The Great NHS gamble: ‘Secret’ plans to trim millions from health budgets

Royal Preston Hospital
Royal Preston Hospital
  • 1 in 6 A&E departments could be closed or downgraded in the next four years
  • 19 hospitals face proposed or likely closure
  • A county GP accuses health chiefs of ‘Shifting the deckchairs on the Titanic’
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The NHS in Lancashire is facing its biggest shake-up in a generation with care from cradle to grave put through an overhaul to slash £572m from the areas’ budgets.

Today, the Lancashire Post and its sister titles across Johnston Press launch ‘The Great NHS Gamble’ – an in-depth analysis of the 44 regional blueprints drawn up to remodel the NHS in an attempt to fill the £22bn financial black hole.

The five-year plans have been criticised for been shrouded in secrecy and filled with jargon, while campaigners fear they will lead to creeping privatisation of the NHS.

Dr David Wrigley, Lancashire GP and deputy chairman of the British Medical Association, today accused the plans of being like “shifting the deckchairs on the Titanic.”

He said: “These Sustainability and Transformation Plans (STPs) are just moving the deckchairs around on the Titanic and are not going to resolve the current crisis facing the NHS.

“They are more of a smokescreen to move things around, cut services and have closures.

“There is a real gamble being taken with the NHS and politicians need to focus on the real issue which is that there is a huge funding shortfall. Unless there is a huge injection of funding, I can’t see how the NHS is going to survive.”

Figures revealed by the British Medical Association today show the plans need at least £9.5bn of capital funding to be delivered successfully – but the NHS leaders don’t have the cash.

In Lancashire and South Cumbria alone, it is estimated a staggering £264m capital is needed to deliver the STP projects.

A recent survey revealed that six out of seven people have never heard of the STPs, prompting warnings the shake-up is being pushed through without meaningful consultation.

A Department of Health spokesman said: “We are committed to the NHS - that’s why we have invested £10b in its own plan to transform services and improve standards of care including almost £4bn this year.

“NHS England are introducing Sustainability and Transformation Plans to help ensure the best standards of care, with local doctors, hospitals and councils working together in conjunction with local communities for the first time.”

NHS England says the NHS needs to make major efficiencies to live within the financial budgets set by Parliament and government.

It believes the best way to do this is for local doctors, hospitals and councils to work together to identify ways that unnecessary future costs can be avoided, such as the sale of surplus land.

NHS England believes it is missing the point to suggest that STPs are all about saving money – and says they are a big opportunity to improve the care that patients receive, based on the experience of areas who are performing best and practical things that doctors and nurses have been saying for years.

Dr Amanda Doyle, Head of Lancashire & South Cumbria STP and Chief Clinical Officer at Blackpool Clinical Commissioning Group said: “Across health and social care, if we continue to deliver services in the way we do now and if demand continues to grow, we will have a £572m shortfall in Lancashire and South Cumbria by 2021.

“More money is still going into the NHS but the demand is growing at such a rate that increases in investment won’t keep pace unless we do things differently.

“This is not about making cuts. There is actually going to be money going into the NHS over the next five years.

“Funding for the NHS in Lancashire is set to increase over the next four years by £345m.

“We just need to manage demand so it does not outstrip resources.

“However, the demand for our health and care services is higher than ever and is predicted to increase. Our staff are are under enormous strain and services cannot continue to deliver sustainably if we carry on with the current situation, even with this additional funding.

“It isn’t all about the money, even if it may appear that way. The health outcomes we get from our services are among some of the poorest in the country.

“We need to work together better across health and care and make better use of technology to make sure people receive the best possible treatments and so these outcomes are improved.

“We have to make the most effective use of the money we have got. We need to deliver care in a different way and use technology better.

“Some of the things that need to happen, we can’t do for people; they are about lifestyle changes and people keeping themselves well. Helping people to address issues such as smoking, obesity and alcohol may seem no specific but it will make a significant difference.

“We have tried very much not to keep things secret but it is not finished. There are still no finalised plans for everything.

“The document we have created does not make any specific proposals for how services may change as there has not been the level of engagement and involvement with staff, clinicians or members of the public that this would require. The STP is made up of the local plans of each of the areas so a lot of things, people will have been consulted about as part of that plan.

“We are working with focus groups and have started having a range of stakeholder meetings.

“There will be a lot more coming out soon.”

Dr Wrigley, Deputy Chairman of the British Medical Association (BMA) and a GP in Lancaster said: “All the STPs are doing is moving the deckchairs around on the Titanic and they are not going to resolve the current crisis facing the NHS.”

“Things are in such a sorry state of affairs, the STPs are being touted as trying to salvage the situation.

“But they are more of a smokescreen to move things around, cut services and have closures.

“There is a real gamble being taken with the NHS as these plans keep talking about moving care from hospitals into the community.

“But the problem is there is no leeway in the community as there is very little spare capacity.

“Social care is collapsing, General Practice is on its knees and that’s all on top of the hospital service being in meltdown.

“Politicians need to focus on the real issue which is that there is a huge funding shortfall.

“Unless there is a huge injection of funding, I can’t see how the NHS is going to survive.

“No STP is going to solve the current crisis facing the NHS.”

Lindsay Hoyle, Chorley MP said: “Nobody seems to understand or know what these plans are trying to achieve apart from the natural instinct that tells us they are a cost-cutting measure.

“It seems they are gambling with people’s lives and health services for the future.

“To create a better health service, we need more funding, better training and more staff.

“I have seen nothing to convince me these STP plans are a good idea and nobody even know what these plans are as they are so vague and full of gobbledy gook.

“My belief is the only motive is saving money by delivering health for less money at the expense of people.”

Mark Hendrick, Preston MP said: “These STP plans are not particularly transparent.

“They are cost-driven, not about clinical evidence and making sure things are the best for patients. They are trying to do things on the cheap.

“The idea that you can map all this out over a five-year period and have a clear fixed budget is outrageous.

“The plans are trying to make things more efficient but that does not solve the problem if there are not enough resources going into the system.

“They are trying to get more care for less money which is impossible.”