Strategic Outline Case (SOC)

Transforming NHS and Social Care Services in Greater

Huddersfield & Calderdale

Upper Calder Valley Plain Speaker Q&A

What is SOC?

•CHFT, Locala and SWYFPT’s SOC is about how they plan to put into action their Health & Social Care Strategic Review proposals

•SOC aims to move CRH A&E & all unplanned care to HRI, cut overall hospital care, and treat all but acute illnesses in the community, using both social care & NHS

Is SOC about moving to a private health insurance

system?•SOC talks about making patients more

“independent” by paying for care through personal healthcare and social care budgets

•This is thin end of wedge for private health insurance - which will only cover patients that ins. co’s can make money from

•People with money will be able to top up their personal budgets. Those without won’t.

What about the health & social care market?•SOC talks about health & social care

“market”

•Social care was privatised/marketised 20 years ago.

•This has lowered standards of care and of care workers’ terms & conditions

•So why repeat the exercise with NHS?

Why SOC?

•There are stated and unstated reasons

•Stated reasons include ‘modernisation’, ageing population, growing costs to NHS of obesity, drug and alcohol abuse; & ‘austerity’

•Main unstated reason is the speeded-up stealth NHS privatisation that the Health & Social Care Act 2012 is designed to bring about, & related NHS funding cuts/shortfall

When?

•CRH services have already been downgraded, without telling the public

•Next up is “Public engagement” ie spin, Spring 2014

•Then “Public consultation”-more spin- summer 2014-holiday time, how convenient

•Decision towards end of 2014

What is ‘public engagement’?

•Marketing speak for spinning a message to the public, then asking carefully designed questions that will produce the desired answers, recording these answers and feeding them into the final proposal for changing the NHS and social care in Calderdale & Gter Hudd. This proposal will then go to a “public consultation”.

Does CCG have a legal duty to allow the public a role in

decision making?•CCCG are banging on about “public

engagement” and “public consultation” because they have a legal duty to allow the public to take part in deciding what NHS services they commission

•Cambridge Stop the NHS Sell Off took successful legal action against their CCCG for failing in this duty

Is there a democratic mandate?

•No. The Health and Social Care Act 2012 was not in Tory or Lib Dems manifestos.

•Tories promised “no top-down reorganisation of NHS” but went ahead & imposed one - the SOC is a key part of this

•The 2 Councils are the only organisations out of the 7 that are democratically accountable

Who is doing this?

•CHFT, Locala and SWYFPT have produced SOC, on basis of government policies

•CCCG and the 2 Councils have approved it to go on to next stage - spin, aka “public engagement & consultation”

•What will various roles of these 7 organisations be from now to start of implementation? Lack of clarity matters.

Does Monitor (NHS £ regulator)say NHS must cut

costs?•SOC is in line with Monitor’s 2013

‘Closing the NHS funding gap’ report, showing expected shortfall of £30bn/year by 2021

•Monitor wants NHS England to cuts costs by ‘productivity gains’,‘right care in right setting’, new ways of delivering care, more ‘rational’ spending - all central to SOC

Why do we need spinwatch?

•CCCG, Calderdale Healthwatch and the Commissioning Support Unit will spin SOC as if their lives depend on it - because they do.

•It’s vital to unpick and counter all spin, to point out what SOC really proposes/covers up. Read the documents & read between the lines - that’s where truth lies.

What about Calderdale Healthwatch?

•Calderdale Healthwatch (CHW) is holding Calderdale A&E/SOCconsultation events that may well count as ‘public engagement’ on SOC - I’ve asked if they do & will update

•CHW is legally prohibited from criticising government policy

•CHW webpage for comments on future of A&E uses a Q&A about SOC that bears SOC logo-it’s not independent information

How much would it cost to make SOC

happen?•£150m capital/building costs at HRI (the

“acute” hospital)

•IT/digitisation - not yet costed

•“workforce reprofiling” (I think this means making people redundant) not yet costed

•creating “locality” centres that combine primary NHS & social care services -?

Where would the money come from?

•70% of savings from closing A&E & 100 hospital beds (£33m) - £24m of this to go into paying for “a range of alternative provision” in the community, as well as statutory community health and social care services.

•Who knows where £150m for HRI rejig would come from?

Has CHFT set up a property development company?

•CHFT has formed a property development co. with Henry Boot Developments

•This co. (Pennine Property Partnership) has been developing Acre Mill site as new HRI outpatients dept.

•What has this got to do with “preferred option”of moving CRH A&E and all acute/unplanned services to HRI? Who knows?

Who benefits?•the NHS Trusts & Locala (all run as

businesses) & Commissioning Support Unit- CSU to be privatised in 2015 or 2016

•private healthcare providers, incl 3rd sector

•private social care providers, incl 3rd sector

•the SOC says that patients will benefit, but this seems very unlikely

Where has SOC come from? (1)

•Calderdale & Kirklees NHS orgs have been working on these plans since at least 2011

•They are rooted in New Labour’s plans to privatise the NHS through introducing a system used by an American private health care insurance and health care provider company, Kaiser Permanente

Where has SOC come from? (2)

•The Health and Social Care Act 2012, which aims to dismantle and privatise the NHS and social care system

•Neo-con theories about the underclass and welfare dependency (eg from Charles Murray), used to justify dismantling welfare state’s institutions for social solidarity

What are sources of SOC? (3)

•A network of vested interests (see chart on next slide -it’s a bit outdated - it shows the new head of NHS England, Simon Stevens, in his previous job as head of US/global private healthcare company United Health)

•Plus, hundreds of MPs and Peers who voted for HSCA 2012 had interests in private healthcare co’s - MPs’expenses scandal pales by comparison

Which vested interests are breaking up the NHS?