There has been a blizzard of articles in the local press recently `celebrating` the reforms to the health service which embed underfunding in the NHS.
The most interesting have been in the Bolton News: on 31st January there were no fewer than 4 big articles. The first praised the CCG for stepping up to plug a gap in funding imposed by the government to Public Health, which threatened the Bolton Health check programme, which the Bolton News had sponsored. The CCG has to raise its profile as it will shortly have to tell us about cuts to surgery to knees and hips under the `Right Care `programme.The second celebrated the signing of a `memorandum of understanding` between Greater Manchester Health and Social Care Partnership and GM Voluntary, Community, and Social Enterprise Sector who are now apparently `equal partners` in driving up standards in the Health Service ( as opposed to gamely plugging the gaps) The most startling was the 2-page centre-fold entitled ` Your Health- Treatments`:on closer inspection this turned out to be advertisements by private companies such as a personal trainer, a personal dental treatment company, and the private hair- laser treatment company of the Chair of Bury CCG, Dr Kiran Patel. The` health treatment` Dr Patel was advertising turned to be `getting your legs beautiful for Summer` The Daily Mail and Sunday Times criticised him for having been the benficiary of two contracts worth £130,000 for his two private companies, from his own Board of the CCG out of NHS funds. So there you have it: two fellow Chairmen of neighbouring CCGs, side by side, each responsible for an underfunded health service , the one telling us we `have to do more with less` in the NHS, the other hoping to attract a few customers to his laser-treatment business. Brass neck or what? You could not make it up.
The Locality Plans are about cuts and privatisation: trying to prove how this happens. Most Bolton Labour politicians are blinded by enthusiasm for integrated care, and dont see how the cuts work.
For cuts look at Right Care which is related to Bolton`s first cut to hospital care which is operations/procedures 13%: Right Care is an argument from GPs that eg 18% of patients report no clinical improvement after knee replacements. They then move on to say this procedure is of `low clinical value` ( even though 82% report improvement). Similar arguments are then made for gall bladder, hysterectomy, etc.These procedures will be delayed/axed. `Right Care at the Right Time in the Right Place`. Under the Bolton final plan A & E attendances will be reduced by 18% and non-elective admissions by 22%: one means of achieving this is by raising the bar very high for admission to A & E: in the Plan a newly designed `Urgent care `system turns out to be a re-jig of urgent care and emergency care: you can only get into A & E if you have a` life threatening illness`- everyone else will be syphoned into a GP facility with the ethos `care outside the hospital`. Entrepreneurial GPs have been meeting at Royal Bolton to discuss ` social enterprise businesses` which may be profit making. It seems all urgent and emergency care bar ` life threatening ` stuff will go into these businesses. Privatisation in Bolton is straightforwardly commissioned eg Beaumont Hospital / Care UK under the concept of `choice` and also covert ie privatisation in the form of `social enterprise ` businesses like BARDOC who have a contract for `discharge to assess` called `take home and tuck up`. They are owned and run by GPs.
BARDOC was a PLC . They are now a Social Enterprise Company with an £8 million turnover. Will this be the future-the Memorandum of Understanding with the Voluntary Sector in Bolton News includes Social Enterprise Companies? Most other Voluntary Agencies will be registered charities, Social Enterprises are not. The movement of healthcare out of hospitals to either the private sector or to the GP sector under the auspices of Social Enterprise is on the increase: the new Local Care Companies, end-stage integrated care organisations, plus the new Urgent Care Organisations will syphon off work from the hospital A & E- Will this reform in the Bolton Plan see a bigger, more lucrative contract for Bardoc – they already take their £8 million from urgent care/out of hours in Rochdale Bury and Bolton. The profits made are syphoned off in turn to other orgs- in the case of Bardoc to `Rock Health Limited` which looks like a little company of GPs in Bury.
Local Care Organisations which in the Bolton Plan are end-stage partnerships of Integrated Care (LA)/ GPs/private care homes and home care businesses(who are trained by the NHS and provided with capital grants). The LCO can then act as a` provider`yet be delegated with a budget and they in turn can commission eg alternative services to the NHS from the private sphere?
Older folk can have integrated care, but cant have a knee replacement or a gall bladder operation, because these are hospital based and hospitals have to be cut. Ironically if prevention actually works – we could be living a tiny bit longer but in considerable pain and discomfort!
A KONP supporter Bolton
Any one who wants to help is welcome.
We have our own Facebook page: Bolton A+E – Save It.
Below is a copy of a letter sent to Bolton Labour MPs and councillors
I am writing on behalf of Save Bolton Health Services campaign. One of our members was at a recent trades council meeting which was told that Ian McCartney the chair of Wigan Labour Party had announced at the last CLP meeting that either Wigan or Bolton A+E would definitely close, it was just a matter of deciding which one.
We are deeply disturbed by this as we keep being accused of scare mongering by suggesting that the closure of Bolton or Wigan A+E is even being discussed, let alone a decision made that one will shut and they are just deciding which one.
We would be concerned about either option. If one closed it would affect the attendance at the other, as people would have to go somewhere. Bolton is already way above capacity. Wigan is well attended. Transport between them is not easy. Evidence shows for every 10 miles traveled to A+E your chance of dying goes up 20%. History of other closures of A+E shows us that a hospital without an A+E is quickly downgraded to not much more than an out patient and diagnostic centre. We still have a petition with over 45,000 signatures on it and have kept the window posters just in case. We are ready to restart the campaign to defend the A+E.
Yet, we keep being adamantly reassured that Bolton A+E is not under threat and a campaign is not necessary.
Can you shed any light on this? Have you heard anything? Can you raise this on our behalf with the decision makers?
1) Healthier Together still have no date for announcing exactly what their plans are for each area. What was clear from the last public meeting they held was they do want 3 different types of hospitals – “super-hospital” with all functions, lesser hospitals with no emergency, trauma, etc and hospitals which are not really hospitals but have out patients, some investigation and walk-in centres.
Bolton Salford and Wigan are all now talking about working closer together. It is not clear whether this means within this 3 type of hospital structure.
2) Bolton Ft NHS Trust have still to make £18m cuts this year and needed 500 job cuts to achieve this. They have got rid of 220 by mainly voluntary redundancies and people leaving, with a tiny number of compulsory redundancies. They are saying they still need to lok at have to get rid of 280 more. Staff seem very demoralised by the whole process, which when combined with the loss of jobs and increased workload and stress on staff, cannot be good for patient care.
As a campaign we remain concerned that the priority for the trust is financial not patient care and that this risks the same drastic drop in quality of care and saftety of care that we saw at Mid Staffordshire hospital.
The £20billion national cut in NHS funding is now producing redundancies in a wider layer of trusts eg 300 Warrington, 500 Liverpool, 800 Pennine Acute etc.
3) Privatisation continues to be driven by this government in the NHS. Section 75 regulations force all Clinical Commissioning groups to expose all services to the tendering process. They specifically cannot refuse to accept a bid because of who provides it ie they can no longer choose to keep a service NHS provided because it is NHS.