Remember David Cameron claiming that the NHS was ‘safe in his hands’? After 6 years of Coalition and Tory rule the evidence is mounting of a developing financial crisis in the NHS resulting from the Health and Social Act reforms and the deliberate underfunding of the NHS. A crisis which is set to deepen over the next five years and will increasingly affect the health care services we all receive.
Both Coalition and Conservative Government have failed to increase NHS funding in line with the changing needs of the population. The NHS is effectively only getting an increase of 0.9% per year but the Government knows that there is a 4% annual increase in the demand for health care, as the population changes and the total number of older people increases.
These real funding cuts will result in a £22 bn deficit for the NHS by 2020-21.
Sustainability and Transformation Plans
The Tory Government’s response to this crisis has been the requirement that local health bodies produce five-year long Sustainability and Transformation Plans (STP) in 44 footprint areas across England. The Birmingham and Solihull STP plan was published on 24th October 2016 and it gives us important details of the problems facing the NHS in Birmingham and of the type of cuts to health services that will likely result.
Hospital Trusts in the red!
At the end of the last financial year NHS Trusts in Birmingham were ‘in the red’ by an unprecedented £71m. Due to the real reduction in funding to the NHS under the Coalition Government many NHS Hospital Trusts started to move into deficit in the last year as they faced growing demand for services. The Government has been forced to act and has provided short term sustainability funds to those Trusts in financial difficulty.
Adult social care ‘black hole’
Massive cuts have been made to Birmingham Council’s social care budget restricting the funding for services that support people to live independently in their own homes. Cuts to care are contributing to older and chronically ill people being more likely to come into Hospital in an emergency and when in Hospital they have to unnecessarily wait before being discharged. £60m has been cut from the Council’s budget over the last five years with further reductions planned in the coming years but at a time when there are more people needing help and support. The Council’s budget for Adult social care is already in deficit this year by £30m and the budget black hole will have to be carried forward into future years.
The local NHS and social care funding ‘Gap’
In the Birmingham and Solihull area the overall funding position of local NHS and Adult social care services will grow to a £712m deficit by 2020/21. A requirement of drawing up the Sustainability and Transformation plans was to identify the ‘Gap’ between the resources available to the NHS locally and the growing demands for health care. The purpose of the STP plans is to identify how to ‘plug the gap’.
What risks does the STP bring to our local NHS services?
Cuts to hospital beds
Jeremy Hunt has stated “The STPs are very simply about reducing hospital bed days per thousand population and reducing emergency admissions.” Reducing the number of people coming into hospital and then reducing how long they stay in Hospital is a key financial objectives of the STP plans.
The new Midland Metropolitan Hospital which will replace City and Sandwell General Hospital’s, will open in September 2018 with 135 fewer acute beds than the current two Hospitals. We need to watch the likely reconfiguration of Hospital services across the city and in particular the likely loss of beds within the Heart of England Foundation Trust.
Closure of walk-in centres
The Cross City CCG is planning to consult on the closure of city’s 8 urgent care centres and upon their preferred option of replacing them with 3 standardised Urgent care centres co-located with A&E Departments.
GPs workload will increase
To reduce the number of people coming into Hospital the STP expects GPs to provide a greater volume of treatment to patients. A leader for Birmingham’s GP’s has said these plans are undeliverable bearing in mind the meagre additional investment in primary care.
Integration of health and social care services
The solution to keeping older and what are regarded as more ‘expensive’ patients out of hospital is the redesign of health and social care services. The integration of health and social care services is unproven and is made difficult by the highly fragmented social care market. The BSol STP makes it clear that urgent new funding from Government is needed to stabilise Adult social care in the city.
Opportunities for private companies
STPs are being directed to “merge” all back office and non-clinical services across the entire STP footprint. This programme will centralise services and make them “ripe” for privatisation.
What you can do
The next five years will bring yet further turmoil to the NHS as it has to do ‘more with less’, with no new significant new investment resources will have to be generated from within the NHS to make improvements to services. The Tory solution is the ‘transformation’ of the NHS through cuts.
Join with Keep our NHS Public Birmingham to fight these Tory plans to cut and privatise our NHS. We have been recently campaigning for there to be full public consultation upon these STP plans and to pressure the Council to take a stand against these Tory cuts.
You can also use this 38 Degrees link to help the campaign nationally https://you.38degrees.org.uk/petitions/stop-the-plans-to-dismantle-our-nhs
Keep Our NHS Public Birmingham firstname.lastname@example.org