorities will manage their own budgets and buy healthcare from hospitals and other health organisations. In order to be deemed a “provider” of such healthcare, organisationswill become NHS Trusts, that is, independent organisations with their own managements.

1991

First NHS Trusts established

Fifty-seven NHS trusts are established to make the service more responsive to the user at a local level.

New NHS Trusts will aim to encourage creativity and innovation and challenge the domination of the hospitals within a health service that is increasingly focused on services in the community.

1994

NHS Organ Donor Register

National register for organ donation is set up to co-ordinate supply and demand after a five-year. campaign

The NHS Organ Donor Register is launched following a five-year campaign by John and Rosemary Cox. In 1989 their son Peter died of a brain tumour. He had asked for his organs to be used to help others. The Coxes said that there should be a register for people who wish to donate their organs. By 2005 more than 12m had registered. Organ donation is needed as demand outstrips supply and this register ensures that when a person dies they can be identified as someone who has chosen to donate their organs.

1998

NHS Direct launches

A nurse-led advice service provides people with 24-hour health advice over the phone.

This service will go on to become one of the largest single e-health services in the world, handling more than half a million calls each month. It is the start of a growing range of convenient alternatives to traditional GP services – including the launch of NHS walk-in centres, which offer patients treatment and advice for a range of injuries and illnesses without the need to make an appointment.

2000

NHS walk-in centres

New health facilities open offering convenient access, round-the-clock, 365 days a year.

NHS walk-in centres (WiCs) offer convenient access to a range of NHS services and are managed by Primary Care Trusts. There are around 90 NHS WiCs dealing with minor illnesses and injuries. WiCs are predominantly nurse-led first-contact services available to everyone without making an appointment or requiring patients to register. Most centres are open 365 days a year and are situated in convenient locations that give patients access to services even beyond regular office hours.

2002 

Primary care trusts launched

Primary care trusts are set up to improve the administration and delivery of healthcare at a local level.

The primary care trusts oversee 29,000 GPs and 21,000 NHS dentists. primary care trusts that are in charge of vaccination administration and control of epidemics also control 80 per cent of the total NHS budget. They also liaise with the private sector when contracting out of services is required. As local organisations, they are best positioned to understand the needs of their community, so they can make sure that the organisations providing health and social care services are working effectively.

2004

Patient Choice Pilots

All patients waiting longer than six months for an operation are given a choice of an alternative place of treatment.

Everyone who is referred by their doctor for hospital treatment is given a choice of at least four hospitals. Nowadays you can choose where and when to have your treatment from a list including local hospitals, NHS foundation trust hospitals across the country and a growing number of independent sector treatment centres and hospitals that have been contracted from the private sector. You can choose according to what matters most to you: waiting lists, MRSA rates, bus routes and so on.

2007

Robotic intervention

Introduction of robotic arm leads to groundbreaking operations to treat patients for fast or irregular heartbeats.

This technological revolution is being used at St Mary’s Hospital, London, and is less risky than more invasive techniques. It works by inserting several fine wires into a vein in the groin, which are then guided to the heart where they deliver an electric current to parts of the heart muscle. Cardiologists control the robot arm via a computer and joystick, but in future the system could be automated. Around 50,000 people develop an irregular heartbeat each year, and it is a major cause of strokes and heart attacks.

2008

Free choice is introduced

Free choice is introduced on April 1 2008. Patients can choose from any hospital or clinic that meets NHS standards.

Patients who are referred by their GP for their first consultant-led outpatient appointment can choose from any hospital or clinic that meets NHS standards. You can choose a hospital according to what matters most to you, whether it’s location, waiting times, reputation, clinical performance, visiting policies, parking facilities or patients’ comments.

2008

The NHS at 60

On July 5 2008, the NHS celebrates its 60th birthday with events across the county.

The NHS was born out of a long-held ideal that good healthcare should be available to all, regardless of wealth. Since its launch in 1948, the NHS has grown to become the world’s largest publicly funded health service. On July 5 2008, the NHS celebrates its 60th birthday. Local events take place across the country, and NHS staff and patients celebrate at Westminster Abbey and 10 Downing Street.

2008

HPV vaccination programme

Cervical cancer vaccination is introduced for teenage girls.

In September 2008, a national programme to vaccinate girls aged 12 and 13 against the human papilloma virus (HPV) is launched to help prevent cervical cancer. A three-year catch-up campaign is also introduced, which will offer the HPV vaccine, also known as the cervical cancer jab, to girls who are 13 to 18 years old.

2009

New NHS Constitution

The NHS Constitution is published on January 21 and sets out your rights as an NHS patient.

The NHS Constitution is published on January 21 2009. For the first time in the history of the NHS, the Constitution brings together details of what staff, patients and the public can expect from the NHS. It aims to ensure the NHS will always do what it was set up to do in 1948: provide high-quality healthcare that’s free and for everyone.

2009 

New Horizons programme launched

The New Horizons programme is launched to improve adult mental health services in England.

New Horizons brings together local and national organisations and individuals to work towards a society that values mental wellbeing as much as physical health.[br][br]It aims to cover a person’s lifetime, from building the foundations of good mental health in childhood to maintaining resilience in older age.[br][br]It also emphasises the importance of prevention, effective treatment and recovery.

2009

NHS Health Checks

The NHS Health Check is introduced for adults in England between the ages of 40 and 74.

Primary care trusts begin implementing the NHS Health Check programme in April 2009. It has the potential to prevent an average of 1,600 heart attacks and strokes and save up to 650 lives each year. It could prevent over 4,000 people a year from developing diabetes and detect at least 20,000 cases of diabetes or kidney disease earlier, allowing people to manage their condition better and improving their quality of life.

Report on ITV News Anglia

Margaret Ridley a retired hospital doctor and campaigner for Hands Off Hinchingbrooke spoke to Claire McGlasson at ITV Anglia on Tuesday regarding the future of Hinchingbrooke Hospital and the NHS. We will fight to protect services at Hinchingbrooke like we have done since 2011, when the hospital was in the process of being run by a private company.

hinch1

 

Watch the report below: http://www.itv.com/news/anglia/update/2016-06-28/campaigners-say-theyll-fight-hospital-merger/

My Experience of the NHS and the Future of Hinchingbrooke: Margaret Ridley

NHS

Margaret Ridley was born in 1948 – the same year as the NHS. At the age of 18, she went to medical school in Leeds, qualified as a doctor in her early twenties and became a consultant psychiatrist in 1985 – a job for life which she kept until she retired eight years ago.

Here in her own words she explains her experience of working in the NHS, privatisation, PFI, Hinchingbrooke Hospital and the future of the Nation Health Service.

“I’m a retired hospital doctor. I would like to discuss what has happened to the NHS since I first started working in it over 40 years ago and I would also like to discuss Hinchingbrooke Hospital.

I was born in 1948 the same year the NHS came into being. Although the post-war government had enormous financial debts it managed not only to introduce a publically funded, publically provided and publically accountable NHS but it also introduced social housing and nationalised the railways and mines.

In 1971 I qualified and started working in the National Health Service. The management structure for the NHS then was the same as that from 1948. The Secretary of State for Health was responsible to Parliament and had a duty to secure and provide a health service for all. The Department of Health managed the 14 regional health authorities which in turn managed the 160 District Health Authorities. There were clear geographic lines of accountability and money was allocated to the regions on the basis of their population health needs.

According to Kenneth Clark MP, the former Prime Minister, Margaret Thatcher did discuss in cabinet privatising the NHS and introducing an American style insurance system. However, it was decided that doing this in one fell swoop would be very unpopular and so they introduced privatisation a little at a time but later under the Blair Labour government they continued the privatisation process. The long term care of elderly patients was transferred from hospitals to private care and nursing homes. The internal market was introduced and hospitals were expected to compete with each other for patients and funds. Hospitals were encouraged to become Foundation Trusts and become independent of ministerial control allowing them to generate money from private patients and commercial backers.  The Conservative government introduced the Private Finance Initiative (PFI) in which private companies funded the building of hospitals and then leased the hospital back to the hospital trust at an exorbitant rent. Initially there was reluctance on the part of major investors to get involved because they feared that if the hospital became bankrupt they would not be repaid. However, the Blair government passed legislation to protect the private investors and ensure that the taxpayer would foot the bill. The cost of building Peterborough City Hospital is £300 million and the PFI debt to be paid back is three times this. The private companies involved are often hedge funds based in off-shore tax havens.

When the Coalition government came into power in May 2010 they rapidly introduced what was to become the Health and Social Care Act of 2012. Oliver Letwin MP for West Dover author of a very helpful book “How to Privatise the World” was involved in its planning together with Andrew Lansley MP for South Cambridgeshire and former Secretary of State for Health.  In the Act Andrew Lansley absolved himself of any responsibility to provide a comprehensive health service for all, by changing a duty to “provide” to a duty to “promote” health. All contracts within the health service, when they come up for renewal, have to be open to competitive tender to whoever wants to bid for them which now includes private, for profit companies. The bidding process involves a vast amount of staff time in drawing up the bids, etc. and NHS staff are at a disadvantage in all this because they are often competing against multinational companies. In 2015 a contract for Older Peoples and Adults for the Cambridgeshire and Peterborough area costed the Cambridgeshire & Peterborough Clinical Commissioning Group over £1 million pounds. The cost of the contract collapsing after only just 8 months later costed the Cambridgeshire & Peterborough CCG £12 million and then in addition to this there is the cost incurred by the other organisations involved. The first duty for private, for profit, companies is to make a profit for their shareholders. The largest cost in the health service is staff wages and so in order to make a profit from a NHS contract they inevitably reduce the number of staff, worsen their terms and conditions of service and end up converting a once skilled work force into minimum wage carers.

In 2014, Simon Stevens was appointed Chief Executive of NHS England. He had previously worked with the Labour Government introducing Foundation Trusts and promoting PFIs. In 2004 he moved to America and worked there for 10 years as vice-president for United Health, the biggest health insurance firm in the USA. One of his roles was to introduce American health insurance into other countries and he has been quoted in a newspaper article as saying that even in poorer countries there is an expanding middle class who will be able to pay for health insurance. United Health has now moved into NHS England and into the market for supplying administration services for general practice. Simon Stevens very soon introduced his 5 Year Forward View and the Sustainability and Transformation Plan (STP) which is another complete reorganisation of NHS England. It does not apply to Scotland, Wales or Northern Ireland because these countries have rejected a lot of the privatisation so far and for example do not have Foundation Trust hospitals. NHS England is now to be divided into 44 STP areas called footprints and these areas have to reduce the amount of money spent on healthcare. Hospital based care is to be reduced and care is to be provided in the community. There is not enough community based care at the moment let alone when more hospital beds are closed. Cambridgeshire and Peterborough are one of those footprints. The Health Service Journal reported that of all these 44 areas, the area which has the greatest deficit in their budget is Cambridgeshire and Peterborough. The deficit is said to be 13% of the running costs. I attended a meeting organised by the Cambridgeshire and Peterborough Clinical Commissioning Group in Huntingdon last year when we were told that hospitals were draining money out of the NHS and that Cambridgeshire and Peterborough did not have the money to fund 3 hospitals. The speaker did not say which hospital was under threat.

At the current moment only 7% of our GDP is spent on the NHS. The UK now ranks 13th out of the 15 original members of the European Union as far as health spending is concerned. France and Germany spend 11% of their GDP on their health service and so have more doctors, nurses and hospital beds.

Dr John Lister is a health journalist who has been following the fortunes of Hinchingbrooke Hospital for several years. He says that in the mid 2000s Hinchingbrooke was a successful hospital providing routine operations at below average cost. Then the way hospitals were reimbursed for operations changed to a payment by results method that should have resulted in the hospital being paid more for the work it was doing. However Cambridgeshire Primary Care Trust, who at that time had control of the budget, then started diverting patients away from Hinchingbrooke in order to reduce the budget back to its previous level. This financially destabilised the hospital and in 2011 the East of England Strategic Health Authority saw this as an opportunity to privatise the hospital. Circle Health took over the running of the hospital in 2013 which already run two private hospitals of 30 beds but they only accepted patients that were going to have straightforward operations because they did not have any intensive care units, as these are expensive. They also did not have Accident & Emergency departments again because these are also expensive to run. Circle’s contract at Hinchingbrooke was based on achieving massive year on year cost savings. The National Audit Office was critical of the contract but did not intervene. Circle had built into their contract from the beginning that they were entitled to terminate their contract if they spent more than £5 million pounds of their own money on Hinchingbrooke and it was clear for several months beforehand that this limit was being approached. They announced the termination of the contract in 2015 a few hours before the adverse Care Quality Commission report was announced which detailed the hospital as inadequate. In 2016, the hospital come back under NHS control, although still under Care Quality Commission special measures, and the Hospital Board are making progress with improvements.

Johnathon Djanogly MP for Huntingdon who has also only recently campaigned for Hinchingbrooke is concerned that the possible collaborative working between Hinchingbrooke and Peterborough City Hospital is the prelude to a merger and then the possible downgrading of Hinchingbrooke with the loss of the maternity and A&E departments. At the moment the managers of the two hospitals are discussing shared back office functions and operational services to deliver reduced costs and sustainable services. There has already been some collaborative working. We have been attending the Hinchingbrooke Trust Board meetings and have heard that the hospital has had a very high staff turnover. A human resources manager has been seconded from Peterborough and this has helped Hinchingbrooke to tackle this problem. I personally think that there are benefits to collaborative working although the marketization and competition ethos of “market reforms” make collaboration difficult. Although the managers may want to cooperate to help both hospitals, it may be that the Government has a hidden agenda to downgrade Hinchingbrooke Hospital in the future to reduce Peterborough’s enormous PFI debt.

However, there are two immediate threats to the viability of Hinchingbrooke Hospital:

The first affects other hospitals as there is a national shortage of nurses because in 2010 the Coalition Government reduced the nurse training places. There’s also a shortage of medical staff and this is resulting in the piecemeal closures of beds, wards and departments throughout the country because they do not have the staff for the departments to run. Currently at Addenbrooke’s there are only half the number of consultant cardiologists needed to run the department and so patient referrals have been reduced and a neurology ward has been closed because they don’t have enough specialised nurses. Is something similar going to happen at Hinchingbrooke? The Government’s dispute with junior doctors has resulted in doctors leaving to train and work abroad. There are apparently 300 vacancies across the country for first year junior doctor posts for the 1st of August whereas previously there would have been none.

The second threat as I have already mentioned is that Cambridgeshire and Peterborough CCG have not been given enough money to continue funding the existing services. The CCG has to come up with a STP plan by June 2016 on how to reduce the cost of the health service and will inevitably cut services. I have heard from two sources that part of the STP plan is that Hinchingbrooke Hospital will be downgraded. Throughout England, hospitals are being threatened with downgrading or even closure. The residents of Shropshire were told that they had to lose either the A&E department in Telford or Shrewsbury. They successfully opposed this closure and said that they needed both A&E departments to remain open. We need to gather support from local people to say that we want to retain all clinical services at Hinchingbrooke Hospital.”

Margaret Ridley

Retired Hospital Doctor

Hospital Boss to be Scrutinised by Council and Public

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Huntingdonshire District Council will be holding a special meeting on Tuesday 28th June, 7pm at Pathfinder House where CEO of Hinchingbrooke Hospital, Lance McCarty and Val Moore from Healthwatch Cambridgeshire will be scrutinised and quizzed by Councillors and the public on the proposed merger with Peterborough and Stamford Foundation NHS Trust.

Hands Off Hinchingbrooke will be attending the special meeting and scrutinising Mr McMarthy on the merger and what future does the hospital have after 1 April, 2017.

If your unable to attend and  you would like to ask Lance MaCarthy a question then email [email protected] or alternativley if you would like us to ask a question on your behalf, then please email us [email protected]