New North Tees hospital: ‘steady return on investment’, exploited staff, endangered patients

A little earlier today I wrote about how North Tees & Hartlepool NHS Trust is planning to cut 9% of jobs at the same time as using the hope of protected employment to try to twist workers’ arms into accepting a reduction in pay.

I’ve just come across an article, apparently published by the Trust today, which announces the probable funding plan for the new hospital – a plan which will ‘steadily’ suck money out of the NHS while the Trust also imposes further measures to take money out of the pockets of hard-working health staff.

You can read the whole announcement via the link just above, but here are some of the key elements:

Pension-fund investment

2 years ago, a new, properly-funded hospital was on the cards for the area under Labour government plans. Almost the first action by the new government was to cancel the project. Now, instead of a state-of-the-art hospital funded properly by taxation and geared up to offer treatment to the maximum number of local residents, the area will have a commercially-funded hospital geared up to ‘attract’ patients and enhance profits. The funds to build the hospital are likely to come from private pension fund companies, who will expect:

A steady return on investment

The Trust claims, as justification for its recent actions in trying to extort signatures to diminished contracts from its staff, that it needs to save £40 million per year in its ‘£40m challenge‘. Apparently, the need to make this saving is so intense and so extreme, that the Trust’s first step was to try to threaten and bully its staff into signing away their properly-negotiated rights for a saving that would represent just 1/80 of the required amount.

And yet, in preparing its plan for a new hospital, the Trust apparently believes that it’s viable and desirable to use a funding method that will mean sucking ‘a steady return on investment’ out of the NHS, away from treating patients and away from paying staff. If you’re not doubting the honesty and integrity of the Trust’s board yet, you should be.

Not only that, but the announcement acknowledges the possibility that:

Any savings might be lost

Under a heading of risks associated with the plan, the announcement states:

Single site savings and the medium term cost improvement plan

We know we need to make savings as the two hospitals are brought together on one site and we know we have to continue to make cost improvement savings. While no one has a crystal ball we are as confident as we can be, backed up by our strong financial track record, of continuing to make the savings and efficiencies we need without compromising our performance or quality. We are aware that the two to one site savings could be eroded by the cost improvements we have to make. Our finance team working with all our managers is continually looking for efficiency schemes and we are determined to continue the excellent achievement we have already made in this area.  

In the current financial climate, which at the moment shows no signs of changing, we know we will have to make efficiency savings but we will have to do this whether we move to a new hospital or not. While this is increasingly challenging it is less onerous to run one energy efficient hospital than the existing two and staff it accordingly without the need for double running.”

In plain language, having one hospital site instead of two might cost less – but those savings might simply be sucked away by the Treasury as ‘efficiency savings’ rather than freeing any cash for more and better treatment.

The excuse for proceeding is “we will have to do this whether we move to a new hospital or not“.However, that ignores the statement made in the preceding paragraph and the fact that funds will have to be funneled away to satisfy the investors. The population of the North Tees & Hartlepool health area face the risk of a triple-whammy – having to travel to a hospital that is further away, that has spent money on a move that it can’t recover or use toward better services because the treasury is taking any savings and having even less cash available for treatment because it’s taken by ‘investors’.

One less hospital, even fewer beds than you’d expect – and greater patient risk

The tale of woe doesn’t stop there. Under the heading ‘Income Growth‘, the announcement states as if it were purely a positive that the new hospital will consist of only individual rooms rather than wards. The Trust trumpets this as an attractive feature that will persuade more patients to choose to be treated at the new facility:

we could expect to see demand for services rising and with a new hospital with single rooms we could expect to see people choosing to have their care there for the privacy and dignity it will undoubtedly offer in a world class facility

What it doesn’t tell us is that any floor plan that provides only individual rooms by definition will be able to offer far fewer beds than one with an open (albeit not mixed) ward system. This adds yet another whammy: less space for local residents while the hospital tries to attract patients from outside the area with nice, single rooms.

Not only this, but having every patient in a separate room is actually dangerous to patient wellbeing. I know of several instances just this year in which patients’ lives were saved because a nurse happened to be passing and spotted that the patient had taken a sudden, unexpected turn for the worse and was able to initiate emergency action.

All wards currently have ‘side wards’ – separate rooms where patients with particularly serious or infectious illnesses can be isolated from the main ward. Nurses know that these patients are at higher risk and so can keep a special eye on them in case of problems, while caring well for the patients on the main ward as well.

If every bed in the new hospital is in its own, separate room, there is simply no way that the nurses can maintain the same level of overall and specific vigilance unless numbers are substantially increased – but the Trust admitted today that it is planning to reduce staff numbers by 440 as part of the migration to the new site. There is no doubt – the combination of these measures will cause avoidable deaths.

It will cost staff more, but tough!

Under the heading of ‘Transitional costs” , the Trust states:

These are the costs which we might expect to incur while moving from the two existing hospitals to the new one. Our commissioners have supported our approach for this and we are already taking steps ourselves to minimise these transitional costs. For example all new employees’ contracts are trust-based, as opposed to hospital site based. This means that the trust will not pay travel costs for all staff on these new contracts when we move to the new hospital.”

In other words, the new site – which is expected to be located well away from the population centres which currently house the hospital and the majority of its staff – will operate to different contracts for the staff working there. The plan is to configure these contracts so that staff cannot claim for any increase in travel costs to get to the new hospital, which will be further away for most of them and less well-served by public transport. How much do you want to bet that this little condition is being slipped, unannounced, into the new contracts that the hospital is trying to coerce all its staff into signing?

North Tees & Hartlepool NHS Trust executives have already shown themselves to be prepared to bully and blackmail its staff for the sake of a tiny saving. They are now in the process of initiating a plan that will hit staff even harder and, even more importantly, will erode funding, damage patient care and endanger lives.

Write to your MP if you live in the area. If you don’t, write to Labour’s health team (Andy Burnham, Andrew Gwynne, Liz Kendall) – and even to the good-for-nothing coalition health team – and demand that this move is blocked until a plan can be found which will not penalise local sick people, not penalise health staff, and not suck even more money away from patient care where it’s most needed.


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