Barts NHS Trust still in crisis and still charging migrants


Migrant Charging

Newham Save Our NHS again challenged Barts Trust Board at its bi-monthly meeting on 1stMay over migrant charging. Despite calls for the suspension of overseas visitor charges by the Royal College of Paediatrics and Child Health, The Royal College of Obstetricians and Gynaecologists and the Faculty of Health , Barts continues its hostile environment policy by investigating suspected migrants and passing information to the Home Office with regard to charging and migrant status. This despite the declaration by the House of Commons Committee of Public accounts on Windrush and recommendations following its own investigations that the Home Office is making decisions on people’s rights based on “ incorrect data from systems that are not fit for purpose”. This is not unconnected to many instances of ridiculously high charges being levied on vulnerable and often destitute people based on their assumed status as not being ‘ordinarily resident’ in the UK. The response to our questions on this from the Trust was to reiterate that they had met with us privately and would continue to consult with commissioners and others about the effects of the charges but that it was not in their remit to challenge the Government on its statutory policies. This is a bureaucratic response which does not fit well with its duty of care to all its patients, irrespective of their status or nationality. It does, however, fit the pattern of their past refusal to take responsibility for this ‘hostile environment’ policy and its effect on people’s lives. The response of the DHSC dated 2ndMay to Hackney Councillor Hayhurst’s complaints about this policy was to simply repeat the Government’s determination to continue with its discriminatory revenue collection exercise and experiment with charging for services in the NHS.

Conflict with NHSE over funding strings attached

We then asked if the Trust was unable to invest adequately in medical equipment, as indicated in their minutes of the last meeting which stated that due to “capital funding constraints”  they were unable to provide such equipment “to support safe, effective and timely care”. They have admitted that it was lack of Government funding which is preventing adequate investment in IT, buildings and medical equipment. Waltham Forest Save Our NHS had also asked why they had not been awarded sustainability funds and why they had not agreed a control total. Such control totals are a way of restricting the expenditure of a Trust by agreeing to spend in different areas according to limits set out by NHSE budget constraints. It transpires that they had been offered £54.9m from the sustainability fund but had refused to accept it because the control total they had to agree would have put patients care at risk. So this is the scenario. Basically you are awarded funds if you agree to make cuts. Catch 22. Take the money and lose or leave the money and struggle with your existing budget. Currently the Trust is £84.2m in deficit and much of this is due to PFI. It puts all of the Trusts long term plans in jeopardy, as they themselves declared.

Staffing Crisis continues

Pressures on staff have continued unabated as conditions of work deteriorate and as the effects of austerity and accommodation pressures in London affect nursing and ancillary staff. The Trust says that it is dealing with 450 more patients per day than it did after its inception. Further, 500 000 patients were treated in A and E over the past year. Some staff have complained that they are being asked to do work which those on higher bands in other hospitals would not ordinarily be asked to do. Management have set a 4% target for incorrect medication and agree that initiatives introduced in the US where incorrect medication is the 3rdhighest killer, should be introduced here. This means primarily that nurses on their rounds should be allowed to proceed with their routine administration of medicine unmolested and undistracted. It doesn’t help that levels of bullying, violence, harassment , health and wellbeing , remain areas of concern. With 1 in 5 staff, mainly female, needing to provide care at home , this has affected absentee rates. Inflexible rosters, lack of onsite creche facilities and rising costs of providing supervision or care for elderly relatives or children all contribute to staff having to take time off after working extensive shifts. Most shocking of all is that in a recent survey 30% of staff interviewed said they are thinking of leaving and 22% are leaving as soon as they can get a job. There are no recent figures on the effects of Brexit on applications in recent months. 

Phil Edwards

BMA joins mounting protest against migrant Charging.

The BMA have just published a report which says exactly what we have been warning about for over a year. Migrant charging deters immigrants from seeking treatment, including for serious illnesses. Newham Save Our NHS and North East London Save Our NHS held a march recently to highlight the issue and we have persistently put questions to Barts Trust about this. At the end of our last march we asked for the Deputy Chief Executive officer to take our concerns back to the Trust Board and asked if they would be willing to tell the Government that local community health groups, institutions and campaigns were concerned about the impact of migrant charging and the ‘hostile environment’ on our diverse communities and among the most vulnerable sections of our local population.
In the BMA survey, 35% of interviewees said patients were being deterred from accessing care. One patient rejected eye cancer treatment and died in her 40’s as a result. Some patients have said they have not attended A and E because of fear of charging ( A and E’s are exempt from charging for care ) . One 60 year old was told before an operation that he would be charged £6000. Many pregnant women have gone without antenatal care and mothers have gone without postnatal care for fear of charging. People have been too frightened to ask for palliative or pain relieving treatment for the same reason. Dr. John Chisholm, chair of the BMA’s medical ethics committee insisted that ” policing patients’ access to and payment for treatment was not part of the remit of health professionals.
The BMA is calling for a review of the impact of such charging. We have been calling for this for some time. Savings from charging in the Government’s own estimation, would barely recoup 0.02% of the annual budget of the NHS. Phil Edwards ( Source: ” The Guardian. Friday 19th April 2019″ )

Response from The Rule Book Guy

Co-operative Manoeuvring II

Since we published our report from the Newham Co-operative Party AGM, we received the following email from “The Rule Book Guy”, who had valiantly challenged some of the key decisions made by the national officer during the meeting:

Hi Newham Transformed

I have been sent a link to your excellent blog piece on the Newham Co-operative Party AGM on Tuesday 09/04.

I am the “The rulebook guy” you refer to and I thought it was worth clarifying a few things that I don’t think were clear to most people at the meeting, that you might want to pass on to others via your blog.

First of all there is indeed a Co-op Party rule book – available in multi-sections here:
https://party.coop/members/rule-book/

The rules that I raised were:
“Branch Party meetings shall be held at least four times a year”
(The Rule Book – Section P – Model Rules for a Branch Party, para 22);
which prompted a less than fulsome apology (but no explanation) from the outgoing Chair Julianne Marriott (who was not standing for re-election) but not a peep from the Secretary Neil Wilson, who, as you report, was subsequently ‘re-elected’ at a second attempt in a questionable re-ballot.

“All elections shall normally be by the exhaustive ballot vote. In elections where there is more than one vacancy to be filled (e.g. Party Council or CLP delegates) the Single Transferable Vote may be used”

(The Rule Book – Section Q – Standing Orders for Party Council & Branch Meetings, para 15);
which as you say the Co-op national officer ‘batted away’ by claiming that the Co-op Party NEC had given a special dispensation for that rule not to apply to Newham Co-op Party.

However, it was national officer’s response to the final point of order I raised that surprised me, and I would be fairly certain that most people present (whatever way they were voting) may not have fully appreciated the implications of.

3.”Society Co-operative Parties registered and affiliated to the Co-operative Party shall be eligible for affiliation to each Constituency Labour Party in their area as the representative of the wider Co-operative Movement.

Representation shall be on the same basis and subject to the same limitations as to the maximum number of delegates as apply to other affiliated organisations”.

(Rule Book – Section G – National Agreement between the Labour Party and the Co-operative Party, para 10).

What the national officer said in response (but without clearly spelling it out) was that the phrase “representative of the wider Co-operative Movement” means is that the number of delegates Newham Co-op Party is entitled to send to each of the two CLPs in Newham is not based on the number of Co-op Party members resident in each CLP or even the total Co-op Party members in the borough, but is based on the number of people involved in the “Co-operative Movement” locally; which in Newham, as in most other areas, overwhelmingly means all the people who have a ‘Co-op card’ as a result of shopping in a Co-op shop.

I am a member of the Co-operative Group that run the shops (in fact it’s a requirement of Co-op Party membership to also be a member of a Co-operative society) and I regularly receive emails from them (usually relating to special offers in the shops), but in none of them has there been any information about Co-op Party delegates who supposedly represent Co-op shoppers on CLP GCs; nor is there any such information on the Co-op Group’s web page inviting shoppers to become Co-op members:

https://www.co-operative.coop/get-involved/its-your-co-op

So we have delegates to CLPs (no matter how small the local Co-op Party membership) supposedly representing mainly Co-op shoppers who are not informed about the existence of these delegates, have no involvement in their appointment, and receive no reports on what these CLP delegates do as their supposed ‘representatives’ (and who in their majority probably regard their Co-op card in much the same way as any other supermarket ‘loyalty card’).

Yet we have local Labour Party members, many who identify as on the ‘left’ (including at least two councillors present) who are either unaware of or happy to become or support the appointment of Co-op CLP GC delegates on the basis of this ‘democratic fiction’?

Lastly, in relation to the alleged ‘spoiled’ ballot paper and re-ballot for the position of Secretary, Deputy Mayor John Gray and another speaker made much of the Co-op national officer supposedly acting as ‘Returning Officer’; implying that his decision on the matter was above question. However, as anyone who has attended the ‘count’ of an election for public office will know, actual legally appointed Returning Officers do not make summary decisions on questionable ballot papers alone but convene a meeting of candidates and/or their representatives at which the questionable ballot papers are presented and the Returning Officer sets out the reasons for their view on whether a particular ballot paper can be regarded as a vote for a particular candidate or not.
Regards

Thank you and bravo, Rule Book Guy! Now we know why you were censured and threatened with eviction from the meeting.

Co-operative Manoeuvring

Report from the Newham Co-operative Party AGM 2019

Newham Co-operative party AGM took place on the 9th of April 2019. After more than one year of inactivity, in which not a single branch meeting was called, the AGM notice was sent like a rat out of an aqueduct, with one week’s notice from the national party’s membership officer, who was present with another officer to officiate the meeting.

The room booked by the existing secretary was so small that with only ten minutes before the start, it was deemed necessary to move to another slightly bigger room inside the same venue. The second room was packed in no time with members shuffling around to make ad hoc seating arrangements. As the door was closed, the total attendance was 53, with a large number of councillors and even the Mayor and the deputy mayor present.

The meeting kicked off with a flurry of points of order. Most of them seemed reasonable concerns, such as: Why the sudden, short notice? Why is the AGM being held during a school half term, when most members with children are likely to go on holidays? Why no meetings were called since the last AGM? Why the national officers are organising it and not the existing local branch officers? But the most interesting one, which seemed a bit mischievous at first, was a member raising health and safety concerns on the choice of venue. However, upon seeing how jam packed the room was, some members felt a bit anxious and murmured what would happen in an event of a fire.


All points of order were dealt with by the national officer, one by one, but his explanations raised further questions. After a bit of clamour and indignation from some members, the national officer proceeded to explain the voting system. Which raised a further point of order. This time, it was from a member who had come armed with hard copies of some extracts from the Co-operative Party’s rule book [Is there such a thing? Ed.] and quoted from it. This too was calmly batted away by the national officer.

Election for the position of chair became a head to head between two female members, as the incumbent stepped down and another male candidate withdrew. Aleen Alarice won, but when some members asked for the count, it wasn’t revealed. The new chair took her position and spoke eloquently asking for unity. She then invited the Mayor, Rokhsana Fiaz, to speak. The Mayor spoke about the crime incident which had taken place in Manor Park the day before, and then spoke really well on cooperative values.


It was then announced that results for all the other positions will be declared right at the end of the meeting. The voting began. But soon hilarity ensued as a member, who had stood for several positions, and who was not in the room, had apparently told some attendees prior to the meeting that he wished to withdraw from the vice chair position. The national officer demanded that unless he sees it in writing, the absent candidate will remain on the ballot paper. After some hurried fumbling and whispers, several members eventually got a text message and one of them showed it to the national officer.


As the agenda moved on to the delegates election to the GC of West Ham and East Ham CLP [The most important bit. Ed.], the member with the extracts from the rulebook raised a very pertinent point of order with regards to how the number of delegate positions (five) for each CLP was calculated. Batted away once again by the national officer, citing some esoteric rule which left everyone in the room baffled. Apart from one or two members, who expressed their admiration for the national officer with spontaneous applause. However, the member with the scraps of rulebook, clutched tightly in his fists, refused to budge and accept that verdict. He was then promptly shouted down and threatened with eviction from the meeting by the national officer. The rulebook guy still managed to say his last few words, which also included the point that he had tried to contact the national office of the Co-operative Party several times over the past year, but never received a response. He finally sat down and didn’t speak again for the rest of the meeting.


Delegates to the West Ham CLP had already been elected unopposed: The local Labour Party deity and West Ham CLP secretary, John Saunders; Councillor and Cabinet Member, Charlene McLean; Councillor Mumtaz Khan; Councillor and the incumbent Newham Co-operative Party secretary, Neil Wilson; and it was third time lucky for the local anti-Corbyn blogger, Martin Warne aka Mr. forestgate.net, who had previously failed to get a GC position at his own Labour Party branch AGM, and didn’t get his chance via Fabians either, as their AGM was cancelled at the last minute. But Warne wasn’t in the room, as pointed out by several councillors, who also seemed to know of his exact whereabouts.

All progressed smoothly, until it was revealed that there was a dead heat for the secretary position between the incumbent and his challenger (remember the absent member?). The ballot papers were distributed once again and the count took place outside. Eventually, as the results for the officer positions were ready to be announced by the chair, one of the observers came back and proclaimed that one of the votes for the absent member for secretary’s position had been wrongly discounted as invalid. The observer then demanded that the ballot paper should be shown inside the meeting room so members can decide whether it was the right decision to discount the vote. Cue pandemonium. It was then suggested that a picture should be taken of the incriminating ballot. Cue mirth and pandemonium. The observer stood his ground for a while until the national officer came back, did his thing, and then gave the chair a chance to read out the results, which were as follows:

Vice Chair: The Progress man, Councillor James Beckles.

Secretary: The man who didn’t call one single meeting and finished the year with flying colours by not managing to even book a suitable place for the AGM, ladies and gentleman, after a controversial recount, put your hands and legs together for Councillor Neil Wilson.

Treasurer: The only existing officer, who seemed to have done some work over the past year, as it was evident from her Treasurer’s report, Averil Donohoe.

For Membership Officer position, there was a wonderful gesture of co-operation by Councillor Moniba Khan, who offered to do a job share with the life-long supporter of that famous peace broker of middle-east, Councillor Alan Griffiths. It was agreed amid a rare display of merriment and conviviality by everyone in the room.


Assistant Secretary: Syed Taqi Jawad Naqvi, who was elected unopposed.


For Events/Social Secretary [You’re joking?? Ed.] Nominations were taken from the floor as nobody expressed an interest during that very long week. Sarup Choudhury was elected unopposed.

For the two auditor positions, only John Saunders, who sent his apologies, expressed an interest prior to the meeting, and was elected unopposed. The other position remains vacant.


The London Co-operative Party Delegates: Councillor Alan Griffiths, Mehmood Mirza, Councillor Sugga Thekke were elected unopposed. The women’s nominations were taken from the floor. Donna Guthrie and Jeanette Dye were both elected unopposed.


The East Ham CLP delegates were, Syed Taqi Jawad Naqvi, Councillor Moniba Khan, David Gilles, Sugga [OK, that’s enough. Who cares! It was all about West Ham CLP AGM anyway. Ed]


The AGM well and truly lived up to its reputation. Councillors packing the room, accusations of stitch-up and rule bending, and complaints about bad behaviour. Some things never change. As it had been the case under the tyranny of Sir Robin, Newham Cooperative Party is still being used as a political tool rather than promoting much needed co-operative values and policies.

North East London Campaign to Protest Migrant Charging

NELSONHS have been putting constant pressure on Barts Health Trust to reveal the extent of their imposition of migrant charges on suspected undocumented migrants. They have continued to intimidate those seeking health care even in Accident and Emergency and from pregnant women since the Government pilot of new forms determining migrant status. Now it has been revealed in hackney that the Trust there are even allowing a Home Office employee to attend assessments.

Project 17, a project assisting destitute migrant families to seek support , including child support, have reported that the presence of an immigration officer to assist with assessments is putting off migrant families from seeking support.

Now North East London Save Our NHS are organising a protest on Friday 22nd March at 1.15pm marching from the mosque on Whitechapel Road to the Royal London Hospital. They will be protesting migrant charges and the “hostile Environment” Policy now infecting our NHS. Please come along and give your support!

STP in East London Fails to win Vital Funds

The ELHCP ( The East London Health and Care Partnership ) is what our local STP calls itself. They have now found themselves victims of NHS England’s austerity drive by failing to win bids submitted recently for much needed funding. All the fine words about integrating health and social care, transforming service delivery in East London and improving public health are now, as our campaign has pointed out all along, fallen at the first hurdle because without proper funding you can’t have a proper service!

The East London STP has received an insulting £5m of the £430m of capital funding they submitted bids for. As a result STP chiefs now claim they will face “inevitable and significant issues”. £350m of the bid was needed to develop the Whipps Cross Site which has failed previous inspections. Also, the sale of land on the St. George’s Hospital site has failed to net additional funds for rebuilding on the site, even though the sale netted £43m for NHS Property Services.

The £5m will be used to develop the Urgent Care Centre run by BHRUT ( Barking, Havering and Redbridge) but no other bids submitted in North east London were successful. No surprise about the urgent care centre which they hope will divert the local campaign away from saving the A and E at King George’s hospital in Ilford.

No feedback on the strategic estates plan or clinical strategy was received indicating any concerns about the plan. So, basically NHS England says nothing about the fine words and plans for north east London and then refuses any funding! STP’s were supposed to be about “sustainability ” but now time and resources have been wasted on plans which have now been made unsustainable! There is a clear dysfunction between the local and central arms of the Government’s STP mission.

When local sites are sold the capital receipts go to NHS England nationally but are not directed back locally necessarily. An ELHCP spokesperson stated that this shortfall “will inevitably make it more challenging to deliver high-quality services to our residents”. The criteria for the bids were deliverability, service and demand management, transformation and patient benefit, financial sustainability, value for money, and estates. In which case, if the bids fail any one of these why were indications not made earlier to the STP following submission of their plans? The answer is simple. Capital is provided centrally and distributed piecemeal as part of the Government’s cruel austerity strategy for the NHS. Who said austerity was over?

East Ham CLP AGM Update

Under the supervision of the new London regional director, the East Ham CLP AGM took place on the 25th of February 2019 as planned. The following officers were elected:

Chair: Tahir Mirza
Secretary: Syed Taqi Shah
Treasurer: Mariam Dawood
Vice Chair Campaigns: Lakhmini Shah
Vice Chair Membership: Moniba Khan
Women’s Officer: Sophia Naqvi
Youth: Azka Rasool
LGBT Officer: Victoria Mitchell
BAME Officer: Sugathan Thekkepura & Asad Shan (Job Share)
TULO: Pushpa Makwana
Political Education: Tariq Hussain

As reported here earlier, this is a diverse officer team consisting of pro-Corbyn Left and other local activists. The elections for the delegates to Local Campaign Forum (LCF) were not held, which, given the recent history of East Ham CLP, is a concern for neighbouring West Ham CLP activists. LCF, among other things, creates the vital link between grassroots activists and the Labour Group, which consists of the Labour Councillors and the Mayor.

Labour Consultation Document a “Breath of Fresh Air”

“short on detail ” but ” a breath of fresh air” was how one local campaigner described the consultation document recently released by the Health and Social Care Policy Commission. This reaffirms conference policy to renationalise the NHS . What needs to be confronted now, and I am sure many responses to the document will reiterate this, is the sheer scale of this project which will mean dismantling the Health and Social Care Act of 2012 and all of the associated bodies set up to allow outsourcing and eventual full scale privatisation of the most profitable elements of the NHS.

Historically, the Lansbury Act set up a division between “purchaser” and “provider” so allowing certain services to be contracted out to private providers. The document outlines the fact that this experiment has been an expensive failure and with 9 years of austerity has led to increased waiting times, unnecessary deaths in hospitals, cuts in services, and demoralisation of the workforce.

The recent establishment of STP’s now morphed into ICP’s ( Integrated Care Partnerships or organisations or systems ) has further eroded the capacity of the NHS to provide services on the basis of need rather than being determined by budgetary constraints. The result of all this has been a £1.23bn deficit overseen by NHS England and with the “uncertainties” of Brexit we will further see and have already seen a crisis of retention and recruitment of the skills base located in the EU.

Demographic changes and in particular the growth of an ageing population with multiple health needs means, as the document points out, that we need a properly funded health service fully nationalised and free at the point of delivery. None of this comes without a price. Of course, Labour is, as the document points out, keen to avoid further disruption to the NHS. The renationalisation of the service, however, means fundamental changes to the way in which decisions are made, the reintroduction of genuine accountability at every level, the dismantling of ICP’s and of the division between “purchasers” and “Providers” and some resolution of the problem of public health provision which has suffered because of 9 years of austerity imposed on cash-strapped local authorities.

Newham Hospital Maternity Facing Unwarranted Skills Shortage

There are a lot of pluses to derive from the recent inspection of Barts Health Trust which moved up the ratings in many areas. The overall rating is ‘requires improvement’, however, as it was before.

Of real concern, however, is that all 4 ‘inadequate’ ratings were at Newham hospital and that 3 of these were located in Newham Hospital Maternity. 

The report states “At both the last inspections we observed midwives were overstretched, and we found this on this inspection too: midwives on the delivery suite did not get breaks and worked beyond the end of their shifts.
Midwifery skill mix was also a concern. The shortage of experienced midwives affected the amount of supervision they could give to the high proportion of less experienced staff.”

This should come as no surprise since a report dated May 9th. 2018 shows that a new ‘skills mix’ was imposed in maternity. This is a method for deskilling the workforce so that costs are cut. There are less doctors, nurses, midwives, and trained professional health workers, which in the case of Mid Staffs Trust actually led to problems with care and standards in general.

The new ‘skills mix’ was transformed from 100% RM ( registered midwives) to 90% RM and 10% MSM ( Maternity support workers) . This means that Newham midwives work without breaks, in excess of their agreed working hours, working long shifts including night shifts, and with tight work rotas. This leads to increased stress for this vital section of workers who deserve better, as do those in their care.

If parks are the lungs of London, leisure centres are its immune system.

Our Leisure Centres are at risk of deteriorating. Is the price of a few pounds per hour, the London living wage, worth paying to save them?

Our new mayor and councillors’ take over at a very unsettled time for Newham leisure services, for example – Balaam leisure centre is currently closed and has been since early January. Atherton swimming pool closes for thirty minutes after every ninety-minute session. And there are significant issues with staff retention in all Newham leisure centres: Atherton requires six fulltime lifeguards, Balaam four and Prince Regent Lane eight. Currently all three have no contracted lifeguards. As a result, more adult-only swim sessions are offered as opposed to general family swim sessions, because only one lifeguard is required for adult sessions.

The stop-start swimming timetable at Atherton has resulted in a drop, in use: pool sheets show that only seven swimmers per thirty minutes use the pool. The last quarterly uptake of new membership was down by thirty percent. Quite often there are additional closures throughout the day as the centre is increasingly used for private hire, a funding source that is deemed necessary by activeNewham.

Staff retention is low, because lifeguards do not receive the London living wage. A young fulltime lifeguard – a single parent living in the area, who loved her job, couldn’t afford to stay because of the £7.85 per hour wage. Sadly, she left at the end of January. Other staff decline contracts because they want to keep their options open. Many move onto other leisure centres like ‘Better’ who do pay the LLW.

The LLW is currently set at £10.55 per hour. Hopefully this is something the new mayor, several excellent councillors or trade unions will address (unfortunately most staff are not in a union). If parks are the lungs of London, then leisure centres are its immune system. Their provision throughout history has provided countless examples of community building, well-being and enjoyment. And importantly, an investment that saves money in the long-term.