Since November 15th`s very well attended public meeting on Tewkesbury`s proposed new hospital, NHS Gloucestershire (NHSG), who refused to attend the meeting, have been keen to defend their plans through their preferred mode of communication – the Gloucestershire Echo!

The primary concern of those attending the meeting was that the new hospital would have only 20 beds instead of the existing hospital`s 48 beds, i.e. a reduction of 58%.
In 2003 there was an attempt by NHSG to save money by closing one of the hospital`s two wards which eventually resulted in a climbdown after 10,000 petition signatures opposing the move were collected and 3,000 people marched through the town. If the new hospital is built, £10 million of taxpayers` money will have been spent on achieving a similar reduction in bed capacity.

Back in March 2009 the Strategic Outline Case (SOC) for the new hospital made it clear that the “best value For money” would be obtained through:

“public capital financing the PCT (Primary Care Trust) development of a fully integrated Community Hospital and 3 combined GP surgeries”

Even at that time the SOC spelled out that the money spent on a new hospital would require savings to be made elsewhere. Under the heading “Financial Impact” it explained that:

“Whatever the financing route and ownership structure selected, revenue affordability needs to take account of increased costs associated with new buildings. The PbC (Practice based Commissioning) Cluster will need to deliver savings from reduced acute admissions and by provision of new models of care to support this development and redevelopment of joint GP premises.”

So clinical decisions have to be modified to save money!
Since March 2009 the financial situation has deteriorated, and in May this year at the “Gloucestershire Health Debate” held in Cheltenham, NHSG Chief Executive Jan Stubbings revealed that the share of national cuts in NHS funding that will fall on Gloucestershire is between £150 and £200m.
In August this year the Full Business Case (FBC) spelled out the current funding situation for the new hospital:

“The first OBC (Outline Business Case) also assumed availability of NHS public capital funding which is no longer available within the foreseeable future or within the projected timescales for this project, and so alternative funding options have been appraised.”

The FBC explained that private funding would come with strings attached. Specifically, any funders/developers who agreed to undertake this project would:

“require a contract to enter into a lease for a minimum of 25 years.”

We now have a situation where instead of public capital financing the PCT development, we have more expensive private funding and development, and instead of a fully integrated Community Hospital and 3 combined GP surgeries we have two separate buildings!

In sharp contrast to the reality revealed by the FBC, NHS Gloucestershire’s locality commissioning director Sarah Hughes was quoted in the Echo as having said that:

“We are very confident of securing the necessary funding for the new NHS hospital and we are exploring both public and private funding options, neither of which involve a PFI-type scheme.”

Ms. Hughes was also similarly misleading over the nature of the community services that will be provided both inside and outside the hospital under NHS Gloucestershire`s plans for a “Social Enterprise Trust” which were delayed by the legal challenge which is still ongoing. She claimed:

“Services provided in the community and the community hospital will continue to be NHS services, free at the point of delivery.”

The reality is that the replacement for the Primary Care Trust (NHS Gloucestershire) is Gloucestershire Care Services Community Interest Company (GCS-CIC), which is NOT part of the NHS, but actually a private organisation registered at Companies House. Staff & services will leave the NHS, services will be more fragmented and a national service undermined.

Use of the NHS name and logo to mask creeping privatisation
No doubt GCS-CIC will continue to use the NHS logo. Use of the NHS name and logo by private health organisations has been allowed since early 2007 when Independent Sector (i.e. private!) Treatment Centres were allowed to call themselves NHS Treatment Centres!  The creation of Social Enterprise Trusts like GCS-CIC and their vulnerability to takeover by profit-seeking corporations after 3 years will help to realise the vision outlined in July 2000 by Dr Tim Evans of the influential right-wing think tank, the Adam Smith Institute. In the interview he gave Evans said that his vision was that the NHS would be just “a kitemark attached to the institutions and activities of a system of purely private providers”. In January this year on Radio 4`s Today programme, Eamonn Butler, the Director of the Adam Smith Institute was asked if he thought the NHS was really going to become “a mere franchise”. Butler replied, quite casually, “It’s been 20 years in the planning. I think they’ll do it.”.
In 2004 the Independent published a story that then Shadow Chancellor Oliver Letwin reportedly told a private meeting that the “NHS will not exist” within five years of a Conservative election victory. Letwin said the health service would instead be a “funding stream handing out money to pay people where they want to go for their healthcare”, according to a member of the audience. Some of that “funding stream” will no doubt continue to go to Care UK for instance, which in 2009 was already receiving 96 per cent of its UK business (amounting to more than £400 million) from the NHS. In November 2009, John Nash, the chairman of Care UK, gave £21,000 to fund then Shadow Health Secretary Andrew Lansley’s personal office.
Despite all the disturbing developments going on behind the scenes, with services either provided by for-profit corporations (whose commercial interests rest on being able to minimise the quantity and quality of care) or by likely short-lived Social Enterprise Trusts who have to produce a surplus, we are sure to hear politicians and careerists inside the NHS reassuring us with a close variant of the dishonest mantra parroted by Ms. Hughes.