Health/Wellbeing Boards, Councils unanimously reject NHS ‘sustainability’ plan

The ‘Health and Wellbeing Boards’ (HWBs) of Liverpool and Cheshire West and Chester, together with Wirral Council’s ‘Overview and Scrutiny Committee’ and Sefton council in the north of Merseyside, have unanimously rejected the government-imposed ‘STP’ (Sustainability and Transformation Plan) for Merseyside and Cheshire. Liverpool Mayor Joe Anderson has indicated that Liverpool City Council will also reject the plan, which will involve reducing the area’s NHS budget by a staggering £540 million over the next two years.

These organisations join a growing list of councils and HWBs, including Shropshire, Telford & Wrekin, Hammersmith & Fulham and Ealing, in rejecting “secretive” closure plans.

NHS England, ordered by the government to find £20 billion in ‘savings’, describes STPs as “a new approach to help ensure that health and care services are built around the needs of local populations”, but Liverpool’s local STP lead has, according to Mayor Anderson, frankly admits that “the changes are all about cost-cutting” and that, while supposedly still in the ‘consultation’ phase, contracts have already started to be negotiated and even awarded under the STP.

Liverpool’s Mayor also disclosed that, when challenged about how services could possibly be maintained, she suggested that councils should cover it by borrowing, “as they can get good rates”.

Liverpool City Council has already suffered budget cuts of 58% since 2010, with a further £19m about to be cut by government. Borrowing even to maintain essential council services will be difficult, let alone to patch holes in the NHS – but this is the mentality of those tasked with implementing STPs.

HWBs are a government invention as part of the Health and Social Care Act 2012 (HSCA) with a specific duty and power to create “improved health and wellbeing for local people”:

The decision by local HWBs to reject the STP means that the government’s own organisational bodies, integral to its vision of how the NHS should function for the good of local people, have concluded – in most cases unanimously – that the STP will do the very opposite and will be harmful to health and wellbeing.

The decision also means that, if the government forces the NHS to implement STPs, it will be trampling the organisations it set up itself, making a mockery of the already much-derided HSCA and showing more clearly than ever that “safe in our hands” was a knowing, outright lie by a party prepared to con its way into power in order to decimate the NHS.

A Merseyside-based founding member of the pro-NHS organisation Keep our NHS Public wrote yesterday to the local CCG (Clinical Commissioning Group, another HSCA-created body) to make clear the situation and the expectations of local people:

Dear Dr Simon Bowers

Liverpool Clinical Commissioning Group Governing Body member,

Re: Cheshire & Merseyside STP and contracts

We are writing following the unambiguous decision of the Liverpool Health and Wellbeing Board on 1^st Dec. to reject the Cheshire & Merseyside STP, which has been widely reported. This follows the rejection of the plan by Cheshire West and Chester Health and Wellbeing Board on 16^th November, Sefton Council on 17^th  November, and the Overview and Scrutiny Committee of Wirral Council on 28^th November.

As you will also know, there is growing public opposition to the plan, shown in the ongoing press coverage, and in recent unanimous decisions of Garston and Riverside Constituency Labour Parties, and by the lobby of the Health and Wellbeing Board at the Cunard Building.

To proceed with the final negotiation of contracts to comply with the budgets imposed for 2017/18 and 2018/19 as part of this STP, would be to ignore the clear decisions of local authority bodies and a gathering storm in the public arena.

We are sure that you do not wish Liverpool CCG to be fighting this battle with patients and their representatives. Yet so far, there has been no consultation with the public, Councillors, NHS staff and their trade unions. Engagement exercises do not constitute consultation, nor is it possible to consult without transparency, including the full financial details of your plans.

The contracts which you are negotiating with providers will enforce your share of the cuts inherent in the STP. You have yet to disclose the details, but it is not possible to take £188m out of the Cheshire & Merseyside NHS budgets in 2017/18 and £360m in 2018/19, dwarfing any contribution from the Sustainability and Transformation Fund, without severe consequences.

In the circumstances, we ask you to pause your contract negotiations, disclose the full detail of your plans, and begin a wide ranging full consultation to include the public, elected representatives, NHS staff and their trade unions.

As health professionals, you will want to act in the best interests of patients. We call on you to do so.

Thank You,

Dr. Alex Scott-Samuel, MB, ChB, MCommH, FFPH
Retired Senior Lecturer (Clinical) in Public Health
Founder Member, Keep Our NHS Public

£548m a year in just one area (of 44 STP ‘footprints’ across England) represents a significant percentage of the current national NHS budget and is clearly untenable if standards and availability of health services are to remain even at current overstretched levels, let alone improve.

At a time when NHS services are already suffering unprecedented strain, exacerbated by the impact of draconian cuts to council funding that have reduced social care to a shell and resulted in huge ‘bed blocking’ by the elderly and infirm who have nowhere safe to go if they’re discharged from hospital, STPs are clearly intended to be a death-blow, not any route to ‘improvement’.

This blog urges all HWBs, councils, local political parties of every colour and even local CCGs to reject these plans that have absolutely nothing to do with the health and wellbeing of the people of this country and everything to do with one political party’s ideological commitment to the fall of the NHS and willingness to lie and misdirect to achieve it.

Acquiescence is not an option.

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