1 December 2016
The Greenwich Greens support Save Lewisham Hospital campaign’s call for Greenwich Council, (along with all other local authorities and clinical commissioning groups) not to approve the South East London Sustainability + Transformation Plan.
What are they, and why do we oppose them?
Sustainability + Transformation Plans (STPs) are 5 year plans for the NHS.
STPs lay out how £22bn of cuts to the NHS over the next 5 years will play out across the country. With the absurd expectation that services will improve, too.
The emphasis is away from hospital care and with a focus on prevention, self-care, and collaborative working across large multi-disciplinary organisations. These plans aspire to a radical reorganisation of health services into ‘local health systems’, consisting of clinicians, patients, carers, citizens, and local community partners including the independent and voluntary sectors, and local government ’to ‘work together to develop robust plans to transform the way that health and care is planned and delivered for their populations’.
To this end, NHS England has divided England into 44 regions (‘footprints’) and each has been asked to help develop an STP. Greenwich comes under South East London – and is lumped with 5 other boroughs: Lewisham, Bromley, Bexley, Southwark and Lambeth.
A new quango called Our Healthier South East London (OHSEL) has been formed in the last 3 years and is now tasked to deliver the STP for SE London. We don’t know much about OHSEL. What we do know, however, is that plans have been drawn up without input from clinicians and frontline staff, and certainly well away from the public. (We can confirm this locally, as staff at Oxleas had no idea until we told them.)
Last week the British Medical Association sounded the alarm by stating that the controversial plans are being used as a cover to make drastic cuts and to run down the NHS.
Others are sounding the alarm too, such as health policy academic Colin Leys, who has questioned the absurd demands of the STPs “given the limited powers and resources available at local level and the lack of a correspondingly serious policy at the national level” and notes “the whole process has a markedly extra-legal character.” While our MP Matthew Pennycook says “there are real grounds to fear that the Government are approaching STPs in entirely the wrong way - it appears that STPs are being used simply as a means of balancing the books.” (email 15 Nov)
So what’s in the OHSEL SE London STP? You can read it yourself here. You’ll see that it’s heavy in jargon and acronyms. Turn almost to the end -page 43 for details of cuts (described, of course, as ‘planned savings + efficiencies’). We’ve pasted it here:
On the left hand table, we can see that Greenwich Clinical Commissioning Group will be cut by £15.5 million in the next year. And looking at the right hand table, Lewisham + Greenwich Trust (LGT) will face cuts of £23.4 million, and Oxleas mental health unit £8.1 million. All together that’s a staggering £47 million over the next year. In total the SE London STP details a defund of £1 billion over the next 5 years.
Such massive cuts points to thousands of beds being lost and A&E & maternity units being closed up and down the country according to research by the Guardian and in Greenwich there’s mention of ‘community based care’ which suggests a move away from hospitals. While this could in theory sound like a positive thing, it should be understood in the context of our local social care budget being slashed by £242 million. It’s no wonder that London councils are beginning to say no. Hammersmith and Fulham and Ealing have taken a lead and said these plans are unworkable.
The Save Lewisham Hospital Campaign and Lambeth Keep Our NHS Public campaigners have been working on what the STP means for us in Greenwich and Lewisham boroughs. They say “despite the rhetoric, the ‘transformation’ is about saving money (£22b reduction in annual funding by 2020), downgrading, cutting and where necessary using the private and third sector to do things on the cheap.”
They also say: “The STPs – forced through by the Government and NHS England in record time – are leading to unrealistic savings – often involving double counting, unrealistic plans, in an atmosphere of secrecy. Plans had to be submitted by the end of June and implementation is due to begin early in 2017. “
It’s also been noted that STPs open the way to further privatisation of the NHS and a way to reconfigure our healthcare more like the American insurance-based model.
Now, The Save Lewisham Hospital Campaign, along with Lambeth KONP have posted their considered view of the SE London STP on their website. You can view it here.
They urge Greenwich and Lewisham Councils, along with the Clinical Commissioning Groups not to give their approval to the SE London STP.
“That the six CCGs and six LAs inform NHS England that good and safe care cannot continue without adequate funding – failure to provide this is seriously undermining health and social care”
And recommend: “That elected representatives, councillors, the Mayor and MPs, write to the Local Government Association, the Prime Minister and explain why the NHS and social care must be funded properly urgently.”
Damning also, is that the health think tank The King’s Fund says ‘It is inconceivable that the NHS will be able to achieve both financial sustainability and largescale transformation within these financial constraints’.
Perhaps, most damning is that even the Programme Director tasked with delivering the SE London STP questions their viability:
STPs then are a redisorganisation to beat all other NHS redisorganisations. And a huge gamble, with our precious NHS. What happens if this speculative redisorganisation fails - which is a very likely outcome? Perhaps the popular alternative name gives a clue: Slash Trash + Privatise.
Save Lewisham Hospital campaign notes that since no capital funding is available for this radical 'transformation' funds will need to come from existing streams, private finance or the selling of NHS estate. Further: "By insisting that providers cope with swingeing reductions in required funding (in social care too), NHS England undermines any chance of clinically safe and sustainable transformation."
This is why we join Save Lewisham Hospital campaign’s call for Greenwich Council, (along with all other local authorities and clinical commissioning groups) to say no to the SE London STP.
Please just spend a few minutes out of your day and ask our elected representatives not to gamble on STPs. Every email they get will send a powerful message that we care about the NHS and don’t trust the STPs to deliver.
Please write to your 3 local councillors + MP. You can find yours here:
Here is a template letter you can use or amend if you wish
And a new petition has just been launched here. Pls sign and share:
Last words to Colin Leys:
“But where we are is the result of political choices. One of these choices is to spend some two and a half percentage points less of our GDP on health than comparable European countries -8.5%, compared with France’s 10.9%, Germany’s 11.0%, the Netherland’s 11.1%, and so on.
This is a huge difference. Matching these countries’ present commitment to their health services would already mean an additional £43bn a year for the NHS”
If you’d like to explore this troubling issue more deeply, we recommend
The paper written by health policy academic Colin Leys:
And the website of the Save Lewisham Hospital Campaign http://www.savelewishamhospital.com/stp/