I am intending to write a regular blog on the NHS in Newham . This does, however, present somewhat of a challenge, as many of the issues we confront do not just relate to Newham and it is difficult to disentangle them from decisions which are already being made right across the North East London footprint. By way of an introduction I feel duty bound to introduce these issues in a more general way, in part because of the way in which the Forward Five Year Plan set up in 2016 has set up decision making structures ( STP’s or Sustainability and Transformation Plans ) which cut right across borough borders . More of that later.
I became involved in our local Newham Save Our NHS campaign, on a personal level, in part because my late wife had since 2012 been treated in every one of the five hospitals which then comprised Barts. Trust. ( This is the largest Trust in the country with a massive budget ) . This includes, of course, Newham University Hospital. Our experience of staff and treatment from diagnosis to treatment and rehabilitation was almost entirely faultless. That is to say, the commitment, professionalism and on a human level the care and concern of staff at every level , could not be faulted. The problems in the NHS, therefore, as everyone must by now be aware, lie in lack of funding by central Government and in a series of restructuring plans begun by the Health and Social Care Act of 2012 and culminating in the latest initiatives to set up STP’s, or since their bad Press, ICO’s and ICS’s ( Integrated Care Partnerships or Organisations or systems). These are designed, without even legislation, to open the doors for further privatising those elements of the NHS outside of acute care and other specialist emergency treatment areas, which the private sector deems to be potentially profitable.
The organisations set up to make decisions regarding providers and commissioners are a complex web of groups which meet regularly and which we as a public campaigning body, try our best to be present at. They are at present largely still open for the public to attend but the mechanisms for genuine engagement or consultation are at best inadequate and at worst, non-existent.
Newham is currently one of 7 boroughs comprising the East London ICO along with Hackney, Tower Hamlets, Waltham Forest, Barking and dagenham, Redbridge and City of London. This is now the ELHCP ( East London Health and Social Care Partnership ). The original STP’s were tasked with implementing £22bn of cuts by 2021 in the guise of “integrating” health and social care. Renamed ICO’s these bodies in some parts of the country are already involving private sector bodies or in some cases are even leaving the private sector to manage their finances. To its credit, our local authority has distanced itself from supporting the ELHCP in a meaningful way but local authorities are becoming increasingly marginalised from meaningful involvement in decisions on budget strategies which will affect their local communities at every level.
Now in the middle of the Brexit chaos , the Tories have announced a further 10 year plan for the NHS. Having been responsible for the decimation of public health budgets, which are supposed to cater for creating the conditions for people themselves to be supported in improving their health and wellbeing, the emphasis now is on putting the responsibility for health and well being on people’s individual behaviours and on keeping them out of hospital. Whilst keeping people out of hospital is a highly laudable aim it ceases to be so if they are being handed back to poorly funded community services already overburdened beyond their capacity in communities decimated by austerity and cuts.
Our local campaign regularly highlights the implications of some of these developments. We have recently engaged with the Barts. Board which met only today, on the issue of increased waiting times, sale of local assets to counter budgetary pressures and particularly over recent months on the ‘hostile environment’ policies in our hospitals. This last issue we have argued, is a way of not just further turning migrants in our communities into pariahs but also of acclimatising people to the notion that charging different groups is legitimate, thus further eroding the foundation upon which the NHS was founded ie. Health provision free and unconditional at the point of delivery. Our questions to Barts have not been properly answered and today we again reiterated some of our concerns. A “Liberty” document called “Care Not Share ” ( available online) describes the evolution of these initiatives and the associated bureaucracies and asks how it can be legitimate on anti-discriminatory and equality levels to pick on sections of society who are the most vulnerable, in order to raise funds and which involve healthcare professionals and administrators in passing on private information on individuals to the Home Office for the purpose of identifying illegal immigrants. Naturally the cohort most likely to be asked to fill in the forms in Barts. hospitals are ethnic minority groups. Furthermore, they are being asked to fill in forms regarding length of stay in the country, ethnicity, address, etc. in A and E wards. A and E is free to everyone. Were it not we would have a public health scandal on our hands . We have a petition on change.org which calls on councillors and members of the public to oppose the hostile environment created in hospitals and to cease cooperating with the Home Office. The scheme set up to find out about patients’ migrant status or otherwise was a pilot . Nevertheless, Barts is still implementing it and even focused its attention on maternity wards. .
We have also campaigned with Tower hamlets Keep Our NHS Public and all the other borough campaigns in our North East London ‘footprint’ on issues including saving King George’s A and E in Redbridge, joining the junior doctors’ pickets outside Newham General , and opposing “GP at Hand”. The Government has announced as part of its 10 year plan, a desire to fully digitise the NHS and its partners in Social Care. “GP at Hand”, set up by an American company called ‘Babylon’, promised immediate access to GP’s online for patients in need. A large publicity drive including enormous posters at tube stations attempted to recruit young healthy adults to its books and benefit , as other private providers do, from grants of money and huge potential profits from a computer savvy generation, leaving those most at risk from acute health problems to be dealt with by the NHS and by mainstream GP’s , already suffering from shortage of numbers and recruitment problems. Furthermore, they did not even announce to their signatories that they would be taken off of their GP’s lists. Those returning to their GP’s caused countless problems at reception in Tower Hamlets when they found this to be the case.
We have constantly complained about lack of consultation, especially around the question of STP’s/ICP’s. The response of the ELHCP has been to set up a Citizens’ Advice Panel. Instead of setting up meetings or asking questions about policy direction or budget pressures they have instead released a number of online surveys. The most recent of these asked personal questions about health lifestyles, drug habits, alcohol abuse and mental health issues. Whilst insisting that this was confidential, it hardly invites those most vulnerable to lifestyle issues to confide in them with their email address at the top.
Newham Save Our NHS meets regularly , is well attended and we are a healthy (!) campaign. We invite anyone interested to contact us and to participate in our activities. We have a Facebook page and a website ( URL’s below) A fuller report on today’s Barts Board meeting and some of the issues raised regarding Newham will appear on our Facebook page in a few days time. Phil Edwards