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Posts Tagged ‘Save our NHS’

Jeremy Hunt: Don’t close our GP surgeries

August 15th, 2014 by

Jeremy Hunt has changed the rules again. He’s bringing in cuts that could see some local GP surgeries closing their doors for good. 700,000 of us could lose our local GP.

The top-up funds that many surgeries rely on are being slashed and the money channelled away from those who need them most. Even NHS England admitted that Hunt’s reforms strike the poorest hardest.

The clock is ticking: some surgeries say they could close within a year. The government won’t want bad news stories sticking around in the run up to the election. If Jeremy Hunt feels another big battle brewing over the NHS, it might be enough to persuade him to stop the cuts.

As Hunt tries to relax this weekend, let’s make sure he feels the heat. We can build a huge petition to leave him in no doubt that these cuts are not ok and we’ll always be here to protect our NHS:
https://secure.38degrees.org.uk/dont-close-our-surgeries

38 Degrees members have already taken on Jeremy Hunt and won before. We stopped his Hospital Closure Clause and people power beat him in court twice when 38 Degrees members helped fund the legal case to save Lewisham hospital.

Protesters with Save our NHS banner in Westminster

As more surgeries are forced to shut, this could open the door for more GP surgeries to be run by large private firms on the cheap.

Hundreds of our GPs have already been campaigning against these cuts – let’s stand with them.

Please sign the petition to stop Jeremy Hunt’s dangerous plans in their tracks:
https://secure.38degrees.org.uk/dont-close-our-surgeries

Posted in 38 Degrees Blog Posts, Stand up for the NHS

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Good Hope Hospital

August 13th, 2014 by

38 Degrees member, Krystyna, has launched a campaign calling on NHS Heart Of England Trust to hold a public meeting about the future of services at Good Hope Hospital.

The Heart of England Foundation Trust recently revealed plans to cut vital services like trauma and surgery from Good Hope Hospital. They promised to hold a public meeting to discuss these changes but have yet to set a date.

The changes could come into place as soon as the Autumn but campaigners say the public haven’t been properly consulted.

Krystyna and other members of the ‘Save Good Hope’s Local Services’ are handing their petition into Downing Street this Friday. Can you help them reach 1000 signatures? Click here.

Here’s what Krystyna says:

“The Trust have stated several times in the media that they would hold a full public consultation but so far have refused to name a date.”

The proposals allegedly involve the transference of key services from Good Hope to Heartlands and Solihull hospitals, both great distances to travel for many people and particularly difficult for carers and those they care for – the elderly, very young and disabled.

“We encourage everyone in the area who would be affected by the Trust’s proposed changes and who wants to have a say on the future of our hospital to sign the petition.”

Click here to sign her petition now:

Posted in 38 Degrees Blog Posts

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Your Decision – 21st July

July 21st, 2014 by

Every week a group of 38 Degrees members vote on which issues our movement should prioritise and which campaigns to get behind. Here are the results for last week.

Protecting the NHS by stopping the government’s dangerous plans like privatisation and closing A&E departments has come top this week.

The next biggest issues were: cracking down on tax dodging by big companies, ban the routine use of antibiotics in factory farming, and campaign for education policies that enable every child to reach their full potential.

You can see how 38 Degrees members voted on other issues on the graph below. The blue on the graph shows how many people answered ‘a lot’ in support of the campaigns listed, the red represents people answering ‘a little’, and the green is ‘not at all’.

What do you think? Please comment below. For a full size chart please click here.

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What did 38 degrees achieve in the hospital closure clause campaign?

June 17th, 2014 by

This article looks back at the recent “hospital closure clause” campaign and tries to take a dispassionate look at the issues and examine the likely effects of the government climbdown on clause 119 (or was it clause 118 because it kept changing).

The central problem the present government faced – and which previous governments faced – was how to manage change in the way NHS hospitals operate without major public opposition?   Amongst all of our public services, NHS hospitals are the services that the public prizes the highest.  In the perception of public importance hospitals come above schools, social care support, roads, leisure centres and community centres.  Nothing brings a community to the streets quicker than a threat to services at their local hospital.  One sniff of unwanted changes in your local hospital and the streets are thronged with angry, banner waving local people who are being whipped up in their indignation by elected and wannabe local politicians.  Making changes to our hospitals is one argument every elected politician wants to avoid or cannot be seen to support.

But changes to the configuration of hospitals has happened since the NHS was created in 1948.  There is a wide and growing professional consensus across those who understand the complexities of NHS patient outcome data that pretty radical change to the way that our hospitals work is needed to save lives and improve services to patients.

But, and it is a bit “but”, it is often only a professional consensus.   Change in the NHS cannot properly be managed only with a professional consensus.  That leaves out the people who are most important of all – the patients – out of the loop.   It is an inconvenient truth for NHS decision makers that patients pay the bills through their taxes, elect the politicians who make the laws under which the NHS operates and are the only reason hospitals exist.  Patients are the most important people in any decision making process.  There was a famous “Yes Minister” episode about a new hospital that won every award going for cleanliness, staff morale and efficiency but, one year on, had yet to admit a single patient.  Sir Humphrey urged the Minister to be proud of the hospital.  When Hacker expressed some reservations Sir H explained in his “let me say this once and I hope you will understand Minister” voice that the hospital functioned so much better without patients.  That was a caricature but, like all caricatures, it had a sardonic element of truth.

My impression (through political experience and when assisting NHS bodies with change processes) is that, for far too long, the NHS has defaulted to managing these hugely complex change processes by seeking to establish a professional consensus in favour of changes and as a last step, once the plans are all but agreed, going through a notional “consultation” process with patients and the public.  This is perhaps seen most acutely where the driving force behind change is a lack of money for an NHS body or having to make up for bad NHS management over an extended period.

The hospital closure clause campaign brought these arguments into sharp focus.  The government wanted to give powers to a Trust Special Administrator (a “TSA”) – something like a liquidator of an NHS trust – to reorganise health services across a series of hospitals belonging to different NHS Trusts if the TSA though this was needed to sort out the financial problems at a single Trust that was in financial difficulty.  The Health and Social Care Act 2012 gave a de facto veto on change at a hospital that was under the TSA’s control to the commissioners of NHS care at the Trust in difficulty.  “Commissioners” are Clinical Commissioning Groups (“CCGs”), mainly consisting of GPs, that have the power to decide what NHS services an NHS Trust should deliver for the local patient population.

However CCGs are accountable to the public and cannot make commissioning decisions without public and patient involvement.  CCGs have comprehensive legal duties to involve patients and the local public in their decision making and so a CCG could not make decisions about whether to approve scaling back or closure of an A & E or obstetric unit at a local hospital without involving patients and the local public in that decision making process.  So giving a de facto veto to local commissioners meant that patients and the local public would get a key say in these decisions.  The public might not agree with the outcome but at least they would be properly involved at an early stage and the CCG had to ensure they listened and responded before key decisions were made.

The next stage in the story is that the government lost the legal case brought by the Save Lewisham Hospital campaign, which was supported financially by 38 degree members.  The courts held that the TSA regime gave powers to a TSA to make changes at a hospital trust to which he had been appointed but had no power to impose change on NHS hospitals run by neighbouring trusts. That stopped a TSA using the Trust Special Administration process as the basis for imposing wide scale changes to hospital services across an area in order to try to solve far greater problems than the insolvency of a single NHS trust.

The government wanted to remove that limitation by legislation and so introduced amendments to the Care Bill to widen the powers of a TSA.  However the problem 38 degrees identified was the changes that the government proposals kept the veto for the commissioners of services at the troubled trust but did not give any decision making powers to commissioners of services at other hospitals where changes were being forced through as a result of the TSA process.  Unless NHS commissioners were decision makers about proposed changes at their local hospitals, there was no process for the commissioners to involve patients and the public in this decision making (because they were not making any decisions).

So the original proposals meant that a hospital manager from another area or even a private sector accountant could close down a perfectly viable NHS Accident and Emergency Unit, scale back a popular consultant led obstetric unit or close a properly functioning hospital in order to drive patients to a hospital that was in financial trouble in the neighbouring borough in the teeth of opposition from the hospital doctors, local NHS commissioners and with only the bare minimum of public and patient consultation.    This was like giving a liquidator of an under-performing supermarket the right to close down a more popular competitor supermarket in order to improve the prospects of the supermarket which had got itself into trouble.

38 degrees pointed out that hospitals were not supermarkets and changes ought only to be made after the public was fully involved in decision making.  That objective could only be achieved by making the local NHS commissioners decision makers about what services should stay or were up for possible change at local hospitals.  Giving commissioners that role would mean that CCGs had to work hard to involve patients and the public in these decisions before they were made.

The campaign was ultimately successful because, towards the end of the parliamentary process, the government accepted the principle that all NHS commissioners who were affected by changes in their local hospitals should have the same de facto as commissioners of services at the troubled trust.  The government introduced a clause which had the same effect as the 38 degrees clause introduced by Paul Burstow MP which gave parity to the decision making positions of commissioners of the affected Trust and any other Trust whose services may be affected by changes proposed by a TSA.

In practice this means that a TSA will not be able to use his appointment as a fig leaf to drive through unpopular changes to NHS hospital services in an area against the wishes to local NHS commissioners.  However the big win in this scheme is that, before any changes are agreed to by NHS commissioners at a local hospital, the commissioners will have to undergo a thorough and meaningful engagement exercise with patients and the public.  So the commissioners will have a duty to explain why changes at a local hospital might be acceptable, test the proposals from the perspectives of patients and the public and take full account of patient and public views before any decisions are made.  This might make clinically driven change slightly slower in the NHS in future, but it will happen with patients and the public being fully informed and involved at an early stage as opposed to being “consulted” when all the key decisions have already been made in meetings of professionals where the public are excluded.  It should mean that NHS administrators and clinicians who support changes to NHS services will have to work harder to explain why they support changes to these important public services and hence take the public with them.  It should mean that there is a greater chance that clinically necessary change to NHS hospitals is managed consensually with the public rather than in the face of determined public opposition.

38 degree members can feel proud of the changes they help bring about.  They achieved a small but significant step on the road to making NHS decision making more accountable to patients and the public.

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David Lock QC, who was MP for Wyre Forest (Kidderminster) from 1997 to 2001. He was counsel for the Campaign in the Lewisham Hospital case in the High Court and Court of Appeal and was instructed by 38 Degrees to draft amendments to the Care Bill. These are his personal views.

This article was written because some 38 Degrees members were asking for more details about what we achieved with the Hospital Closure Clause campaign. Please comment below with your thoughts.

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Simon Stevens, NHS England: will you meet 38 Degrees members?

May 13th, 2014 by

Back in March, nearly 150,000 38 Degrees members added their names to a petition to Simon Stevens, the new head of NHS England. We called on him to make the NHS more transparent. Now he’s responded. And it’s promising.

The petition called for NHS England to be more open about how decisions about our NHS are made. Especially when it comes to contracts with private companies.

In a statement in May’s board papers, Simon’s said he’s committed to transparency. And he’s agreed to publish, for the first time, top NHS bosses’ meetings with private companies. Here’s the full thing:

“NHS England has set new standards for openness and transparency in all of its operations, compared with what went before. And I’ve set myself and our organisation the goal in everything we do of ‘thinking like a patient, and acting like a taxpayer’. We meet as a board in public, are publicly set goals through a democratically-accountable Mandate, and maintain and publish declarations of interest for all Non-Executive and Executive Directors. NHS England already publishes information on expenses incurred by national directors and we hold a register of gifts and hospitality received. One additional transparency step we will now take – similar to the practices of government departments – is to routinely publish information on the chief executive’s and executive directors’ business meetings with external non-public sector organisations.”

That’s a big step in the right direction. It means we can call out meetings that look dodgy and see – a little more clearly – who’s really influencing NHS policy.

But we still don’t know how his commitments will work in practice. And he hasn’t responded at all to our call not to pay corporate lobbyists to write government policy.

NHS England are front-page news today for another reason – an emerging expenses scandal. So far, they’ve responded by announcing a clampdown on lavish spending, alongside setting a new goal for the whole organisation: “Thinking like a patient, and acting like a taxpayer”.

So let’s make sure Simon Stevens knows what patients and taxpayers want! 38 Degrees members are emailing Simon Stevens in their thousands today to ask him to meet face-to-face with us. Putting our points to him face-to-face could be just what we need to find out where he stands – and give us the chance to tell him how he can protect our NHS. If you’d like to email Simon too, please click here.

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The Finlay amendment to the Care Bill

April 22nd, 2014 by

Baroness Finlay, an influential Crossbench peer has scheduled the following amendment to the Care Bill in the House of Lords:

Lady Finlay to move, that this House do agree with the Commons in their Amendments 40 to 43 and do propose Amendment 41A in consequence thereof:

1.      In section 65DA(1) of the National Health Service Act 2006 (Chapter 5A of Part 2: Objective of trust special administration) omit “objective” and insert “objectives” and omit “is” and insert “are.

2.      After subsection (1)(a) insert—

“(b) the continued provision of such of the services provided for the purposes of the NHS by any affected trust at such level, as the commissioners of those services determine”

3.                  After subsection 1(b) omit “(b)” and insert “(c)”.

4.                  In subsection (2) of that section after “The commissioners” insert “of the trust in special administration and any affected trust”.

5.                  In subsection (4) of that section after “the commissioners” add “of the trust in special administration and any affected trust”.

6.                  In subsection (9) of that section after ““commissioners” means the persons to which the trust provides services under this Act” add “and the commissioners of services at any affected trust”.

7.                  In section 65F insert—

“(2E) Where the administrator is considering recommending taking action in relation to another NHS foundation trust or an NHS trust which may become an affected trust, the administrator shall engage with the commissioners of services at any such NHS foundation trust or NHS trust in order to enable those commissioners to make decisions pursuant to the matters set out in section 65DA”

8.                  In section 65I(1)—

a.           after “action which the administrator recommends that the Secretary of State” insert “or the commissioners of any affected trust”; and

b.           after “should take in relation to the trust” insert “or any affected trust”

9.                  In section 65K add—

“(3) Where the final report contains recommendations for changes to be made to services provided by an affected trust, the commissioners of services at that affected trust shall make a decision within 20 working days whether they wish to undertake public and patient involvement regarding all or any of the recommendations and, if they are so minded, shall comply with any arrangements for patient and public involvement agreed by those commissioners under this Act before making any final decision concerning the said recommendations.”.

10.              In section 65KA add—

“(7) Where the final report contains recommendations for changes to be made to services provided by an affected trust, the commissioners of those services shall make a decision within 20 working days whether they wish to undertake public and patient involvement regarding all or any of the recommendations and, if they are so minded, shall comply with any arrangements for patient and public involvement agreed by those commissioners under this Act before making any final decision concerning the said recommendations”

11.              In section 65KB(1)(d) after “that” insert “to the extent that the report recommends action in relation to the trust in administration”.

12.              In section 65KB(2)(a) after “decision” insert “in relation to any recommendations made the in relation to the trust in administration”.

13.              In section 65O add—

“(4) In this chapter “affected trust” means—

(a) where the trust in question is an NHS trust, another NHS trust, or an NHS foundation trust, which provides goods or services under this Act that would be affected by the action recommended in the draft report; and

(b) where the trust in question is an NHS foundation trust, another NHS foundation trust, or an NHS trust, which provides services under this Act that would be affected by the action recommended in the draft report.

14.              In section 13Q(4) at the end insert “save to the extent required by section 65K(3) or 65KA(7)”.

15.              In section 14Z2(7) at the end insert “save to the extent required by section 65K(3) or 65KA(7)”.

16.              In section 242(6)(b) at the end insert “save to the extent required by section 65K(3) or 65KA(7)”.

 

Posted in 38 Degrees Blog Posts

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Poll Results: Hospital Closure Clause

April 10th, 2014 by

It’s been a few weeks since MPs debated the hospital closure clause. Here’s a quick recap of what happened: Lib Dem MP and former health minister Paul Burstow tabled an amendment which aimed to remove the worst parts of the clause. The amendment was drafted by lawyers funded by 38 Degrees members. But Burstow decided to withdraw his support for the amendment at the last minute after the government offered some concessions.

Since then, the 38 Degrees office team have been speaking to experts to decide how meaningful the government concessions were, and whether Paul Burstow was right not to push for a vote. And it’s worrying news. The government’s concessions did not go far enough.

They committed to consult local people about any proposed hospital closures. They also said that local doctors should be consulted. But lawyers have said that while some of the concessions are a step forward, our hospitals still aren’t safe.

It’s disappointing that we didn’t make as much progress as we hoped. But the hospital closure clause is not law yet. It returns to the House of Lords on the 7th May. So, last week, 38 Degrees members voted to decide our next move.

The results are in! 38 Degrees members have decided that we want to keep campaigning on this issue, and to shout about the fact that no hospital will be safe under the current proposed bill. (The red shows 38 Degrees members who ranked it as their top priority, and green and dark blue show members who support it as an option, and light blue are those who want to stop campaigning on this issue).


So, it looks like we’ll be keeping on campaigning. Watch this space for our next move… more information in the next couple of days.

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Poll Results: March 29th 2014

March 31st, 2014 by

Every week a random (but representative!) sample of 38 Degrees members vote on which issues our movement should prioritise and which campaigns to get behind. Here are the results for March 29th 2014.

The blue represents people answering ‘a lot’ to the question of whether 38 Degrees members should spend time on each issue, the red represents people answering ‘a little’, and the green is ‘not at all’.

Protecting the NHS by stopping the government’s dangerous plans like privatisation and closing A&E departments has come top this week! See here for a campaign to uncover links between NHS England – the body in charge of privatisation contracts in the NHS in England – and big business.

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Poll results: March 22nd 2014

March 24th, 2014 by

Every week a random (but representative!) sample of 38 Degrees members vote on which issues our movement should prioritise and which campaigns to get behind. Here are the results for March 22nd 2014.

The blue represents people answering ‘a lot’ to the question of whether 38 Degrees members should spend time on each issue, the red represents people answering ‘a little’, and the green is ‘not at all’.

Protecting our NHS from privatisation has come top this week! See here for a campaign to uncover links between NHS England – the body in charge of privatisation contracts in the NHS in England – and big business.

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Hospital Closure Clause: what do you think?

March 11th, 2014 by

Late this afternoon, MPs debated the Hospital Closure Clause. Since then, the office team has been trying to work out what to make of how it went. It’s quite complicated, and there’s still quite a lot of analysis to be done.

Here’s some questions 38 Degrees members will need to consider together over the next few days:

- how far has the government moved to meet our concerns?

- the government says the changes needed can be written into guidance which is prepared after the law is passed. Is this true, or do we need to amend the law further when it returns to the House of Lords?

- what other things could we be doing, together, to keep our local hospitals safe?

Please comment below with your thoughts.

Here’s what Paul Burstow MP thinks:

I want to thank 38 Degrees members in my constituency and across the country for raising concerns about the changes the Government was proposing to the way in which a hospital in serious financial or clinical trouble is handled in the NHS.  Trust special administration (TSA) as it is known was introduced by Labour in 2009.  It is a blunt process that should only ever be used in exceptional circumstances.

For me the starting point must be that decisions about the future of local health services are grounded in clinical evidence, supported by local clinicians and drawn up with the active involvement of local people. In the last few days with the support of emails from 38 Degree members to MPs and the 159,000 signatures we have got the Government to make some important concessions.  The amendment played a vital part in getting Ministers attention.

Today Ministers gave Parliament the assurance that everything possible will be done to help any potentially failing hospital to sort out their difficulties so that a TSA is only ever used in rare and extreme circumstances. Following my lobbying Ministers have amended the Bill to strengthen public and patient involvement by the inclusion of local Healthwatch.  In addition local councils are being added for the first time too.  In the Lewisham case the local Council played a vital role in standing up for local people.

Also as a result of today TSAs will have to consult with NHS Trusts and their staff and with commissioners (CCGs) of any affected NHS organisations.  And as a result of the amendment Ministers have conceded that equal weight must be given to views of each involved Trust, staff  and commissioners.  Finally Ministers confirmed in response to my amendment that any TSA plan must have the agreement of ALL relevant commissioners.

When it came to pushing the amendment to the vote I had to make a fine judgement.  Having secured important changes and commitments from the Government I took the view that pushing the amendment to a vote ran the risk of defeat and sacrificing what the Government had offered.

That is not the end of the matter.  A cross party committee of MPs and Peers will be set up to agree the guidance to TSAs.  I will be chairing that Committee and I am keen to engage with 38 Degree members as we draw up the rules to make sure the views of local clinicians and local people are heard.

And here’s a response from Jamie Reed MP, Shadow Health Minister:

I read Paul Burstow’s blog to 38 degrees members and to give him credit he was right about one thing – the amendment certainly got Ministers’ attention. So much so I had Tory MPs coming up to me last night saying that George Osborne was dragged in at the last minute to heed off any potential rebellion in the Commons.

Looking at the voting figures, the real tragedy is that if Paul had pushed our amendment to a vote, and brought with him the Lib-Dems, we could have won that vote last night. Instead only one Lib-Dem ended up voting for Paul Burstow’s amendment. And it wasn’t Paul Burstow.

The truth is no meaningful improvements to the hospital closure clause have been secured and it would be delusional to believe that they had.

But let’s have a look at the “important concessions” the Lib-Dems claim they won.

The first concession is a new job for Paul chairing a committee of MPs and Lords which will look at the guidance on how the legislation will be used in future. I’m not holding my breath.

The second concession is that Healthwatch will have a say in any decisions made. That’s the same Healthwatch who under the Health and Social Care Act is barred from criticising Government policy. And that’s the same Healthwatch who has just had its funding cut by £10m.

The final concession is that the Trust Special Administrator will now have to ‘consult’ with NHS staff affected by the changes, but crucially they will be under no obligation to take their advice, and, unbelievably, they will not be required to consult with local people.

I’m afraid Paul has sold out thousands of people who signed the 38 Degrees petition for some pretty meaningless public relations designed to let Jeremy Hunt get his way and save the face of the Lib-Dems.

We knew this was always likely to be the case.

The truth is that – from the widely hated Heath & Social Care Act onwards – the Lib-Dems have enabled the Conservative Party’s vandalism of the NHS. 38 Degrees members came under attack from Conservative MPs during yesterday’s debate – and not for the first time. Let’s not forget it was your donations that paid for the legal advice that drafted the amendment that Paul refused to push to a vote.

Instead it was left to Labour to ensure that the voices of the 159,000 petition signatories – and millions more in the country at large – were heard in Parliament.

Reading Paul’s justification for his actions, I was reminded of Ricky Gervais’ David Brent character breaking the news of redundancies to his staff after promising them there would be none: “The bad news is there will be redundancies. The good news is, I’ve been promoted…”

But it’s not all bad news. It turns out that the job offered to Paul in the chamber of the House of Commons in return for not moving the amendment is not remunerated. That’s bad luck – at least Judas was paid.

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