Health Campaigns Together Supportedl Defending by Keep Our Our NHS NHS l Public www.healthcampaignstogether.com & London Health Emergency l l No. @nhscampaigns 5 February 2017 l l FREE FREE Would May try to flog our cash- starved NHS to appease Trump? As Theresa May flew out to her toe-curlingly humiliating the developed world. encounter in Washington – holding hands and seeking War on Want campaigner, Mark Dearn, said: a post-Brexit trade deal with the newly inaugurated, “It would be no surprise at all if Theresa May offered race-baiting US President Trump – she pointedly refused up the NHS in a new trade deal with the USA when you to comment on whether the NHS would be off the table consider that our government has already done exactly in any future talks. the same in TTIP. She would only say that she was committed to “If public services are combined with a ‘corporate a health service that is free at the point of delivery, court’ mechanism in a trade deal - something both the fuelling suspicions that health services could be offered USA and UK are very keen on - any future attempt to up to grasping US insurance companies and the vast renationalise any or all of the NHS would see US health corporations that have made US health care the most companies suing the UK for lost profits resulting from expensive, exclusive, wasteful, inefficient and corrupt in their lost ‘market access’.” NHS ON Top doctors, MPs

and NHS Providers NATIONAL DEMONSTRATION THE call for more cash SATURDAY 4 MARCH 2017

12pm, Tavistock Square, London WC1 (tube: Russell Sq / Euston) March to Parliament

Called by Health Campaigns Together & The People’s Assembly For info, coaches & supporting organisations visit: www.ournhs.info

A petition to ministers signed by over 2,000 senior doctors was The NHS has, so far, just about managed this year’s winter pres- of which has already been swallowed by deficits). prematurelyBRINK! publicised at the weekend, before even more could sures without a meltdown. But it has been a close-run thing. Some However Dunne’s figures show growth will fall sharply next sign up. They were demanding the government back down on its trusts have failed to cope at times. year, down to just a 0.9 per cent increase in 2017 – well below the relentless squeeze on NHS funding, after a winter of near-misses In some of the areas where those failures have occurred or 4% annual increases in cost pressures. It would then go negative and system failures – with the prospect of two even meaner years come closest Tory MPs, wary of more cuts looming and the threat by 2018-19 with a 0.6 per cent fall in real spending per head in of funding to come. to close or downgrade hospitals, have also begun pressing The- that financial year. The doctors’ appeal coincided with an urgent call from the resa May’s government to reconsider its refusal to relax the vicious Growth would remain very low in 2019-20 at 0.2 per cent and hospital trusts’ body NHS Providers, demanding a swift review of austerity squeeze implemented by George Osborne in 2010. 0.9 per cent in the years following. how effectively the NHS prepared for this winter, looking at how Meanwhile waiting times are lengthening, performance is fall- So there’s no time to lose: the March 4 demonstration we funding for winter pressures is distributed and how services are ing back, the population is still rising – while ministers now admit called for last autumn, expecting a winter of crisis, proves to be supported by social care and GPs. funding is set to fall further behind in 2017 and actually drop by ideally timed, and promises to be big (see Back page). “Since it is trusts who bear the burden of the current approach, 0.6% per person in 2018. Join us and bring your colleagues, friends and neighbours: they should have the chance to set out what has worked for them In a written statement to the House of Commons, health minis- demand an end to the cuts and closures, an end to privatisation and what needs to change: expert organisations such as the Royal ter Philip Dunne said NHS England’s per capita real terms budget – and fair pay and conditions for our precious NHS staff. College of Emergency Medicine should also be consulted.” will have increased by 3.2 per cent in 2016-17 financial year (much It’s Our NHS! We need to fight for it – or risk losing it! NOW 12 packed pages! Back Page: March 4 our NHS – latest support 2 Systems

AsFailure this issue of Health Campaigns from their local authority in 2015 Together goes to press, the Guardian than 2010. Over one million older reports the NHS has experienced the people now have unmet care needs busiest week in its history between according to Age UK. 8-15 January, with record numbers The CQC’s annual State of Care of hospitals having to send patients report shows 81% of councils have elsewhere or declare a major alert. spent less on adult social care in the In that week, 52 trusts had to be last five years. diverted to other hospitals, almost The funding outlook for the next double the 27 similar occasions in the four years looks even worse. Public 2.8Average number of same week of 2016, and almost half spending on adult social care is set of all English hospital trusts – 68 out to fall to less than 1 per cent of GDP. beds per 1000 people of the 152 – declared an alert, 61 of Many local authorities will struggle to in UK Chris Hopson, chief executive NHS them on a single day, another record. meet even basic statutory duties. Fifteen trusts were on alert contin- The marginal measures an- Providers, said on January 11: uously for 11 days in a row between nounced by the government, allow- “Can we all now agree there is a clear gap between what the NHS is ex- 3 and 13 January, with Bath’s Royal ing councils to raise limited extra pected to deliver and the funding available? Most people, including many United Hospital running two weeks funding through increased council senior leaders across the NHS, recognise the service can no longer deliver on “red alert”. tax, will not meet a widening gap all its current priorities and performance standards within current fund- Bed occupancy is close to maxi- between needs and resources, which ing.” mum. On January 8, NHS England is set to reach at least £2.8 billion by “If the money is fixed, how do we identify what the NHS will stop doing? figures show average bed occupancy 2019. “Once the hard choices have been made, how do we marry up the na- levels at 95.3%, while more than half The resources for social care and 5.0Average beds available tional debate with local plans to ensure we actually deliver what we know of all trusts (78) had upwards of 97% services outside hospital have de- per 1000 people across will be unpopular? of their beds occupied, and 36 trusts clined in inverse proportion to the “We can never assume the longstanding political consensus behind our had more than 99% of beds full. increasing rhetoric from NHS leaders OECD countries, de- current model will stay in place indefinitely, particularly if the public feel 6-year cash freeze and politicians on the need for “inte- the NHS is overwhelmed or failing to keep up. When will we reach that grated care”. spite having very similar point? Can we avoid it, if the current trajectory continues over the next The brutal 6-year freeze on NHS But the disintegration is even three years as the lower levels of NHS funding kick in?” spending, which is set to tighten fur- wider still. Many of the plans to cut lengths of stay. ther in 2017 and 2018, has already spending towards bridging massive brought a collapse of performance projected shortfalls in NHS funding on a whole range of targets, from the involve closing community hospitals, maximum 4-hour wait to be treated and reducing numbers of community or discharged from A&E through to based health staff and resources for waiting times for cancer treatment. mental health services. But the bed shortages flow not At the same time budgets for pub- just from the NHS cash freeze but also lic health measures aimed at reduc- the draconian cuts in council spend- ing of ill-health have also been cut. 4NHS cost %and demand ing since 2010. And all the while GP-led primary The beds shortages are insepara- care services face rising workload rises each year bly linked with the desperate crisis in with none of the promised extra social care. In many acute hospitals funding. up to one bed in five is filled with peo- So it’s no surprise the system is ple who need no medical treatment, broken: six years of Conservative-led but cannot be safely discharged with- government have been methodically out support at home, or a care home breaking it. False assumptions deepen crisis place that is not available. Without a reversal of the cutbacks, Six consecutive years of cuts to < A November report from NHS Pro- previously: the crisis will inevitably deepen, drag- Average1 annual% rise in viders explained that the Five Year “Trusts have delivered annual local authority budgets have led to ging us back to the bad old days of Forward View in October 2014 “as- savings of 1.4% on average between 26% fewer pensioners obtaining care the late 1980s. NHS funding 2010-2020 sumed that growth in acute hos- 2008/9 and 2013/14, against an unre- pital activity would be reduced by alistic target of 4% set for the last six now from 2.9% to 1.3% per year years.” through a range of transformation That level of year-on-year efficien- programmes. However demand cy savings “has never been achieved growth is actually speeding up in the NHS before and is unlikely to be rather than reducing.” delivered.” £3.7 Performance figures in the NHS NHS Providers also stress that, con- are now at their worst in a decade. trary to the Prime Minister’s claims: This drop in performance is marked “An extra £8 billion on the health by: budget was the lowest amount the l the large number of trusts miss- NHS asked for over the spending re- ing their performance targets; view period. l the number of targets being “In reality, the health budget only billionUnderlying deficits of missed; received an increase closer to the £4.5 l the scale of dropping per- billion mark. Plans for the NHS to NHS & foundation trusts formance – targets are now being generate £22 billion in efficiency sav- missed by a much larger margin than ings were too ambitious.” March 4 the NHS: It’s Our NHS protest – https://www.facebook.com/events/1771664639725061/. 3 Councils versus STPs NHS bodies have never been in any Mayors challenging their local STPs way democratic: since 1948 the key has grown. players shaping policy have been It’s not clear whether council op- appointed to health authorities, hos- position would be sufficient to force pitals boards and their successors in an STP to be rewritten or scrapped, today’s CCGs and NHS Trusts. but it’s clearly a symbol of popular Foundation Trusts conduct elec- opposition making it much more dif- tions for governors, but their non- ficult to proceed as planned. number of county councils, including nity bed cuts to be put on hold to al- meeting on January 17. executive directors are appointees. So where councils have not yet Shropshire, Oxfordshire, and Warwick- low MPs to lobby the Government for In Lincolnshire, South Kesteven In other words they are in no way decided, or where they decided in shire have either rejected their local an ‘urgent and significant’ increase to council, hit by STP plans to down- democratically accountable to the lo- sketchy information to endorse STPs, STPs, or challenged the process and NHS funding. grade Grantham hospital’s A&E, has cal communities they cover. they should be challenged, lobbied distanced themselves from the plans. Telford & Wrekin in Shropshire was also voted to oppose the STP in its Now, by trying to engage local and driven to vote against. In Devon, where the STP runs the first unitary council to oppose present form. authorities into signing off STPs, NHS Despite decades of feeble and in- alongside a so-called “success regime,” its STP, while Liverpool’s Mayor Joe In London, where the revolt has England has for the first time opened adequate engagement of local coun- and plans for wholesale closures of Anderson is perhaps the most high been led in in NW London by Ham- up a possibility of forcing some ac- cils even with the powers they have to smaller hospitals and vital community profile leader of a major council to mersmith & Fulham and Ealing coun- countability – and councillors, elected shape local health services, it clearly beds, County Council (DCC) members have specifically opposed their local cils, there is opposition from five bor- every three years and representing can be done. unanimously backed calls for commu- (Cheshire & Merseyside) STP. He said: oughs in SW London, five boroughs much smaller constituencies, can be As we go to press, we know that a “I want to make it very clear that in North Central London, and the first most vulnerable to pressure, and least the proposals within the STP are re- moves to opposition in Waltham For- easily contained by party discipline. jected by the Council and this (Health est in North East London. The STPs are proclaimed as “part- Local MPs feel the heat and Wellbeing) Board, because it fails Isle of Wight’s council executive nerships” with local government, There are also stirrings among local MPs, Tory and Labour alike, recognising the to address the key issues facing our Executive have been recommended even though it’s clear that many, if not level of public hostility to cuts and closures on their patch, and that an election residents and their health in the years by their Chief Executive and Deputy most councils, and almost all council- may come sooner than 2020. to come.” Leader not to endorse the Hampshire lors, were deliberately kept in the dark The Tory Chair of the Commons Health Committee, Sarah Wollaston, whose The same STP is also opposed by and Isle of Wight STP document, and as the key proposals were drafted. Totnes constituency is in the midst of the Devon protests, has become an open Sefton, Wirral, Cheshire West and to continue to lobby NHS England to So it’s no surprise that as the STPs critic of the continued squeeze on NHS funding by her Party in government. Chester Councils. ensure that the needs of Island resi- themselves were published in the If campaigning is to be successful, these rumblings of concern need to be Bristol campaigners have also per- dents are fully taken into account. first few months of last year, the list built into rifts within the governing party that force Theresa May and Chancel- suaded their city council to pass a n Do you know more? Pass it on at of county and district councils and lor Philip Hammond to change course. strong motion against their STP at a [email protected]. How the Public could stop these cuts and closures Commissioners’ legal duties are compulsory, not optional! Nora Everitt, National NHS ‘collaboratives’ of commissioners, public Voice STPs, started redesigning ALL service All NHS commissioners have a legal delivery in their area. duty to involve the public in deci- No decisions about these chang- sions about, and in any proposals to es, involved the public. change, how services are planned NHS England, CCGs and Trusts and delivered (Health & Social Care were all treating their legal ‘duty to Act 2012). involve us’ as optional! All NHS Trusts have a similar legal In the summer of 2016, patient ac- duty to involve the people who use tivists, including National NHS public their services in all decisions about Voice (NNHSPV), challenged this bla- service delivery, including plans for tant breaking of the law. changes (Health & So- NHS England hurriedly published cial Care Act 2006). a guidance docu- Campaigners highlight ‘humanitarian crisis’ in NHS In 2013 NHS Eng- ment, in a week, that The Junior Doctors Alliance, People’s Assembly and Health bed than during the whole of January last year. land, and Clinical Com- pointed out if WE the Campaigns Together held an emergency protest in freez- The Red Cross is right – this is a humanitarian crisis and missioning Groups, public were not in- ing rain at the Department of Health Whitehall on 12th is a disgrace. But why is the NHS in this position? The NHS is CCGs, were showing a volved, those exclud- January. against the arrogance of the Government’s dan- not facing unprecedented demand – it is facing unprecedent- commitment to direct ing us were open to gerous attitude to the NHS. ed and deliberate neglect from this Government. public involvement, legal challenge. The rally highlighted the serious abdication of respon- Hunt blames irresponsible patients who do not know and also to transparen- Join our cam- sibility by Secretary of State for Health, Jeremy Hunt, dur- how to use A&E. We blame an irresponsible Health Secre- cy and accountability. paign. NNHSPV are ing one of the most serious crises ever in the history of the tary and deliberate Government underfunding of the NHS. But this commit- challenging NHS Eng- National Health Service. Valuable finances are wasted on consultancy fees for de- ment has disappeared land Board members What will it take to get the Government to take respon- veloping sustainability and transformation plans in the 44 in the last two years on this – join us and sibility for its role in creating the current crisis in the NHS? areas up and down the country, wasteful market processes with the development let’s challenge them In the face of the public statement from no less a respect- and widespread privatisation, adding to the shrinking of of the Simon Stevens’ legally. ed body than the British Red Cross that the NHS is facing viable public services. proposals that were to WE, the public, a humanitarian crisis, Jeremy Hunt has retreated into spin Dr Tony O’Sullivan, retired paediatrician (Health Cam- ‘reshape service deliv- could stop these cuts and the use of several dishonest arguments. paigns Together) said: ery across the country’ & closures as NHS In a week when two patients died on trolleys in Worces- “The Government and NHS England insists that there and find ‘efficiency savings’ at the England, CCGS and Trusts are break- tershire Royal Hospital’s A&E department awaiting a hos- are sufficient beds, and patients should be looked after in same time. ing the law. pital bed, Jeremy Hunt blames too many patients coming the community, but the cuts in social care and the poverty In 2015, ‘collaboratives’ of NHS pro- n See https://nhspublicvoice.word- to A&E unnecessarily. Yet during this last week three times of resource in community-based health services make this viders, started redesigning some ser- press.com/ or contact us on more people (485) were waiting more than 12 hours for a plan unworkable and potentially dangerous.” vice delivery, e.g. A&Es. Then in 2016 [email protected] l www.healthcampaignstogether.com l [email protected] l @nhscampaigns 104 Privatisation round-up Virgin empire Private firms - leeching more cash from NHS While campaigners and NHS Providers correctly While the rate of increase is not as rapid as vet and restrict GP referrals of patients for hospital expands press the case for increased funding for the NHS, it was when it mushroomed from near-zero to outpatient treatment. it’s also important to keep an eye on where the billions under Tony Blair’s government from 2000 New units politely named “referral management Virgin Care wins £700m contract to money is being spent. to the 4.4% in 2009, it still indicates a dangerous centres” can block or redirect GP referrals for run health services in Bath and North The latest figures suggest that since David erosion of the NHS. procedures such as hip and knee replacements, East Somerset. Cameron took office in 2010 billions more of the Private firms of management consultants treatment for allergies and cataract surgery, to Virgin Care will be given a 7-year inadequate NHS budget are now being squandered appear to have largely supplanted NHS manage outpatient activity at local hospitals. £700million contract to oversee more on purchasing services and health care from private management in shaping local plans. Tens of Bedfordshire CCG has used two referral than 200 health care and social care providers, while NHS trusts have faced ever- millions have been spent on drawing up STPs – management “hubs,” run by private companies, services in Bath and North East Som- increasing cuts in the tariff they are paid for patients. and other controversial plans for hospital cuts, since 2014. One for dermatology services claimed erset - the first time a for-profit firm The Labour Party now says spending on private closures and “reconfiguration”. it had reduced planned hospital attendance by a will deliver a council’s social care for providers rose to £8.7 billion in 2015/16, or 7.6 per Meanwhile a British Medical Journal survey has massive 65%, while the other for musculoskeletal adults. cent of the NHS’s day-to-day running costs, up revealed that tens of millions are also being spent services said referrals to the local hospital trust had B&NES Councillors supported the from £4.1bn, (4.4 per cent) in 2009/10. by local CCGs commissioning private companies to been reduced by 30% in its first six months. deal with 35 votes for and 22 against, following a decision by health bosses to let Virgin Care run community health and social care services in the district. Private insurance still lacks appeal to punters This is thought to be the finan- “Private insurance sales surge amid insurance and private health 64.3 million in 2014 according to the cially-largest deal the company has NHS crisis” said the Guardian (16 Janu- care represent, given the pri- ONS – meaning that private insurance ever won from a single authority and ary) – but the facts fall well short of vate sector’s stubborn failure for 4 million covers just over 6% of the Virgin are giving the impression they the eye-catching headline. The num- to offer any of the services population. would reinvest any profit, although bers are correct … but not necessarily most pressurised in the NHS. It appears that the inflated figure it’s not clear what commitment has in the right order. There is NO private sector reflects the fact that the health insur- been made. The figures, from private health- A&E, only the most limited ers are really only interested in cover- Since 2006 Virgin Care has care analysts Laing & Buisson, relate private maternity care – and ing around 63% of the whole popu- scooped up a number of NHS con- not to the current period but to 2015. NO private hospital wanting lation – those of working age (16-64 tracts, although it appears they have Nor does the feeble 2% increase to take on the treatment of years old) – leaving the more risky, yet to deliver a profit on any of them. justify description as a “surge”, espe- any of the frail elderly who expensive (and often poor) millions of In 2016 the company took over chil- cially when it turns out to be not the are filling front line NHS children and older people to the NHS. dren’s care services in Wiltshire, and result of disgruntled individual pa- beds. This selectivity helps ensure the won a £126 million contract to take tients giving up on lengthening wait- Nor indeed does the new bloated profits that are correctly cited over services at hospitals in Kent. ing lists. in numbers of individual subscribers. fractionally enlarged total of in the second half of the Guardian ar- But unions and campaigners have The increase is from company Far from a surge of support, the 4.022 million people equate to any- ticle. all raised concerns. Lewis Carson schemes, giving health insurance as current total of people paying for thing like the “10.6% of the popula- The insurers banked £4.7 billion in from Unison said: “We’re fighting to a spectacularly useless perk to largely their own health cover is now over 7% tion” as stated in Patrick Collinson’s premium payments, but forked out oppose the contract. We have con- fit and prosperous staff. LOWER than that in 2008. no doubt hurried and insufficiently just £3.6 billion to pay for treatment – cerns about what this means for staff In fact we are told further down This suggests many people have checked article. laughing all the way to the bank with conditions and service delivery.” the article that there was a 1.7% FALL recognised what a rotten deal private The current UK population was truly gross profit margins of 26.7%. ADVERTISEMENT

The Socialist Health Association is a democratic membership organisation campaigning for a fairer, more equal and healthier society. We helped to persuade the Labour Party to set up the NHS. Since 1948 we have been working to defend and extend it. We stand for: Universal Healthcare meeting patients’ needs, free at the point of use, funded by taxation Democracy based on freedom of information, election not selection and local decision making Equality based on equality of opportunity, affirmative action, and progressive taxation We campaign for an integrated healthcare system which reduces inequalities in health and is accountable to the communities it serves. 22 Blair Road | Manchester M16 8NS | https://www.sochealth.co.uk STP round-up 5 Anger over Cornish STP A public consultation meeting in Penzance ended in chaos on January 10 as an angry crowd refused to be “organised” into small workshop groups and instead spent 30 minutes telling NHS chiefs that they should focus on securing more investment for Cornwall’s health service. About 400 people listened to Garth Davies, of the Royal Cornwall Hospital Trust, outline the basis for a Sustainability and Transformation Plan (STP) aimed at cutting £260 million from the local health budget. Many fear that Cornwall’s network of community hospitals are at risk of www.cornwallreports.co.uk closure – and health chiefs have flatly refused to rule out the possibility. But as Mr Davies sought to describe the current situation – in which up to 100 patients per day, who are not ill, STPs lag behind NHS England plans have to stay in a hospital bed because they cannot be cared for at home - it The variegated and inconsistent series heard of STPs, and in many areas the although they are still seen as “the was clear that the meeting was not of 44 ‘Sustainability and Transformation figure would be little higher for front only game in town”. going to plan. One after another, Plans’ that were grudgingly and line NHS staff. The secretive process Indeed looking at the plans as people stood up and demanded belatedly published at the end of last has meant no real engagement with published it does not take long to information which the health chiefs year have clearly fallen far short of NHS staff or public. see that they will not deliver the said they simply did not have. England chief executive Simon Stevens’ Some STPs have successfully roped promised results: The meeting (pictured above hopes a year ago. in gullible local politicians and pliable l most STPs offer no viable or right) broke up early, without any of It was clear from the flurry of MPs prior to publication, to give sustainable plans for staffing or the workshops. Leaflets distributed NHS England directives that began blanket support and semblance of management of the “innovative” by Labour and Liberal Democrat just before Christmas 2015 that authority to plans which many of them proposals to divert services away new structures were expected to clearly had not even seen or read. from hospitals, so the services any financial detail, and almost none party activists claiming the STP was of them have any worked-through simply an excuse for budget cuts. crank up the NHS to drive through a A year ago these plans were proposed are not sustainable; streamlined process that would speed seen as the future: but now they are l there’s virtually no capital practical plan for implementation. One pointed out that Cornwall But however vague the STPs, it Partnership Foundation Trust has up cash-saving measures, implement way behind schedule, could even be available from NHS England to long-delayed hospital closures and sidelined. finance any serious transformation; would be a mistake to underestimate already closed 29 in-patient beds in the determination of NHS managers community hospitals. reconfigurations, and impose a To judge from the increasingly l and in many STPs the numbers “transformation” to as yet experimental sceptical line of coverage and plainly don’t add up, and there is little to drive through far-reaching Former St Ives MP Andrew changes and reductions in services to George, a former member of new models of health care. reports in the HSJ, NHS England or no evidence that some of their key But this revolution in thinking has directors and Simon Stevens himself proposals can work in practice. deliver on their savings targets. the Parliamentary Health Select CCGs may lack public support but Committee, has warned that the STP not been completed. A Health Service have begun distancing themselves We know that STPs in general seek Journal poll in January 2017 found six from the STPs, describing them to cut jobs, bed numbers and hospital they don’t lack determination, and is “fundamentally budget-driven” their plans remain a threat. and that it “merely rearranges the people out of seven had never even as “proposals” rather than plans – admissions, but many of them lack diminishing deckchairs of the NHS.” Health chiefs claim the deficit could reach £277 million by 2020 if they do nothing. n Reporting courtesy of Rashleigh MacFarlane and Julia Penhaligon, Cumbria carers abandoned www.cornwallreports.co.uk Alice Bondi, Alston Moor sustainable. removal of consultant-led maternity NHS. branch Labour Party There is no public transport worth and in-patient paediatrics. The Equalities Impact Analysis (EIA) mentioning. Women expecting a straightfor- absurdly states that because patients Before STPs emerged into public The GPs and the hospital’s League ward labour could give birth at the and babies are roughly equal male awareness, NHS England decided that of Friends have presented a plan to midwife-led unit at WCH, all others and female, there is no gender impact three areas of the country needed bring together the care home, shel- having to go to the Cumberland Infir- of removing consultant-led maternity to be ‘sorted out’. One was a huge tered accommodation, hospital beds mary in Carlisle (CIC). from WCH, nor hospital beds from the swathe of Cumbria, from the west and GP surgery, providing integrated Approximately one in four births three affected communities. coast across to Alston Moor in the health and social care, a declared aim runs into problems unexpectedly, and of the SR and STPs. then women in labour would travel by Ignored North Pennines. It’s as if carers and families don’t ex- The key proposals from the Success The SR boss, Sir Neil McKay, has ex- blue-light ambulance along 40 miles pressed some support, but the future of very slow road. ist. Similarly, having stated that rural- Regime (SR), charged with undertak- ity is an equalities issue, the EIA then ing a clinical review, are to downgrade is unknown until the consultation re- There is no doubt that babies sponses have been ‘analysed’ and the would die, and possibly mothers, on ignores the impact of such things as services at the West Cumberland Hos- lack of public transport. pital (WCH) in Whitehaven and close Clinical Commissioning Group makes the hour-plus journey to Carlisle. its decision, some time in March. As for sick children in CIC, the jour- CIC is already over-crowded. With three community hospitals. much-reduced convalescent, end-of- Norfolk demo Alston community hospital serves At the western side of the area, the ney for west Cumbrian families to visit ‘preferred options’ for WCH include would be exceptionally difficult. life and low-risk beds at community about 2,500 people (including some hospitals, and more pregnant woman February 25 over the border in Northumberland). ‘Preferred options’ and children transferred from WCH, NHS Norfolk Action Group will Four of the five roads go over high Meanwhile, the STP was published. the pressure on CIC will be intolerable. be having a Save our NHS demo passes, often snow-blocked in winter. This assumes that the SR’s ‘preferred The STP fantasy is that telemedi- in Norwich 25 February, meeting 20 miles from any care options’ will all go ahead. cine (in an area with often slow broad- 11.00am at St Peter Mancroft It’s at least 20 miles to any other The lack of understanding of the band and no mobile signal) and self- Church. healthcare. The hospital has seven realities of rurality and the life of car- care advice will result in such a drop It will be a lively event, with a inpatient beds, a 24-hour minor inju- ers is shocking. There is concern in hospital admissions that 100-150 samba band, singing, a ‘Howl for ries unit, and is the base for commu- that carers, often elderly, a majority beds can be removed from WCH and the NHS’ at the end of the march as nity nurses and professionals allied to female, will attempt to care for their CIC by 2020. well as speakers, so please join us, healthcare. partner, relation or friend well beyond Removing community beds that bring your musical instruments, The GP practice, with pharmacy, the moment when they should be in keep pressure off acute hospitals; risk- whistles, pots and pans and is in the same building. The GPs pro- hospital, because once the patient is ing babies’ lives; ignoring distance placards, and let’s make some vide medical cover for the hospital, in a hospital far away, they will be un- and slow roads; fantasising about tel- noise for the NHS! and all health professionals work as able to visit. emedicine… More info: email one team. If the hospital goes, the GP Health breakdown of carers can We can only wonder what planet [email protected] practice warns that it might not be be expected as another strain on the these people live on. 6 STP round-up West Yorks STP sets its DRIP sights on £1bn savings The full draft of the West Yorkshire eralised figures show that over £300m FEED Sustainability and Transformation across West Yorkshire – a third of the Plan (STP) was finally revealed in No- planned NHS savings – are to come A round-up of news vember. It raises more questions than from unspecified “provider efficien- nurses working during the day in it answers. cies” – squeezing more work for less Don’t ask for costly October 2016, according to Health While it’s impossible to disagree from a reducing workforce. Service Journal analysis. with many of the declared objec- What else does the STP propose? treatment in Yorkshire Eighty-five per cent – 190 tives for improving the public health, A series of measures, none of which Two West Yorkshire CCGs, North hospitals – missed their target for reducing their need for and depend- are explained or supported by any Kirklees and Greater Huddersfield, nurses working at night. ence on health services and prolong- evidence, to reduce smoking preva- have stopped offering expensive Tougher caps on agency spending ing healthy life, it’s hard to have much lence, reduce the numbers develop- treatments not usually provided resulting in a fall in agency staff confidence in a document which of- ing diabetes, increase early detection under the NHS in a bid to save an on hospital wards have made it fers no evidence for extravagant and and treatment of cancer, and cut car- estimated £750,000, according to The even harder for trusts to meet their ambitious plans, and appears to have diovascular admissions by a massive Commissioning Review. planned nurse staffing levels. been drafted on Fantasy Island. 10% – all by 2020-21. The ban is initially in force for The West Yorkshire “footprint” All of these would be great, as six months, and is expected to take Last crust reaches from Calderdale in the south, West Yorkshire “gap” would any measures to reduce youth effect immediately but, according The Royal Shrewsbury Hospital is so through Kirklees, Wakefield, Leeds and unemployment and tackle loneliness to recent board papers, will exclude broke it has been deferring payment Bradford, to York and Harrogate in the among older people, both of which those with a condition that is £1.074 billion for salads and sandwiches normally north – covering 2.6 million people, The figures have not been devel- are also mentioned – but there are no immediately life threatening or available for staff and patients. around 2000 square miles, 11 Clinical oped by NHS managers, but expen- clear ways in which the services, staff where a delay would cause “a real The unnamed current sandwich Commissioning Groups, 13 NHS trusts sively compiled by a management or resources would be developed to and imminent risk of harm”. supplier pulled the contract in and 113,000 health and social care consultancy (PWC). make them happen, let alone quickly. According to a joint statement January after firms supplying Royal staff, with a total budget of £4.7 bn. The STP insists the potential “Do And, like every other STP there is from the CCGs, the decision was Shrewsbury Hospital and Telford’s Each of the localities and providers nothing” “finance and efficiency gap” a huge question mark over how de- “driven by a financial Princess Royal were told will be forced to jockey for position and in 2020/21 would be £1,074m across layed discharges of care and the col- challenge and the need to they would not be paid resources, and as the NHS cash freeze the whole STP. lapse of social care could be resolved invest the local NHS budget until April. deepens in 2017 and 2018 any area But these figures aren’t real: they given the massive, continuing cuts to to benefit the health of the Lee Herkes, RSH League could find its resources squeezed by al- are deliberately inflated to scare local government budgets. whole population and ensure of Friends shops manager, liances of any of the other 10 CCGs. people into accepting ever increas- At the end of the day if there’s no value for money”. So when the STP argues that the ing cuts and workload. “Do noth- extra cash services will run out of told the local paper: “There current provision of five Hyper-Acute ing” is an imaginary situation: in fact money and old-fashioned cuts and One in 5 waits too have been a few people Stroke Units is too high to be sustain- trusts have had to make “efficiency closures will be used. worried that if the Trust able, there are real grounds to fear savings” every year since anyone can Already the STP hopes to save long for cancer care can’t afford to pay for that one or more will close – and the remember. £50m a year by restricting access to The NHS in England has been sandwiches, how are they going to locality affected community will have Even without the STP, these “busi- what are called “low value clinical pro- unable to meet its target for cancer pay staff?” no means of preventing the change. ness as usual” savings would contin- cedures and interventions” and there waiting times for nearly three years There’s a promise that “The people ue, so the real gap would be nowhere will be more patients deemed ineligi- according to new data. Pre-Brexit panic who make up the workforce will be near as big. ble for treatment. Monthly cancer waiting times The Daily Telegraph reports that energised, happy and fulfilled in their The STP does not give any proper l This is an edited version of a re- data shows that nearly 25,000 ahead of Brexit, the NHS is trying work and not limited in their ability to financial details to show how much port in Mid Yorkshire Hospitals Branch people had to wait longer than the to recruit hundreds of GPs from EU care.” Wouldn’t that be lovely? might be saved this way: but the gen- UNISON’s magazine Union Eyes. targeted 62 days for treatment in the countries such as Poland, Lithuania, past year. The target has now been and Greece with promises of £90,000 missed for 11 months in a row and salaries and “generous relocation has only been met four times in three packages” in a bid to plug shortages 167 beds to close plus years. of family doctors. The data shows almost one in five The plans aim to bring 500 (18%) of the 12,808 patients referred doctors in from the EU after warnings by their GP in November 2016 to that rising numbers of patients are A&E downgrade in Staffs start their first treatment for cancer being forced to wait a month to see The STP for Staffordshire and Stoke reduce non-elective admissions by a and a record number waited for a GP, with estimates of a shortage of on Trent declares that the “do noth- massive 23%, while at the same time more than two months for treatment up to 10,000 GPs by 2020. ing” gap for health alone is £286m by discharging patients faster from hos- to start. The 12 weeks preliminary training 2020-21, with almost the same again pital with “re-ablement packages.” recruits will have to undergo in – £256m – for social care. For patients with Long Term con- Nurse staffing targets Poland will provide medics with It’s claimed that on top of this the ditions the STP wants an “enhanced missed – by almost all English language lessons. result of doing nothing would be an model of primary care so that the GP And maybe health ministers 214 acute hospitals – 96 per cent of extra 28,000 in-patients per year, re- can manage uncertainty in the com- should be forced to attend some of those reporting – failed to meet their quiring another 267 beds and 1302 munity”. the sessions that will also be run on own planned level for registered staff (59 of them consultants). One of the three sites currently the “culture of the NHS.” “Apart from being unaffordable, delivering A&E and acute hospital ser- this is also not practical from a work- vices is to be downgraded – a choice force and bed capacity perspective”. between Burton on Trent, Stafford, or So the focus is on reducing the sustainable.” Five of the six local CCGs the costly new PFI hospital in Stoke. “unit cost per citizen” of health and were in the bottom 30% of CCGs for It’s a no-brainer. It’s clear to all that social care services. The plan wants early detection of cancer. Stafford’s hospital, which has been “harsher” implementation of restric- Of course none of this prevents the constantly under fire since the Mid tions on “procedures of limited/no STP proposing to dump more work Staffordshire Hospitals collapse of benefit”. onto overloaded GPs and community care over a decade ago, is again in the But solutions are hard to find. Al- services. Indeed the STP proposes to frame for cutbacks. ready it seems the CCGs have made close 167 community hospital beds, Meanwhile the CCGs are pressing a pig’s ear of commissioning decent 68 of which have already gone, creat- ahead with their hugely controversial services. According to the STP, “com- ing massive problems discharging pa- plan to privatise the management munity services remain disjointed, tients from Stole’s University Hospital. of cancer and end of life services to overburdened and with many of the At the same time the STP proposes privately-led consortia, with support staff demoralised,” while the “work- “increased community and primary service firm Interserve set up to take force and workload crisis” in the area care interventions.” charge of cancer care on an under- “fast rendering General Practice un- They hope the combined plan will funded, untested five-year contract. STP round-up 7

STP to the need to reconfigure ser- vices and the problems sustaining Fears grow of seven acute hospital sites, that the Campaigners call for pause, disclosure and South Tyneside FT and Sunderland merger and FT coming together to be managed under a single management could be consultation on Cheshire & Merseyside STP downgrade in a prelude to a merger in which one hospital or the other would be down- Dear Liverpool CCG Governing Body consequences. graded – leaving patients from the member, In the circumstances, we ask Tyne & Wear other area to travel much further for We are writing following the un- you to pause your contract ne- The Northumberland, Tyne, Wear and treatment. ambiguous decision of the Liverpool gotiations, disclose the full de- North Durham STP sets out plans in These concerns will not be placat- Health and Wellbeing Board on 1st tail of your plans, and begin a response to a claimed £641m gap in ed by the evasive wording in the STP, December to reject the Cheshire wide ranging full consultation the health system by 2021, plus an- which states: &Merseyside STP, which has been to include the public, elected other £263m gap in social care. “Whilst South Tyneside and Sun- widely reported. representatives, NHS staff and Its plans include £241m “provider derland hospitals recognise the im- This follows the rejection of the their trade unions. efficiencies,” potentially clashing with portance and value of having a local plan by Cheshire West and Chester As health professionals, you another £105m CCG efficiencies and hospital providing a range of servic- Health and Wellbeing Board on 16th will want to act in the best in- £31m to be saved through “back of- es, they equally recognise the urgent November, Sefton Council on 17th terests of patients. We call on fice” cuts. The plan also calls for £89m need to rebalance services across November, and the Overview and the STP. You have yet to disclose the you to do so. to be saved through “out of hospital” both organisations as it is no longer Scrutiny Committee of Wirral Council details, but it is not possible to take Yours, services and another £44m through safe or sustainable for either organi- on 28th November. £188m out of the Cheshire & Mer- Dr. Alex Scott-Samuel, MB, ChB, cuts in specialist services commis- sation to duplicate the provision of As you will also know, there is seyside NHS budgets in 2017/18 and MCommH, FFPH Retired Senior sioned by NHs England. services in each location.” growing public opposition to the £360m in 2018/19, dwarfing any con- Lecturer (Clinical) in Public Health There are obvious concerns In other words, they are clearing plan, shown in the ongoing press tribution from the Sustainability and Founder Member, Keep Our NHS among NHS staff and campaigners the decks ready for unpopular an- coverage, and in recent unanimous Transformation Fund, without severe Public that with references through the nouncements to come. decisions of Garston and Riverside Constituency Labour Parties, and by the lobby of the Health and Wellbeing Board at the Cunard Building. Notts plans to axe nursing staff and 200 acute beds To proceed with the final negotia- tion of contracts to comply with the Nottinghamshire’s STP is unusual in vision of care in ‘alternative settings.’ 40% reduction in non-elective admis- budgets imposed for 2017/18 and spelling out the scale of proposed re- Since the STP also wants a 25% re- sions in Greater Nottingham / South 2018/19 as part of this STP, would be duction in the NHS workforce – with duction in admissions to nursing and Nottinghamshire, a 15.1% reduction to ignore the clear decisions of lo- a net reduction of 562 staff (2.7%) to residential homes, this requires the in A&E attendances – and a 19.5% re- cal authority bodies and a gathering help bridge a “do nothing” gap esti- development of extensive services in duction in non-elective admissions in storm in the public arena. mated at £628m. “the community.” Mid Notts leading to a 30.5% reduc- We are sure that you do not wish In an Appendix to the STP figures The STP wants to see a huge 20- tion in non-elective acute bed days. Liverpool CCG to be fighting this bat- show that 218 posts in Bands 1-4 tle with patients and their representa- would be cut, and 644 Band 5: the tives. aim is to recruit instead an extra 153 Yet so far, there has been no con- Band 6-7 and 146 “advanced” staff sultation with the public, Councillors, above these grades including medi- NHS staff and their trade unions. cal staff. Engagement exercises do not More for less medical staff in a range of settings, constitute consultation, nor is it pos- hospital pharmacists, care home nurs- sible to consult without transparency, The aim is to expand community es and home care staff, it’s not clear including the full financial details of and primary care staffing by 24% how they expect to pull this off. your plans. while still saving £12m a year on pay. The STP also calls for a “system re- The contracts which you are ne- But since one of the key challenges design” to enable a reduction of 200 gotiating with providers will enforce is difficulties in “attracting and retain- beds in acute hospitals – almost one in your share of the cuts inherent in ing key staff groups,” including senior eight – over the next 2 years, with pro- Bringing East London’s health Derbyshire hopes to axe 535 hospital beds campaigns together Derbyshire’s STP, seeking to close a worsened by the fixed and rising cost On top of that another 150,000 financial gap of £287m by 2020, calls of its PFI contract for another 23 years people will be “supported to better Sign our local anti STP petition: for the closure of 535 hospital beds, or so, the consequences of cutting manage their ongoing care needs.” https://you.38degrees.org.uk/p/NoSTP most of them acute hospital beds, the funding for 188 of its 1100 beds This requires the development th but also 85 community beds are to be are likely to be disastrous, but are not of “multi-disciplinary proactive care We support 4 March NHS Demonstration axed. addressed in the STP. teams,” spanning Primary Care, Com- Contact us through: [email protected] What is even more unusual is that Enormous munity and Mental Health together Or our local groups 188 of these beds are to close at the with “voluntary sector,” Social care Hackney: [email protected] Royal Derby Hospital, a brand new These enormous cuts in hospital and “Specialist input.” Newham: [email protected] £334m PFI hospital opened in 2010: care are apparently to be achieved But since it’s all supposed to con- Tower Hamlets: [email protected] another 112 in Chesterfield – and the through a switch to “proactive” case tribute to saving money, it’s not clear We are Waltham Forest: [email protected] others out of the county. management of 5 per cent of the how this enhanced level of commu- Outer London: https://www.facebook.com/SaveKingGeorgeHospital/ Since the Royal Derby Hospital population: 50,000 patients – an nity services can be achieved. https://peoplevsbartspfi.wordpress.com Trust is already running at a deficit, enormous task. 8 Reports from around the country Starting the fight in Dorset Southend: Dorset KONP is a recently established We had a March on 15 October in group which started last year. Debby Poole against Dorset NHS cuts and to Monkhouse is the local contact: Save Poole A&E and Maternity which A&E threat “We formed following announce- was widely covered before and on the ment of CCG plans to downgrade or day by local press. We have had leaf- Norman Traub is the group North Lancashire : close 1 of 3 A&Es, 1 or 2 of 3 Maternity leting stalls to engage with the public coordinator: Bristol Victory Services, and close or lose beds from in Poole, Dorchester and in Swanage. “In the past few months Vanguard Footprint Bristol Protect Our NHS 6 of 13 Community Hospitals. We’ve tried to hold the CCG and Southend KONP have been We work with Dorset Health Cam- Councillors to account by asking concentrating their attention (KONP Affiliate) paign who formed to protect Mater- questions, and are working with La- on attacking the Mid and South Margaret James-Barbour is the Essex Success Regime STP. Bristol Protect Our NHS (PoNHS) nity, Neo Natal and Paediatric Ser- bour councillors to try to get a pro- group’s coordinator: “We have been working have recently succeded in getting vices in Dorchester County Hospital: posal to fully scrutinise the STP. We’ve “According to our STP health together with the Southend their city council to reject their STP. Save Kingfisher/Special Care Baby met with the Chief Executive of Poole and quality of life in large parts of Trades Council and Southend In common with many other local Unit, which have been under threat Hospital and been approached by this area are amongst the worst Against The Cuts(SATC). health campaign groups around the for some years. a Tory MP regarding closure of the in the country, plus we have a “Among the proposals being country, Bristol PoNHS had already Since forming we also work with community hospital in his constitu- potential £572m funding gap by considered in the STP are the stepped up its activities since Sep- other local groups fighting for our ency. 2021. downgrading of two A& Es and tember, in preparation for the emer- NHS including Save Poole Hospital, “Implementing the Carter the conversion of the third into gence of that city’s STP. Swanage Senior Forum, and to a less- • Dorset KONP: Review financial recommendations a major trauma centre. They have been questioning the er extent, Unite and Unison. [email protected] would potentially only save £176m “It is believed that Basildon CCG, briefing Bristol’s Mayor and key in Lancashire and South Cumbria. will be the major trauma centre, councillors about the real implica- “Our CCG is a Vanguard which will handle all emergency tions of the plan, lobbying the three footprint. It is changing from North cases. Broomfield Hospital local authorities involved and en- Lancs to incorporate South Lakes, in Chelmsford and Southed couraging the people they talk with creating a huge and varied area. Hospital will have their A&Es at their regular street stalls to sign “It straddles two County downgraded and will handle their petition calling on the Council Councils and will morph into Bay minor trauma. to reject the STP. Health Care Partners. It will join “This proposal has met with One encouraging spin-off from four other Lancashire areas to form opposition from the public, who all this activity is that a motion (joint an even bigger footprint. are naturally concerned that the Labour and Green) put to Council on “At times we have worked with lives of emergency cases, having 17th January attacking the STPs and the Labour party, Green party, to be transported many miles associated NHS and social care cuts Lib Dems, Momentum, Unite, from all corners of Mid and South was passed. No Health Sell off in Morecambe Essex, along busy roads, where Bristol City Council’s refusal to en- Bay, 38 Degrees, Global Justice there are often hold-ups, will dorse Bristol’s STP and instead com- Now, Stop TTIP and others on be placed in jeopardy or suffer mitting itself to call for increased various issues and occasions; and deterioration in their condition. funding for health & social care in the we have Dr David Wrigley! (Local “We have held a very city is important because it will com- GP, seasoned campaigner, KONP successful rally against STP in mit Bristol City Council to lobbying member and currently BMA Deputy Southend High Street, where Ministers and local MPs on the issue. Chair.) we distributed leaflets, with It’s really encouraging to see a “We have good contacts with signing of petitions. Our rally was positive response from the hard work some local and county councillors filmed by BBC East television. undertaken by PoNHS. and have had six one-to-one We presented petitions against meetings with Tim Farron about A&E downgrading to the CCG Reclaiming/ rebuilding the NHS NHS and TTIP, and outsourcing the , first holding a demonstration hospitals’ pharmacy. outside the building housing the The group are also working on “Some of us were on the CCG and we were then allowed positive aspects about the future of Leicester: Heart Centre battle picket line with Junior Doctors to speak when handing over the the NHS too. They have been focus- in Lancaster on every strike day. petition. ing on promoting the NHS Bill. Fol- Leicester KONP’s Sally Ruane: service reconfiguration and have We have written letters to the “We also set up stalls in lowing a successful interview about “The Campaign Against NHS watched these morph into what we government, and councillors, Southend against STP. the current state of the NHS with a Privatisation in Leicester, now know as the STP. These propos- attended and sometimes spoken “We asked questions at the local radio station Ujima, they have Leicestershire and Rutland (which als have always been problematic at meetings in Lancaster and South Scrutiny Committee of Southend been asked to do a specific slot on incorporates the local KONP group) since they threaten the closure of Lakes, and are currently trying to Borough Council about the why the Bill is so important and how has focused in recent months on the acute beds (when we already don’t re-invigorate South Lakes Health downgrading of the A &Es and to campaign for it. STP and the threatened closure of have enough), the closure of com- Action Group in Kendal. were told by the chair she would They are working towards a public the congenital heart centre which munity hospitals and a downskill- “We have been attending have to be assured that the meeting about the Bill later this year, serves families throughout the East ing of the workforce as a whole. We Hospital Trust Board meetings and plans would be to the benefit of with a platform of some of the key na- Midlands but is located within the investigated and learnt that moving AGMs for years, likewise the CCG, patients before approving them. tional figures involved in trying to get Leicester acute hospital trust. services into community settings and have good communication We are also working with Labour it passed through Parliament. “We have collaborated with the often neither permits the closure of with both.” Trust, councillors, with the local acute beds nor releases cash savings. and Momentum locally. We have had good local press coverage. • Bristol Protect our NHS: newspaper’s patient panel and with With this, we knew the underpinning • North Lancashire KONP: “We supported the JDs strike campbell.dongola@blueyonder. other campaigners and together assumptions of the STP were flawed. [email protected] and were on the picket lines with co.uk have organised a public meeting, two “We have attended Health and demonstations and a petition which Wellbeing Board and Scrutiny meet- them. We also held a successful has gained more than 120,000 signa- ings, making interventions when rally in Southend in support of Birmingham: 2 STPs to watch tories. allowed, tabling questions and on the strike. “The care given at the heart cen- one occasion a petition demanding “We have planned a public John Caffrey, Birmingham KONP’s sioners’ Convention and Regional tre is excellent as are its outcomes. effective scrutiny. We have met with meeting in Southend in Secretary: Unison, and are about to embark on Should it close, there would be no the acute trust Chair to discuss our February against STP and are “Our main focus has been on the a joint campaign with Unite WM. congenital heart centre on the east- concerns. trying to build up a united two STPs of Birmingham and Solihull “We helped press the SWBH trust ern side of England between Newcas- “We meet monthly with a second resistance in Southend, Basildon (BSOL) and the Black Country. into admitting that there might not tle and London. This apparently poses monthly meeting for steering group and Chelmsford against the “We have worked closely with be enough beds planned for their no concerns for NHS England who are members; we’ve also developed downgrading of the A&Es.” Solihull KONP on the BSOL STP and new Metropolitan Hospital.” under the impression Birmingham is good partnerships with local branch- have engaged with Birmingham City only 15 minutes away from Leicester es of Unite. “ • Southend KONP: Council,. • Birmingham KONP: (presumably by Tardis). [email protected] “We have contact with the Trades [email protected] “In relation to the STP, we have • Leicester KONP: Council, Momentum, the WM Pen- been monitoring closely plans for [email protected] 9 Welcome, Jeremy! Islington KONP South Warwickshire: “We subsequently gave evidence ourselves and also lobbied our council leaders separately, achieving Council opposes STP but... a joint position for all five leaders, including Conservative Barnet, that Anna Pollert is the group contact: “When the STP was finally they would not endorse the STP until “Coventry and Warwickshire STP was published, we got good media they were convinced that the case one of the very last in the country to coverage on our views that not only had been fully made for change, publish. It finally did so on December was it late, but it was meaningless, together with full financial details 6th. lacked any financial detail, and was and public consultation. “We campaigned with both full of empty jargon. We are planning the next stage Coventry City Council and “On December 13th, one of of the campaign, likely to involve Warwickshire County Council, our SWKONP members and a being present at many of the public informing them of the dangers Labour Councillor on Warwickshire engagement meetings to ensure of the STP. During November we County Council, successfully put a that they do not get hijacked by the increased our campaign with the resolution through to the full Council facilitators working for the STP team councils not to endorse the STP Meeting to oppose the STP. It was but actually focus on the crucial once it was published. Meanwhile, unanimously passed. issues. several SWKONP members attended “Despite this vote, on 23rd “We have already been mobilising consultations run by South December, South Warwickshire public opinion against the STPs, and Warwickshire Foundation Trust Foundation Trust (SWFT) signed a held a very successful public meeting about Out of Hospital Services. Our contract with South Warwickshire in November. members also tried to raise the CCG on Out of Hospital Services. I “Both of Islington’s MPs spoke issue of the STP at the regular South wrote to the CEO of SWFT, pointing from the floor at the meeting Warwickshire CCG PPPG meetings, out that all contracts associated and Jeremy Corbyn MP became a but were stonewalled. with the STP should have been member of KONP at the meeting. “At the beginning of December, suspended. The reply was that a lot “We will be trying to wake the parts of the STP were leaked to of work needed to be done, and general public up to the threat to the the press, that maternity and A&E that NHSE would allow variations NHS. would be moved from George Eliot in contract signed, and that the “We have a further public meeting Hospital, Nuneaton, to University contract signed was only a ‘financial in Islington Town Hall on 16 February Hospital Coventry and Warwickshire, envelope’ and didn’t tie SWFT to any Labour leader Jeremy Corbyn joins KONP at 7.30. This will use a ‘question time’ while stroke care throughout the details of service provision! format and on the panel will be Sue footprint would also be moved to “To date, no changes have taken Sue Richards (right, in picture) for attention on the Joint Health Richards from Islington KONP; Janet UHCW. We sent Health and Wellbeing place on the STP. A series of Health Islington KONP: Overview and Scrutiny committee Burgess, deputy leader of Islington Board elected members on WCC and Wellbeing Board meetings are “We formed a joint campaign of the five boroughs, first alerting Council and lead member for social briefing notes. scheduled, but we are finding it hard group last summer with other them to the importance of the issue, care; and a local GP. “I also spoke to a few Labour to know which are public, and when campaigners in the North Central then working with them to set up We will use these meetings and councillors on Coventry City Council Overview and Scrutiny Committee London STP footprint - Camden a panel inquiry in the STP in North any other vehicle we can think of to and Bedworth and Nuneaton. We are meetings are to be held. KONP, Haringey Defend our Services Central London, providing them with ensure that as many Islington people now in contact with a sympathetic “As well as publicising what is (full affiliate of KONP) and other briefing. as possible join the march to save the journalist at the Coventry Telegraph. happening, we are holding monthly campaigners in Enfield and Barnet. “Three of us sat with them as the NHS on 4 March.” We are now co-operating with the SWKONP Saturday stalls.” “We called ourselves NCL STP- STP top team gave evidence and paper, which has set up a campaign watch and campaigned together asked probing questions on the • Islington KONP: to save A&E at the George Eliot • South Warwickshire KONP: against the STP. We focused committee’s behalf. [email protected] Hospital, Nuneaton. [email protected]

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www.doctorsforthenhs.org.uk @Doctors4NHS 10 London snapshots An e-mail to staff at Ealing and policies are wrong, dump the wider circulation” and unseen even patients’ lives. We need more beds Northwick Park Hospitals instructed decision to close Ealing Hospital by some of the councils involved. and more staff, not ongoing cuts.’ them to find ways of sending patients A&E and restore the much needed The plans include: Olivia O’Sullivan, secretary of Save home early to make room for more: A&Es at Central Middlesex and l The loss of 3,658 NHS jobs in Lewisham Hospital campaign reports “We are asking for your assistance in Hammersmith Hospitals. NW London next year 17/18 - rising that Lewisham Hospital – the hospital undertaking an exercise to release 100 They should also re-open A&E to 7753 job losses by 20/21 they wanted to close three years ago extra beds through expediting patient facilities for children at Ealing. All l Almost 50,000 planned in order to ‘save 100 lives every year’ discharges over the next two days.” of those A&Es were there because admissions and 222,370 outpatient (Keogh, Hunt) – was described in the The email, signed by bosses of they were needed and they are still appointments cut by 20/21. Already Guardian as so full on 9 January it the London North West Healthcare needed today. If they are brave patient waiting times for planned had run out of beds, and an email to NHS Trust, went on to claim this was enough to do this, they would also operations are at record levels - these [trust] staff described the situation as because of unprecedented demand boost morale of health staff, which is plans will only make things much, “critical” and “not safe”’. for hospital services. currently at rock bottom.” much worse. “We are now campaigning against However figures released by Plans to slash NHS jobs and l The loss of 500 - 600 hospital tenders for the services going outside health researcher Colin Standfield services in NW London have beds with the closure of Charing Cross the Trust. We have challenged the SE from NHS data show demand in NW been developed in secret by and Ealing as major acute hospitals London STP directly in face to face have been very proactive on this London is in fact no different than NHS bureaucrats and only been l A reduction in A&E attendances meetings with Our Healthier South issue. The full Council voted on 23 previous years. uncovered thanks to a Freedom of by 64,175 in the next 5 years. East London (OHSEL) – particularly November to demand publication of Oliver New, chair of campaign Information request by a Brent health There is NO evidence that there will the double counting we have the STP in full, including the financial group Ealing Save Our NHS said campaigner. not be a need for these departments uncovered in their budget - and in appendices, which had been denied “Kicking patients out early is totally This revealed the NW London and acute beds in the future. council, JOSC and CCG meetings. by OHSEL even to the Chairs of and utterly wrong. NHS North Delivery Plan for the STP Oct 16 Merril Hammer, Chair of Save Our “We have briefed Councillors Committees. OHSEL published it in West London should admit their labelled “strictly confidential not for Hospitals, said ‘These plans threaten extensively and in Lewisham several full the next day.” Manchester bosses sign up for austerity cuts Caroline Bedale and most unfit buildings tend to be in appears to have shifted from arguing When the STP process was initiated, areas with the lowest property values. that there is no chance of getting any Greater Manchester was already a There is a major problem with the extra funding, to saying that as mayor long way ahead of other areas in pro- cost and the unreliability of the cur- he would be willing to argue that the ducing plans about transforming ser- rent private provision of social care, funding deal is not good enough. vices, new models of care, improving both in terms of inadequate care in Projected Deficits outcomes, and radical upgrades of people’s homes and reducing longer population health and prevention. than necessary hospital stays. All the boroughs forecast fund- The Plan, ‘Taking Charge of our Many boroughs plan to make ing gaps totalling £992m by 2020/21 Health and Social Care’, was produced more use of the voluntary sector unless they are able to make savings in December 2015, with minor updat- (whether paid staff or volunteers) to and/or receive an allocation from ad- ing in July 2016. This was submitted provide a range of community men- ditional NHS funding or protection of as GM’s STP. tal and physical health and wellbeing adult social care funding. The devolved health budget for GM projects. The Manchester Locality Plan is an was originally £6 billion – which meant The assumption by all the 10 bor- example of how figures are manipu- the city region would be £2 billion oughs, and by the GM Health & Social lated to show how they might bridge short by 2020/21. Even the extra fund- Care Strategic Partnership, that they the funding gap. ing they got for the Transformation can provide adequate services within It provides two scenarios, an Up- Fund was woefully short – they had the budget constraints, means that side and a Downside. In the former, calculated at least £1 billion would be £140m reform of NHS trusts, £21m – and referrals for hospital care will their plans give credence to the gov- the outcome would be a surplus of needed, but they got just £450m. commissioner collaboration, £736m be tightly controlled, especially for el- ernment’s claim that enough funding £21m by 2020/21 – based on getting Local leaders of Devo Manc appear NHS provider productivity savings, derly people. is being provided, and that commis- extra NHS funding, protection of so- to have been ready to accept the il- £100m from provider joint working) GM is also one of four pilots for sioners and providers just need to cial care funding, transformation of lusion of power with the reality of appear now to have been overtaken shared services and functions (such work more efficiently. services, and providers making mas- blame for cuts. by the individual boroughs’ hoped-for as finance, payroll, HR, IT, estate man- sive savings. savings. agement, and pathology), in the hope Accepting cuts In the Downside there would be Massive gap remaining The Plan is also tied in with ‘Health- that this will save £100m – but with The ‘Stockport Together’ plan sums a deficit of £149m by 2020/21. The By late 2016 the projected deficit ier Together’, which was mostly about unknown costs to staff. up the way GM boroughs are accept- £48.6m of savings includes £14.1m had fallen to £1.1 billion, because the concentrating specialist services in They expect providers to make ing cuts: to be cut from mental health servic- NHS allocation to CCGs and the social four ‘super’ hospitals (Central Man- much higher levels of savings than “It is evident that certain types and es, £7.4m from learning disabilities, care precept and the Better Care Fund chester, Oldham, Salford, Stockport) they are currently achieving. Bury’s levels of provision that have been £19.1m from neighbourhood care, were added to the opening position. which coordinate shared single ser- plan shows about a third of the fund- made available for many years will £7.9m from urgent care first response, Clearly this still leaves a massive fund- vices – teams of medical staff working ing gap should be filled by providers have to be removed and replaced by £10m from primary care, and £6.9m ing gap. across different hospital sites in each savings, but admits: lower cost alternatives which ideally from community intermediate care The Plan is full of wishful thinking of the four sectors. “This is a high risk assumption for will also deliver improved outcomes. and reablement. about how different models of care, It also claimed not to be about the locality given that our main local “Furthermore, there will need to be There is no indication how any of health improvement, people taking closing A&E departments – but some acute provider is currently not deliver- a slowing down in the rising demand these savings can be made without responsibility for their health will re- had already closed or been down- ing its CIP target this year.” for high cost services and a greater severe detriment to services, in par- duce ‘demand’ for expensive (hospi- graded. In Salford, “2015/16 marks the first reliance placed on community based ticular mental health, which has con- tal) services, on the assumption that: Locality Plans time that Salford Royal is forecasting a provision and preventative measures.” sistently been underfunded. “We can tackle this [deficit] by re- financial deficit (circa £17m across all Andy Burnham, the Labour Manchester Mental Health and So- ducing demand on expensive, reac- All the 10 Locality Plans follow the services of which £9m relates to Sal- candidate for GM Mayor, has said that cial Care Trust is merged with Greater tive public services, through greater GM Plan’s line in terms of areas they ford locality). Whilst GMW [the mental he would like to see social care brought Manchester West from January 2017. integration, prevention and early in- identify for potential savings, and all health trust] is planning to break even within the NHS team, with proper However we don’t know how this will tervention” and are as unrealistically optimistic about in 2015/16, it has signalled that future training and career opportunities affect services. It’s also proposed to “We are supporting residents to their chances of success in reduc- years will be difficult to break even.” for social care staff along the lines of create one hospital trust to run the become increasingly independent, ing ‘demand’ for hospital services by Yet the providers are expected to UNISON’s Ethical Care Charter. three acute hospitals. resilient and better connected to the more prevention of ill health, by bet- contribute £42m towards bridging He has also accepted that privati- In many ways that would be ration- opportunities of economic growth.” ter self care and better management the funding gap of £65m. sation of health care has been a dis- al, but as the driving force is financial The original projected ‘savings’ of health conditions. There are indications that some aster, a 20 year experiment which has – to save £20m – it’s likely that already in the GM Plan (£88m from preven- Hospitals will be much smaller – hospital buildings/estate could be failed. Interestingly, over a series of stretched services would be further tion, £446m from better care models, even more bed cuts are proposed sold to raise money, but the oldest public and trade union meetings, he ‘rationalised’ across the 3 sites. www.healthcampaignstogether.com or contact us at [email protected] 11 Good intentions Huddersfield campaign NHS England can’t rescue NHS unbowed by setback in Leeds refuse Mike Forster The campaign then got stuck in to take a letter By Christina time of financial crisis. over the Summer raising funds for our Transforming care and delivering HandsoffHRI recently celebrated its legal challenge. Huge amounts were Campaigners from Yorkshire region McAnea, genuine integration comes at a cost. 1st Anniversary following the an- raised at festivals, fetes and fayres. met on 23 December 2016, in There may be savings in the long run nouncement of the proposed closure We held our own festival in Sep- Leeds to mark the day contracts Head of through fewer hospital admissions of A & E and the downgrading of Hud- tember in Huddersfield’s largest open were supposed to be handed in to Health, but not if the social care model is dersfield Royal Infirmary. air park, which attracted over 7,000 NHS England in a great rush, three built on a system of low pay, zero- In that time the group has main- people with a large feeder march and months earlier than normal and UNISON hours contracts, and staff with little tained a strong community based protest from the hospital to the park. valid for two years rather than the or no training and support. campaign with huge public support. This was our most successful com- traditional one year. Better integration of health and In the short term costs may This has been sustained by creating a munity event which raised just over Christmas carols with appropriate social care, patient centred services, actually go up as there may be number of local groups where people £6,000 for the campaign. words for explaining the Slash Trash focussing on patients and forward double running of services and to completely new to campaigning have To date we have raised just under and Privatise plans were sung by the planning based on the needs of local provide training for staff working in just got stuck in. £40,000 and have two public meet- sizeable crowd gathered at the NHS communities. new ways or new settings. And all To maintain momentum, we have ings with our legal company. England headquarters at Quarry They’re all laudable aims that few, this at a time when local authority organised monthly activities which Although the CCG voted in Oc- House, Leeds, before the hand-in if any, would object to or want to budgets are being slashed. has continued to attract big crowds tober to proceed to full business of a letter signed by hundreds of oppose. Opposing some of the massive and generate huge publicity. case, we are advised we have a good people. I’m sure most of the people changes being proposed is not Following our two big protests in chance of winning our legal chal- G4S security at the door went who sat in small rooms around because unions are dinosaurs and February, we had a sponsored walk, lenge; it is inevitable Joint Scrutiny to the offices of NHS England to England, drafting Sustainability and want to maintain the status quo at a peoples debate at the university, a will call in their decision and local GPs let them know there was a letter Transformation Plans (STPs) did so all costs. huge mobilisation at the first public are considering a vote of no confi- waiting – but NO ONE was prepared with the best of intentions – with the Our members who work in health meeting of the CCG well over 2,000 dence in the CCG. to come down to receive it. aim of meeting all those objectives. are not opposed to change – indeed and another similar mobilisation The campaign begins 2017 with What did they think would Professor Jane Cummings, Chief the opposite is true - they work in a where they were forced to call anoth- renewed vigour and we look forward happen? Nursing Officer at NHS England sector where change is part of the er meeting due to lack of room at the to seeing you all in London on 4th Campaigners recognised that this wrote eloquently last month on the job. They are certainly not opposed first one. March was their Martin Luther moment, challenge of STPs, and claimed it to improving services for patients but in the absence of a nail and would mean: “more people can be and their families. a wooden door to bang it into, looked after with care personalised But the danger is STPs will be resorted to tying the letter to a pillar to their needs”. overly optimistic about the effect of before leaving to blend in with the Mammoth in the room cutting beds, departments and even throngs of Christmas shoppers. whole hospitals. The Association of The text of the letter is available But the huge mammoth in the room Directors of Adult Social Care has to read here:-http://www. is funding, or more specifically, the estimated that £4.6bn was cut from stopthestps.org.uk/open-howl-at- lack of it. The NHS has been starved social care budgets between 2010 stp/4593415239 of cash year on year since 2010. and 2015. The government’s claim to have ‘protected’ the NHS simply means Care homes closing 200 acute beds ministers have not slashed the The number of care homes budget in health as drastically as in England fell from 18,068 in they have in other public services. face axe in Oxon September 2010 to 16,614 by mid Bill authors Allyson Pollock and Peter Roderick with Margaret Greenwood MP It is dishonest to pretend, as 2016, and recent BBC research has The Oxfordshire component Theresa May is doing, that cuts in suggested a quarter of care homes of the Berkshire Oxon and social care, the lack of investment in will close in the next three years due NHS Bill 2016-17 next steps Buckinghamshire (BOB) STP turns low-cost housing and draconian cuts to funding problems. The NHS Bill, introduced by Margaret Greenwood (Labour) MP for Wirral West out to include the loss of 200 acute to welfare benefits are not having Cutting NHS services before there under the Ten-Minute Bill procedure in July, failed to get any parliamentary beds, seeking to bridge a claimed any impact on the NHS. is secure social care infrastructure in time at second reading on 4 November. “do nothing” gap of £200m by 2021. Weekly, if not daily, there place would be catastrophic. It has been moved to Friday 24 February where it is added to a previously Other cuts include “centralisation” are reports of A&E targets being Meanwhile, this year, winter scheduled agenda. However, it is seventh on the order for the day and chances of stroke and critical care services, missed, ambulances queuing pressures in the NHS haven’t even of debate time are vanishingly small. and the loss of more services from outside hospitals because they can’t peaked and already the system is The only way forward is for a concerted effort by the Labour Party to organ- Banbury’s Horton General Hospital to handover patients and operations at breaking point. The NHS and ise as a party to back future efforts to present the Bill and to forge an alliance Oxford, 28 miles away. being cancelled due to lack of beds. social care need an urgent and with MPs in other parties supporting the bill – notably the original sponsor, The STP-wide “do nothing” gap is As the last bastion of care free immediate injection of cash. Genuine Caroline Lucas (Green), John Pugh (LibDem) and the SNP en bloc. put at an improbable £479m, with at the point of use, the NHS is integration of health and social care If 100 MPs attend in support, then it is possible to move changes to the Oxfordshire’s providers facing the becoming the safety net for many around patient needs must be done agenda in parliamentary private members’ bills sessions. Efforts to gain such largest deficits. people with social needs as well as with patients, communities and with commitment from the Labour Party continue. Campaigners are already chal- health ones. If STPs are genuinely the workforce – not by a small group The Campaign for the NHS Reinstatement Bill will do its best to ensure that lenging the plan and its assump- to deliver better health and care in a dark room – no matter how well the NHS Bill will be represented in future parliamentary sessions. tions. services this cannot be done at a intentioned. LEEDS DEMO APRIL 1 11.30 outside Art Gallery l Councillors, MPs and Minis- ters must reject Sustainability & Transformation Plans, end cuts and closures and insist that our NHS is fully funded. l Stop privatisation and restore our publicly funded, publicly provided NHS! https://leedskeepournhspublic. wordpress.com/ Health Campaigns Together is delighted that the Aneurin Bevan Society wishes to be a supporting organisation. It’s Our NHS demo London March 4: www.ournhs.info Organisations supporting the march as we go to press … BFAWU (Bakers, Food and Allied NHS Solidarity Workers Union) NHS Support Federation BMA – British Medical Association Open Democracy – ourNHS CWU Communication Workers Union People’s Assembly against Austerity GMB – General, Municipal and Politics of Health Group Boilermakers Union Socialist Health Association NAPO – The Union for Probation & LOCAL CAMPAIGNS March 4 Family Care Workers NUT – National Union of Teachers Defend Our NHS Chester PCS – Public and Commercial Birmingham KONP Services Union Bristol Protect our NHS POA (Prison Officers Association) Defend Our NHS York RCN – Royal College of Nursing Ealing Save Our NHS RMT – Rail, Maritime and Transport Greater Manchester KONP Union Hands off Huddersfield Royal RMT London Region Infirmary UNISON North West region It’s Our NHS Worcestershire UNISON South East region Keep the Horton General UNISON Mid-Yorkshire Health Merseyside KONP Unite the Union (national) Newcastle KONP Unite: Doctors in Unite (previously Oxfordshire KONP Support is constantly growing for Our12 noon March 4 NHS! MPU) Save Lewisham Hospital Campaign the national demonstration called Save Our Hospitals Hammersmith & Tavistock Square London WCi in London on March 4 by Health UNIONS: Trades Union Charing Cross (tube Russell Square or Euston) Campaigns Together and People’s Councils and related Save Our Hospital Services Devon Assembly. SOS Grantham Hospital Leeds Trades Council March to Parliament Among recent national supporting Stroud against the Cuts Ealing Trades Councils organisations we have been pleased Support Stafford Hospital Huddersfield Trades Council to welcome the BMA and the Royal Sussex Defend Our NHS National Shop Stewards Network College of Nursing, whose activists Wirral Defend Our NHS will be marching alongside TUC Worcester TUC health unions, other trade unions and NATIONAL CAMPAIGNS POLITICAL PARTIES, national campaigners from a wide political 999 Call for the NHS & local branches, politicians spectrum and across England. Big up the NHS East Devon Alliance Party The demands of the march are Bursaries or Bust Ellesmere Port Constituency Labour simple and inclusive Doctors for the NHS Party n No Cuts, Closures & Hands Off Our NHS Green Party Privatisation Health Campaigns Together John McDonnell, Shadow Chancellor, n End Pay Restraint for NHS Staff! Health Emergency Labour Party n For A Fully Funded, Publicly Junior Doctor Alliance Hackney North & Stoke Newington Owned National Health & Social Care Keep Our NHS Public CLP Service! Momentum Kilburn and District Labour Party Coaches are being booked from National Pensioners Convention National Health Action Party many areas – details and advice for NHS Reinstatement Bill Campaign Yorkshire Regional Labour Party organisers at www.ournhs.info/ For us in health Campaigns Get YOUR trade union, political party or local campaign to Together the key is ensuring that the campaign effort is redoubled after support: details and suggested motions available from the the March. This is no one-off protest. We are fighting till we win! demo website http://www.ournhs.info/ Unions, campaigners, join us! HeC alth ampaigns Together is an alliance of organisations. That’s why We aim to produce Health Campaigns Together newspaper we’re asking organisations that want to support us to make a financial contribution to facilitate the future development of joint campaigning. quarterly if we can gather sufficient support. We welcome support from: It will remain free online, but to sustain print publication l trade union organisations – whether they representing workers in or we need to charge for bundles of the printed newspaper: outside the NHS – at national, regional or local level (postage will rise from Issue 6 to post the larger newspaper). l local and national NHS campaigns opposing cuts, privatisation and PFI Cost per issue: Health Campaigns l pressure groups defending specific services and the NHS, n 10 copies £5 + £3 post & packing Supportedl Defending by Keep Our Our NHS NHS l Public www.healthcampaignstogether.com & London Health Emergency Together l @nhscampaigns l FREE Would May try to flog our cash- l No. 5 February 2017 l FREE l pensioners’ organisations starved NHS to appease Trump? n 50 copies £15 + £8 p&p As Theresa May flew out to her toe-curlingly humiliating encounter in Washington, holding hands and seeking the developed world. a post-Brexit trade deal with the newly inaugurated, War on Want campaigner, Mark Dearn, said: “It would race-baiting US President Trump she pointedly refused be no surprise at all if Theresa May offered up the NHS in to comment on whether the NHS would be off the table a new trade deal with the USA when you consider that in any future talks. our government has already done exactly the same in l political parties – national, regional or local She would only say that she was committed to TTIP. a health service that is free at the point of delivery, “If public services are combined with a ‘corporate n 100 copies £20 + £10 p&p fuelling suspicions that health services could be offered court’ mechanism in a trade deal - something both the up to grasping US insurance companies and the vast USA and UK are very keen on - any future attempt to corporations that have made US health care the most renationalise any or all of the NHS would see US health expensive, exclusive, wasteful, inefficient and corrupt in companies suing the UK for lost profits resulting from their lost ‘market access’.” The guideline scale of annual n Pay us direct online – or with PayPal if n 500 copies £40 + contributions we are seeking is: you have a credit card or PayPal account £15 p&p NHS ON l £500 for a national trade union, To streamline Top doctors, MPs at http://www.healthcampaignstogether. and NHS Providers NATIONAL DEMONSTRATION l £300 for a smaller national, or com/joinus.php administration, THE call for more cash SATURDAY 4 MARCH 2017 regional trade union organisation n bundles of papers will For organisations unable to make 12pm, Tavistock Square, London WC1 March to Parliament (tube: Russell Sq / Euston)

Called by Health Campaigns Together & The People’s Assembly A petition to ministers signed by over 2,000 senior doctors was For info, coaches & supporting organisations visit: l £50 minimum from other supporting www.ournhs.info prematurelyBRINK! publicised at the weekend, before even more could only be sent on receipt sign up. They were demanding the government back down on its The NHS has, so far, just about managed this year’s winter pres- relentless squeeze on NHS funding, after a winter of near-misses sures without a meltdown. But it has been a close run thing. Some trusts have failed to cope at times. of that swallowed by deficits). payments online, cheques should and system failures – with the prospect of two even meaner years However Dunne’s figures show growth will fall sharply next of funding to come. In some of the areas where those failures have occurred or come closest Tory MPs, wary of more cuts looming and the threat year, down to just a 0.9 per cent increase in 2017 – well below the The doctors’ appeal coincided with an urgent call from the 4% annual increases in cost pressures. It would then go negative hospital trusts’ body NHS Providers, demanding a swift review of to close or downgrade hospitals have also begun pressing The resa May’s government to reconsider its refusal to relax the vicious by 2018-19 with a 0.6 per cent fall in real spending per head in organisations. how effectively the NHS prepared for this winter, looking at how - that financial year. funding for winter pressures is distributed and how services are austerity squeeze implemented by George Osborne in 2010. Meanwhile waiting times are lengthening, performance is fall- Growth would remain very low in 2019-20 at 0.2 per cent and of payment, and a supported by social care and GPs. 0.9 per cent in the years following. ing back, the population is still rising – while ministers now admit “Since it is trusts who bear the burden of the current approach, So there’s no time to lose: the March 4 demonstration we they should have the chance to set out what has worked for them funding is set to fall further behind in 2017 and actually drop by 0.6% per person in 2018. called for last autumn, expecting a winter of crisis, proves to be be made out to Health Campaigns and what needs to change: expert organisations such as the Royal ideally timed, and promises to be big. College of Emergency Medicine should also be consulted.” In a written statement to the House of Commons, health minis- ter Philip Dunne said NHS England’s per capita real terms budget Join us and bring your colleagues, friends and neighbours: If any of these amounts is an obstacle will have increased by 3.2 per cent in 2016-17 financial year (much demand an end to the cuts and closures, an end to privatisation – and fair pay and conditions for our precious NHS staff. Together, and sent c/o 28 Washbourne full postal address, NOW 12 packed pages! Back Page: March 4 our NHSIt’s Our NHS! –We needlatest to fight for itsupport – or risk losing it! to supporting Health Campaigns preferably online. Together, contact us to discuss. Rd Leamington Spa CV31 2LD. Contact us at [email protected]. www.healthcampaignstogether.com