I have a feeling this is going to be very big, and very significant for the Stafford hospital fight and the wider NHS. Please share as widely as you can.
As you will know if you follow this blog, or NHS news in general with any closeness, on 31 July the ‘Trust Special Administrators’ (TSAs) appointed by the government to formulate proposals (if that’s really the right word for something about which one of the TSAs was heard to mutter, under pressure from an angry crowd at a public meeting, “This is not negotiable.”) on the future of health services in Stafford, and of Stafford hospital in particular.
The proposals involved the dissolution of Mid Staffs as an NHS Trust, and major downgrades to services such as maternity, paediatrics and critical care, and the confirmation of a part-time ‘A&E’ as a permanent feature. The changes were such that, while the hospital has not been closed outright as yet, it can surely be only a matter of time before the government claims that its partial, part-time services are not viable and that ‘for the safety of patients’ the hospital must be fully absorbed into its neighbouring Trusts.
The public ‘consultation’ is not yet halfway through its duration, but it’s becoming ever plainer that the ‘proposals’ are, in fact, a plan – with possibly a slight chance of ‘saving’ maternity or paediatrics as a sop to the people of Stafford in the hope that they’ll then acquiesce to the remaining measures that will in reality seal the long-term fate of the hospital.
To most informed people, the ‘consultation’ is no more than a sham and it’s now inevitable that the future of acute hospital services in Stafford will depend on a legal challenge to the decision.
The recent court victory of campaigners in Lewisham, in which a judge ruled that Health Secretary Jeremy Hunt had exceeded his powers in decreeing the downgrade of Lewisham’s hospital because (supposedly) of problems at a neighbouring but completely separate Trust, has given many Stafford campaigners hope that a legal challenge to the TSA’s decision might also succeed.
The information I’m about to reveal might just make that hope a little more concrete.
The SKWAWKBOX has learned that the Department of Health (DH) has issued an urgent request, to a number of contract consulting companies, for bids to provide a report relating to Stafford’s services. The specific scope of this report, for which the bid deadline is this Friday, 16 August, is:
to look at the loadings that the proposed planned future housing numbers have on services, not just hospital provision but the full network to include transport, schools and social infrastructure.
As one of those who contacted me about the bid request explained to me:
Normally we would be commissioned to do this body of work either by the Local Authority, County Council or the Department for Communities and Local Government but this request came from DH.
So clearly something unusual is going on.
The ‘proposed planned future housing’ can only relate primarily to the addition of the 1st and 16th Signal Regiments to the 22nd Signal Regiment that is already based in the town, when they are ‘rebased’ from Germany in 2015.
Either figure means a huge additional demand for services – including health services. A key excuse for the decision to downgrade the hospital is that it serves too small a population to be viable – so the arrival of so many new residents is a massive factor that should be taken into account.
The TSAs’ draft report claims emphatically that the arrival of the armed forces personnel has been considered in its proposals – but claims that this will represent,
a potential increase of some 1,040 service personnel who would bring with them ca. 420 families with 600 children.
A quick bit of arithmetic (1040 personnel, of whom 420 are married, plus 600 children) shows that the TSAs are expecting just over 2,000 additional people in Stafford after the rebasing. However, local Tory MP Jeremy Lefroy’s website quotes the following government figures relating specifically to the Stafford move:
The government is investing £1.8 billion in the new basing plan and £1 billion of this will be spent on building brand new accommodation. This will see around 1,900 new family homes being built and more than 7,800 new rooms for single soldiers, along with over 800 upgraded rooms for single soldiers and over 450 upgraded homes for families.
That’s 2,350 family homes, plus 8,600 rooms for single soldiers. Even assuming only one child per family on average, that’s a minimum of 15,650 extra people.
By the time you add on additional civilians who’d move in to provide services to the military and its personnel, this means a very cautious estimate of the increase in the town’s population of 17-20,000 people – an increase of around 30%, or around 16% of the population of the wider borough.
Numbers that would radically increase the demand for acute hospital services in Stafford.
Edit: It appears that the article on Mr Lefroy’s site was phrased a little sloppily, so that national figures were presented as local figures. The real total moving into Stafford is expected to be some 3,000. However, this changes nothing about the main point, which is that – as the title of this article indicates – the TSAs appear to be requesting a backdated impact report to cover for the fact that they made and announced their recommendations without having done one. Also, the impact assessment will also need to take account of planned new housing that is not connected to the military move, so the increase in population will still be much higher than 3,000.
Something doesn’t add up. The TSAs claim that they’ve taken into account the known future developments in Stafford, but seem to have underestimated the numbers hugely. But we haven’t come to the most incriminating evidence.
As you can imagine, this massive influx of people into Stafford is something that has been raised vociferously by the local people attending the TSAs’ public meetings – yet it has been, to quote one local man, ‘sidestepped’. I’ve been unable to locate anyone who attended the meetings who has felt that any kind of substantive answer has been provided to the question – let alone a satisfactory one. Clearly the TSAs did not want to address the issue – or even acknowledge it in the public meetings.
I’ve already mentioned the report, for which the government has asked various contractors around the nation to bid. But there’s something I haven’t mentioned.
The invitation to bid states specifically that the report must be ‘backdated’ – and that it must be completed by a specific deadline.
To give you a proper idea of the importance of this piece of information, I need to set the two specified dates out against two key dates relating to the TSAs’ ‘proposals’, and the ensuing ‘consultation’ period.
The proposals for Stafford hospital were announced 31 July. The new report into the impact of new arrivals is to be dated 5 days before the announcement.
The ‘consultation’ closes as 30 Sep turns into 1 Oct. The new report must be completed no later than 30 Sep.
These dates can only mean two things:
- that no proper analysis of the impact of the major population influx was carried out – perhaps no real analysis at all
- and that the TSAs and DH want to be able to present, as soon as the ‘consultation exercise’ is complete, a report into the population impact that appears to have been completed before the TSAs’ recommendations were made.
Or, in simple terms:
the government and its agents want to cover up the fact that no proper analysis was done before the recommendations were announced – and consequently that far from being evidence-based proposals, the ‘recommendations’ are, in fact, a pre-ordained set of decisions made for ulterior motives which have nothing to do with the best interests of the health and wellbeing of the people of Stafford.
The government has attempted, in a cynical political move that even one of its own MPs specialising in health condemned as disgraceful and dissociated himself from, to convince the public that the Labour government attempted a cover-up at Stafford. A cover-up of ‘hundreds of needless deaths’ that never actually occurred.
But now the government, and specifically its dire, odious excuse for a Health Secretary, has been caught red-handed trying to cover up an omission that exposes the sham nature of the TSA process and which could, if these ‘proposals’ go ahead, really cost hundreds of lives, even thousands over the coming years.
Stafford campaigners and their legal advisors are already working on a legal challenge to these proposals-cum-decisions. The fact that the decision was made without properly taking into account a massive change in the circumstances of the town must surely mean that no judge could support it.
The fact that the DH has tried to cover up its incompetence/malignancy must surely seal the deal – and should ensure that no right-thinking person of any political persuasion could ever contemplate believing anything this government says about the NHS, let alone ever voting for them again.
Thank you Steve, thank you very much……….I feel sick to the stomach that a government can do this, they are despicable and disgusting!
My god Steve – you appear to have come across conclusive proof that the TSA “proposals” are utterly corrupt -as we have always suspected. You are fantastic and I thank you from the bottom of my heart. I thought this government could do nothing to make me think worse of them – but yet again, they prove me wrong. Let us hope a legal judgement goes in our favour too. Thank you!
I just hope it’s treated as it deserves to be, for the good of Stafford and the NHS!
But thank you! 🙂
Jesus wept; but I’m not even surprised and, scarily, unless you’re someone who lives in Stafford who gets to hear this, it will whoosh over everyone’s head. Thank you, Steve, for what you do.
Hopefully not! This might just be incriminating enough to tempt some of the nationals into covering it – hard to resist a headline that potentially juicy.
Steve..bless you for being on this planet of ours and for digging outthe material that confirms our views but has been dismissed, evaded, avoided, negated….thank you
My goodness, the corruption has no bounds it seems.
No wonder the govt don’t want you asking too many difficult questions.
Reblogged this on Grannie's Last Mix and commented:
This post left me speechless with rage. Please share this information with as many people as you can…
Thank you for uncovering this and getting what is happening into the wider audience. We are fighting for our lives and those of our children and for future Staffordians. With your help WE WILL BE HEARD!!!
The extent of the deceit around Stafford goes deeper and deeper.
Will all this deceit be published in our filth Tory media so that it
will inform voters fully? I doubt it as we evidently do not live in a
democracy.
To be honest this is really scary,for if they carry out their plans in Stafford ( I was born there lol) What hopes are there for the rest of the country?
Dear Steve,
One point in relation to the report on my website which quote. The figures for rebasing refer to the entire rebasing programme across the whole country and several sites.
The figures for Stafford are –as you say – two regiments totalling c1200 servicemen/women. The estimates for additional people in Stafford, including families, are c2500. 350 new homes are being built and the rest will be housed in existing accommodation. So impact of the rebasing for Stafford is an additional 2,500-3,000 people (assuming people relocate to Stafford for civilian jobs, which may of course be taken up by local people already living here).
There is of course the question of additional non-military housing which is likely to add 10-15,000 people to Stafford Borough in the coming 10-15 years. That depends on what planning approvals are givem.
Yours sincerely,
Jeremy Lefroy
Member of Parliament for Stafford constituency
House of Commons, Westminster, London, SW1A 0AA
t +44 (0) 20 7219 7154 f +44 (0) 20 7219 4186
e jeremy.lefroy.mp@parliament.uk w jeremylefroymp.co.uk
Thank you. I’ve added an edit to the article accordingly, though it doesn’t change the main point of the backdated report. The article on your site is a little misleading, though!
If only, IF ONLY, some top TV journalist would pick this up NOW and run with it….you can but dream cant you. Thank you Steve. x
With hindsight, this comes as absolutely no surprise whatsoever. Having known about the Army rebasing for a while, the TSA’s are clearly operating to a particular remit. These “decisions” were indeed made well ahead of any consultation period, which is now redundant in the light of these revelations. The DoH are obviously losing control of their bowels at this point. I’m not politically minded either way – I voted for Mr Lefroy because I thought he was the right man for the job irrespective of his party, and still do – but the level of utter deceit this Con/Lib government is willing to sink to over Stafford Hospital is becoming even more odious. Well done for uncovering this Steve.
Bastards. In an earlier age, lying to the public and the rape of the NHS by Bullingdon Club alumni would be tantamount to treason and ‘treated’ (at public expense) with a long spell in the Tower or as a hanging offence.
If willing to lie endlessly to us, and so clearly to Parliament too, and for the lies if unchallenged to become a major factor in future deaths (even the term “healthnic cleansing” may not prove inappropriate), these alumni members ought to be considered a public menace and arraigned before a high court without further ado.
They should be kept in cells overnight, for a minimum of one thousand and one nights (until they can no longer fool us via PR and Nudging to contemplate their re-election) or that great French invention the guillotine imported and kept ever sharp as a deterrent to such errants (http://www.mirror.co.uk/news/uk-news/bullingdon-club-initiation-ceremony-claim-1725912)..
;-|
Steve, you are doing an amazing job – I don’t live in the Stafford area but I know it’s the thin end of the wedge as far as the NHS is concerned… The dirty tricks employed by the Bullingdon bullies are beneath contempt, but we do need your sort of ammunition to expose just what a bunch of crooks our unelected junta are; thanks again for all your time and energy.
Thank you!
Superb research as always Steve – well done!
The issue of future population is proving to be one of the more difficult things to tie down – I think that it is very useful that Jeremy Leftroy has responded to help to clarify the areas of uncertainty that exist on this.
In some ways I see it as a positive that this extra research has been commissioned. It may be of course that the DoH do see the question of future demand as a weakness in the current proposals and are seeking to defend the proposals that they probably favour against an attack.
One of the most important supplementary questions on this is I think “what information was supplied to the people who were invited to bid to provide services?”. The argument that the TSA keep coming back to on Maternity is that no one offered to provide this service. This is most probably because there is a very clear signal from DoH and “independent clinical experts” that Maternity units under 2,500 births per year cannot (financially) support the desired number of consultants (which very few units have) and therefore should be phased out. There are around 20 units that could be threatened by this, nationally. (does there need to be national debate about the future of small maternity units)
If the information about numbers of births is misleading. (the drop in numbers over the last couple of years has probably been caused by the reputational damage – and should therefore be seen as temporary. – and the increase in population is uncertain) then this may explain why none of the 40 organisations who made a bid to provide services at Stafford have offered to provide maternity.
When I have attempted to point out that the numbers could well be close to or at 2,500 then the response I am getting is that 2,500 is the bare minimum, and that the future should be bigger (& better) units.
It’s interesting that the Royal College of Midwives Good Practice Guide I referred to yesterday states:
“There are very few studies of UK hospital mergers but one study presented by AndrewTaylor, Director, NHS Co-operating and Competition Panel at The Nuffield Trust, Annual Health Strategy Summit 2010 found that:
• Cost reductions were much smaller than anticipated.
• A negative impact on the recruitment and retention of staff.
• Time required to restructure organisations was always underestimated.
• Negative effect on service delivery due to loss of managerial focus.
• Analysis to date does not seem to show that larger hospitals are more efficient or have a lower cost base than smaller ones.
The guide also says that “There is very little evidence to underpin a recommendation for the optimum size for an obstetric unit. However maternity units with 6000 births per year) may not benefit from economies of scale. The RCM believes that maternity units undertaking up to 6,000 births a year are more personal and woman-friendly than large units and that there may be issues of safety if units become very big and are not appropriately staffed. For very large units i.e. those undertaking more than 8000 births a year, the challenge will be to demonstrate they are able to achieve the same quality and safety standards as smaller units.”
There is also useful information about a Community Midwife Unit and areas of viability – I don’t profess to know what one of these actually is or how it differs from anything proposed so far.
I think we must accept that the current drivers from government are financial rather than clinical, cloaked in apparent concerns around safety.
Great info!
Part of this seems to have got lost – the range was units with fewer than 2500 births up to greater than 6000 births. Sorry!
Even the figures being used for the projections of ‘returning military’ do not show the whole picture of the load on health services (and other services) of the ‘welcome home’ factors. People returning from high stress areas have been known to create both positive and negative pressures – psychological, alcohol, substance abuse, family re-orientation, pregnancies etc for those returning. It is not surprising after their time away and there will need to be additional resources (over and above raw numbers) available to assist in re-acclimatisation. So even the load described above may understate the problem. I am no statistician but there is real evidence available and professionals to process it that could be used to make valid projections and help Stafford and other places like it to prepare for what should be positive events.
As several people have pointed, closure of small maternity units will have a big effect on choice for women and will further medicalize a normal experience of everyday family life.
Please can we be very clear.
Where properly conducted analyses have been done:
There is no evidence that Trust or hospital mergers have EITHER produced better clinical outcomes OR saved money in EITHER the short OR longer term.
There is no evidence that larger hospitals are more efficient (the optimum, if there is one, appears to be serving a population of 250,000).
There is a good deal of evidence that numbers of cases RARELY matter in terms of outcome. For medical cases, even complex ones, there is no advantage, for surgical, there is sometimes a training threshold but it’s often far lower than “advertised”.
These arguments, if put forward, are SPURIOUS but like all arguments, if they are said often enough and have some sort of plausibility, can become accepted currency.
The centralisation/closure agenda is driven by politics, potential for privatisation, finance, empire-building, logistics, junior doctors hours/rotas etc – none of which reasons are patient-centred (especially if the patients are poor or disadvantaged).
Patients understand long-standing necessary centralisation like extreme specialisation (heart transplants), expensive and very heavy kit (radiotherapy) and the need for wide-ranging teams on call together (major trauma with helicopter transfer).
If they are told they “will have to travel” to give birth, find out if their child is worryingly ill or not, have an injection or infusion, see a consultant, have an X-ray and a plaster put on their arm, be taken to a doctor when they are a bit confused and feeling rough – they know it’s a con.
I could do with Gail and NHS worker giving me some of these insights in a way I can use with HEIA
Have PM you the documentation.
Here are some references:
Size of Hospitals:
https://www.york.ac.uk/inst/crd/EHC/ehc28.pdf
http://www.bmj.com/content/319/7216/1063.1
(second one is a very good summary; follow the link, then it will be clear how to get the full article)
Trust Mergers:
http://www.bristol.ac.uk/cmpo/publications/papers/2012/wp281.pdf
I’d have thought this was quite newsworthy. Denis Campbell of the Guardian (health correspondent) could be a good idea. He can be contacted at: denis.campbell@theguardian.com and he is on twitter too.
Done!
Steve, I don’t know if you have seen the current copy of The Lancet (no reason why you should!) but there is a very interesting article in there entitled “The NHS:free and caring or a market commodity?”. To me, it sums up all the things that are wrong with the way that the government is “improving” the NHS – an NHS which was supposed to be safe in their hands!! Many people are beginning to question and criticise what is happening but I fear it may be too little, too late. Perhaps you should apply for the role of Chief Executive of NHS England, Steve, because as the article points out the candidate does not have to have experience of health care systems; however, you are the person who has spoken the most sense and worked tirelessly to get the truth out there and I, for one, would vote you in if I was on the interview board.
Thank you very much! Under the current lot, I suspect I’d be among the last people they’d want in, though – and we have to hope you’re wrong about it being too late, though it’s certainly too late to prevent a great deal of damage being done.
(Immy & I vote for Grandpa & Steve respectively, as either would provide a more incisive analysis of NHS issues and an impartial, balanced perspective – plus a much less blinkered appreciation of the current stats than a certain GW*)
* PS: GW isn’t apparently an acronym for ‘Gone with the (Cure) Wind’ or ‘Grossly unfair tWeets’ or even ‘Genetically Weird’, etc..
🙂
How much of this can be sent to the TSA? And does it matter who sends it to them?
I don’t want to get people in trouble for divulging “secrets” – unless it is the TSA.
I wouldn’t send it to the TSAs. I’m sure they’ll be aware of it, but no point in providing them with more info than necessary that they can find a way to explain away. Other people are working on how best to make use of it, though.
Thanks for the advice. Glad that the info will reach a wider audience.
Steve, I’ve seen nothing in the process so far to contradict your statement, “the ‘recommendations’ are, in fact, a pre-ordained set of decisions made for ulterior motives which have nothing to do with the best interests of the health and wellbeing of the people of Stafford.
Yes indeed, the process is essentially financial, based on a bizarre way of funding a health service. It’s not even an economic assessment because that would include in the equation the VALUE of services to the local economy (and by extrapolation to the individuals). A local 6 year-old who is a regular in the paediatric department is on the front page of the local paper having written to the Queen to say that the hospital is being attacked by “nasty selfish men” and would she like to visit to see how good it is before it is closed down? If only she knew how close to the truth she actually is.
Yes, and they are preparing to lay out at least £305 million for the implementation of the TSA’s recommendations:
http://www.hsj.co.uk/news/analysis-mid-staffs-administrators-plans-would-see-millions-in-investment/5062367.article
As PDF:
https://www.dropbox.com/s/q92rtpi8qfcknpn/Analysis_%20Mid%20Staffs%20administrators%27%20plans%20would%20see%20millions%20in%20investment%20_%20News%20_%20Health%20Service%20Journal.pdf?m
Official figures on MOD is 1500 soldiers with approx. 450 families. Not known how many children. Also more civilian staff required. Hopefully most will come from local community but some might have to be brought in if they need specific skills
official figures for MOD is 1500 troops plus families, (approx. 465), not sure about nos of children that includes. Also need more civilian workers on base. Some may have to be brought in from elseware if we don’t have necessary skills in Stafford
What about the Bulgarians and Roumanians ?
What about them?
I was referring to the likely influx of immigrants many of whom will not be slow to avail themselves of free healthcare