How “Reforms” Hit a Local Hospital – The View from Weston

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April 10, 2014 by Protect Our NHS

Weston General Hospital
The Government has decided that all hospitals must become Foundation Trusts, with the stated aim of creating greater independence and more accountability to local people. However, Weston General Hospital (WGH), is one of the smallest Health Trusts in the country, is too small to stand alone, especially as it is in chronic financial difficulty.

Funding problems

Weston has been underfunded for many decades. The Medical Director of WGH in the 1980s used to complain of underfunding. In the 1990s local GPs formed a Locality Commissioning Group, a voluntary and minimally funded response to Practice Fund-holding, and their first act as a Commissioning Group was to investigate the level of funding for our area. It was found that local funding was well down on the Bristol area average. The Health Authority sent an accountant in to look at the figures in more detail. His conclusion was that the area, including Weston Hospital, was about £3 million a year short of what would be expected.

Year after year of a £3 million funding deficit is bound to have a profound effect on health services in the area. In 2014 it is £5 million in debt. The old Primary Care Trust used to cover this debt, but the new Clinical Commissioning Group cannot do this.

So Weston has a problem – and the idea put forward is that it should be sold to a private concern who will make a profit from it. The logic of this line of reasoning is not immediately apparent to the innocent bystander, but the reason given is that private corporations will run the hospital more efficiently. No evidence has been put forward to substantiate this claim.

Bed Ratio Problems

Weston General Hospital has between 249 and 320 beds. Why the range? It seems to be because 320 is the maximum and 249 is the amount actually in current use.

It serves a population of 212,000 locals, but each summer Weston gets 2.5-3.3 million day trippers, and 375,000 staying visitors. If they all stay one or two weeks, that adds 7-14,000 spread over the year, which means we are serving around 222,000 people. Last April/May we know that it was operating at capacity.

So the WGH bed ratio is between 1.12 and 1.5 beds per 1,000 population. The hospital authorities claim a bed ratio of 1.99 per 1,000, but this is obtained by leaving out visitors. And now the local paper runs a report in which the Hospital chief executive announces he can save £1m by cutting or mothballing up to 40 more beds.

We find here from World Bank statistics that the UK average bed ratio is 3 beds per 1,000 population, and the numbers are getting worse year on year.
The UK also has a worse bed ratio than Lithuania.

Therefore WGH is both underfunded and overloaded. The hospital needs a thorough review of its funding and workload. It needs its debt written off and a better financial deal. It needs many other reforms, across the board.

The last thing that WGH needs is to be sold off to a private healthcare corporation, either as a whole or in part. It needs to be linked up once again with the Bristol hospitals, but this time with adequate funding.

All NHS Trusts are required to achieve Foundation status by April 2014. Clearly this has not happened here. Foundations are more independent of the NHS, and are supposed to be more responsive to the local community. Weston Area Health NHS Trust, as a standalone entity, is unable to satisfy the financial requirements required to achieve Foundation status. Therefore it must find a partner, either an NHS Foundation, or a private health corporation, who will take on a “franchise” for the services, or a social enterprise.

Capita, Serco, Interserve Developments, Circle and Care UK are the corporations who are interested. NHS Trusts in Bristol, Taunton and elsewhere are interested. One Social Enterprise group is interested.

CCG Chair Conflict of Interest

Kathy Headdon, who is chair of the local North Somerset Clinical Commissioning Group and also chair of the Stakeholder and Quality Control Group, is also a consultant to Capita Symonds, which is part of one of the corporations who are interested in the franchise. The local Protect our NHS group have complained about this conflict of interest, which is so blatant that even a Bristol Conservative MP has remarked on it. However, the CCG have defended her position. The ProNHS group is therefore consulting with lawyers with a view to taking formal legal action.

Lack of Public Consultation

In their Project Initiation Document, the Project Initiation Board is required to
“Meet Secretary of State 4 tests in relation to service reconfigurations:
o clinical evidence base underpinning the proposals
o GP commissioner support
o promoting patient choice
o patient/public involvement”

The contention of the ProNHS group is that involvement of the public and patients in the process has been minimal to non-existent. The Project Board claims that it will consult when the Outline Business Case has been given the go-ahead by the Department of Health. The ProNHS group believes that the public should have been consulted at an earlier stage. This matter is also subject to legal consultation.

The local opposition in Weston is co-ordinated by Protect our NHS and includes Trades Union members and members of the local Green Party, Labour Party and Liberal Democrat Party.

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