An Open Letter to the Board of NHS Gloucestershire

The following open letter has been sent by Cheltenham Against Cuts to the Chief Executive (Jan Stubbings) and Chair (Ruth FitzJohn) of NHS Gloucestershire, and to the local press. Cheltenham Against Cuts urges members of the public, in particular health workers, to write similar letters to the Primary Care Trust (i.e. NHS Gloucestershire) and their elected representatives, making their views known.

Letters can be sent via email to or in the post to Jan Stubbings, Chief Executive, NHS Gloucestershire, Sanger House, 5220 Valiant Court, Gloucester Business Park, Brockworth, Gloucester, GL3 4FE
The email address of Ruth FitzJohn is

You may also want to send copies to the non-executive directors who make up the board:

Dear Jan Stubbings,

An Open Letter regarding Keeping Gloucestershire’s NHS Public
We are writing to appeal to you to halt the proposed transfer of Gloucestershire’s NHS Community Services out of the NHS and into a “social enterprise”. On behalf of the residents of Gloucestershire we urge you to instead choose one of the options still open to you to keep these services (including nearly 4000 staff and nine hospitals) within the NHS.
We know from the level of support the campaign has received that once they understand the full implications of the transfer out of the NHS the overwhelming majority of patients, staff and residents want our health services to remain within the NHS. There is an outcry about the failure to consult or even inform the public about the plans, which reveals the truth behind the spin that these plans are “patient led” or will increase “staff ownership”.
We have seen no good arguments for transferring services out of the NHS into a social enterprise, and much cause for concern. If transferred the services will be owned by a private company (a so called Community Interest Company- CIC), required to turn a profit and forced to cut corners in patient care to do so. As a private non-NHS body it will be saddled with extra VAT and substantial extra costs for administrative functions that were previously provided centrally by the NHS.
It will no longer be publicly owned or accountable and the public will have little right of redress if problems occur. Within three years – or much sooner, if services are judged to be failing – services will be opened up to the possibility of a private sector takeover. In Hull, within three months of transfer to a CIC private companies were invited in to cherry pick and take over clinics that were perceived to be failing. Cut loose from the NHS family our health services will no longer be able to draw on NHS expertise, funding reserves, purchasing power and economies of scale. They will be far more vulnerable to takeover by multi-national companies in the future, particularly in the light of changes proposed in the Health and Social Care Bill. We actually have direct evidence of this: in the first test of this policy, Central Surrey Health lost its bid for contracts for community services to a private healthcare company owned by Virgin.
We know staff are proud to work for the NHS and are angry that they were not given a proper say in this proposal. Time and again we have heard staff say that hardly anyone supports this transfer. Consequently we believe that skilled frontline staff will leave (indeed, are already doing so), placing our local services at risk.
The lack of community engagement means that the proposed CIC cannot possibly succeed against such a widely and deeply felt level of opposition. Few here want this and we suspect that this is your own view also.
Therefore we hope you will concede the clear legal advice as highlighted in the recently issued judicial review which is that you can legally keep services in the NHS and you do not have to open the services up to private sector competition. For instance it would be possible to set up a new NHS trust. There is no legal barrier to this; it would be a matter of Department of Health approval. What you cannot do is just hand NHS services over to a non-NHS body like a CIC without considering matters in a proper and lawful manner. Nor can you truthfully claim that the CIC is the only option and there are no NHS options available, when it is quite clear that in many other areas in England other PCTs have chosen to place these services in existing trusts or newly created trusts and have not considered a CIC to be appropriate. We are very concerned that staff have been given inaccurate information on this matter and hope you will rectify this. Were the legal case to succeed, you will be required to reconsider your decision and we are quite clear that these NHS options will still be open to you. It is only if you deliberately choose to pursue the CIC option that you will have to consider open competition.
We therefore urge you to stop all the uncertainty for staff and patients and accept that the best solution for community services in Gloucestershire lies within the NHS, thus avoiding the need for continuing legal argument and expense.

Yours sincerely,
Cheltenham Against Cuts


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