Government accused over ‘secret plans’ for more NHS privatisation
“Secret” plans to close underfunded A&E departments and hospitals could be used as a stalking horse for privatisation, Labour has claimed.
Shadow health secretary Diane Abbott said the Government’s plans are already “far advanced” but have received no public consultation.
Over the summer an investigation commissioned by campaign group 38 Degrees uncovered 44 sustainability and transformation plans (STPs) being drawn up across England to meet significant cuts.
Ms Abbott (pictured) said in the Black Country, there are proposals to shut the A&E department at the Midland Metropolitan Hospital and to close one of two district general hospitals as part of a planned merger.
In a debate on the issue led by Labour, Ms Abbott told the Commons: “The strong suspicion is the combination of cuts, the reorganisation of services on geographical basis and the growth of hospital chains will all facilitate the greater privatisation of the NHS.
“It is absolutely right that health and social care stakeholders should come together to plan for the future.
“It is absolutely wrong that social transformation plans should be hatched in secret and used as a cover for cuts and hospital closures and it is increasingly clear that social transformation plans may be a stalking horse for more privatisation.”
Ms Abbott added: “The alarming aspect of these sustainability plans has been their secrecy.
“In the world of the STPs the public has no right to know. The Government knows if the public understood what STPs mean there would be an outcry.”
Health minister Philip Dunne said the plans offered the healthcare system “a unique opportunity”, as he brushed aside Labour’s concerns.
He said: “I’d like to be absolutely clear to the House that for all her protestations, these plans are not about cuts.
“They’re about local areas, including commissioners, providers and local authorities coming together and deciding how to improve services in the medium and long term.
“Some areas are taking difficult decisions, often looking to tackle longstanding problems, but this will be subject to rigorous and national scrutiny.
“No changes will occur without local consultation and the normal process in the event of any proposed configuration.
“There has been no secret. What is new is that for the first time in years, different NHS bodies with local authorities have been working collaboratively to develop these plans.”
He said the plans would enable local authorities and NHS organisations to work together to tackle bed blocking, where patients cannot be discharged from hospital due to a lack of social provision.
Figures released in the summer said 32,000 bed days were lost while people, mostly elderly, were waiting for care and support in their own home, a rise of 37% since last year.
Mr Dunne also dismissed any concern the plans were being kept under wraps.
He told the Commons that NHS England had published planning guidance in December last year that outlined the STP process, of different organisations coming together across local geograpy.
Each area’s plans are due to be submitted in October for scrutiny, and implemented early next year after consultation.
Mr Dunne added: “These plans offer the NHS a unique opportunity to think strategically.
“For the first time, the NHS is planning across multiple organisations, both commissioners and providers, with local authorities, to address the whole health needs of an area and the people it serves.
“This is leading some STPs to face up to tough choices about the future of services, often choices that may have been postponed again and again because they were always too hard, or relied on individual organisations operating on their own to shoulder the responsibility rather than share it.”
He also said this was the first year NHS bodies would have done multi-year plans.
Mr Dunne concluded with a swipe at Ms Abbott’s criticism of the private sector.
He said she had been advised by the campaign group 38 Degrees, which had been advised by a private sector advisory group, Incisive Health.
“It’s a bit rich of her to come to this House arguing against the use of the private sector when she does so herself,” Mr Dunne said.
SNP health spokeswoman Philippa Whitford, a surgeon, said she welcomed the principles behind the STPs.
Dr Whitford, MP for Central Ayrshire, added: “But you actually have to get it right. To turn this into a game of just moving the deckchairs on the Titanic would be, really, an opportunity we would all regret in a few years’ time.”
Dr Whitford’s wide-ranging critique of the health system included the tariff system, which cuts funding for A&E activity above target levels, as well as the challenges of an ageing population and a shortage of staff.
She also questioned whether enough funding had been allocated to implement such a dramatic transformation.
There is £2.1 billion allocated for sustainability and transformation in the NHS – but £1.8 billion of this is already earmarked to cover deficits in NHS trusts, leaving just £300 million spare.
“You cannot transform a system on the scale that’s being considered on £300 million,” Dr Whitford said.
She also said social care needed to be developed as a profession, much like nursing has been.
Conservative MP Sarah Wollaston, a former GP who chairs the Health Select Committee, attacked the secrecy and lack of public engagement around the proposals.
She said: “I think it is a real shame that this debate has developed the hashtag of #secretnhsplans, and I’m afraid that NHS England now has to look at that, take a step back, and say how could they have been better at engaging local communities and those that represent them.
“I think it’s a great shame that members across this House weren’t able to see the draft plans until they were leaked to the press, that isn’t the right way forward for any genuine engagement.”
She also warned that while funding has gone up, it is not keeping pace with extra demand placed on health services through an ageing population.
And she said that funding given to NHS England has been taken out of public health and capital budgets, putting a “squeeze” on these parts of the system.
She urged minsters to “take the long view” on improving the service.
Labour MP Heidi Alexander, the former shadow health secretary, said the NHS is suffering from “chronic underfunding” from the Government.
And she also criticised the cloud of secrecy the plans were drawn up in.
She said: “It is an inescapable fact that these plans are being developed where there is huge public cynicism about the motives of a Tory government when it comes to change in the NHS.
“If you want to deliver change the debate with the public needs to start in the right place – not behind closed doors, not using jargon that no-one understands.
“It needs to be focused on patients and their families and not accountants and their spreadsheets.”
She said the NHS and social care system is at risk of “buckling under the strain” and warned “the NHS is on its knees”.
Ms Alexander added: “Whilst we should never give up on trying to organise the NHS in the most efficient way possible we have a choice as a country – do we want to cut services to match the funding available, or do we want to pay more to ensure that our grandparents, our mums and dads get the sort of care that we would want for them?”
Kwasi Kwarteng, the Tory MP for Spelthorne, said the financial realities facing the NHS cannot be ignored.
He said: “I wish we could relegate finance to a subordinate and back-burner role, if you like, but I don’t think that that’s fair on the country. I don’t think it’s fair on our constituents.”
He also attacked Labour’s position which he said amounted to repeating the “same mantra: stop the cuts, more money”.
Mr Kwarteng said: “For every single problem that we face as a country, this seems to be their sole solution, the one answer.”
He added: “I think it’s entirely unconstructive and it’s very disappointing to hear absolutely no constructive ideas, no reform, no appetite for fresh thinking, absolutely nothing in the way of intellectual engagement with the very real problems that we face as a nation.”
Meanwhile, Liberal Democrat former health minister Norman Lamb, said the Government must show it is willing to listen when the plans are consulted on.
He said: “If they really think that a formal consultation process, after full draft plans have been produced in a secret process, will in any way convince the public that they are being properly involved, it will fail. It’s inevitable that it will fail.
“People are so suspicious of consultation processes, they simply do not believe that they are properly being engaged with.”
Mr Lamb said the Government could face “political disaster if it ploughs on” without properly engaging with local people.
Labour’s motion, which included calling on the Government to publish the STPs, was defeated by 280 votes to 195, majority 85.
Copyright (c) Press Association Ltd. 2016, All Rights Reserved. Picture (c) Lauren Hurley / PA Wire.
