JAMES KILLDARE, our health correspondent, reports on a worrying report, much of it due to be discussed in secret at the Town Hall tonight, where wide-ranging cuts are expected to be suggested
You might do well to give a miss to tonight’s coverage on the interweb of the council’s health scrutiny committee – it could see your blood pressure rising to dangerous levels.
Councillors will try to quiz GPs and health managers who are responsible for Croydon’s NHS commissioning, in particular about how much healthcare in the borough is about to undergo some serious surgery.
The most grizzly bits will be revealed only in private, with our local councillors sworn to secrecy about the plans for healthcare reductions.
If the cuts to be proposed go ahead, then NHS services in this part of London will probably need treatment in intensive care, with the closure of one of the area’s hospitals again under serious consideration.
There’s no sense of irony in the official, public report from Paula Swann, the chief officer of the Croydon Clinical Commissioning Group, and Mike Sexton, the CCG’s chief financial officer, when they state that, “the CCG are accountable to the public, communities and patients the CCG serve”.
Because there is only a very thin paper made available to the public.
The gory details of the coming health cuts will only be discussed in secret session at tonight’s committee.
Accountability of an already publicity shy organisation of GPs, who are unused and uncomfortable about being questioned in public, has been further compromised by the recently announced resignation of Croydon Healthwatch’s chief executive Charlie Ladyman.
Ladyman has not given any official reason for her departure after just 18 months in post, though it seems likely to be linked to watchdog Healthwatch losing its funding.
Croydon Healthwatch was set up after the abolition of Local Involvement Networks (LINks) by the Tory-led coalition government, to hold the local NHS to account. But after receiving £200,000 in each of its first two years of existence, Healthwatch has suffered gradual and sustained cuts ever since, as the local council has shared around its grant reductions from government.
“Healthwatch funding is due to dry up in September 2017, with no central government commitment of any more funding,” a source has revealed.
No one has made clear who will be there to represent patients and health service users if Croydon Healthwatch ceases to operate in 12 months’ time.
What is clear from the public papers made available to the councillors ahead of tonight’s meeting is that the GPs running the financing of that part of Croydon’s NHS, that does not include their own practices, are facing a real crisis as their CCG organisation joined Mayday Hospital in the sin bin of being in “special measures”.
No one has resigned at the Croydon CCG to accept accountability.
The GP website reports what the consequences might be: “Inadequate CCGs will be required to implement an improvement plan under legal directions from NHS England. CCGs could be required to cease performing particular functions, or have their accountable officer replaced.
“Other measures could include adjusting a CCG’s area and membership practices, disbanding the CCG, requiring groups to share management, or the creation of an accountable care organisation to take on responsibility for the local population’s healthcare.”
The report to councillors states that “significant service changes” will be required. You don’t need to be Alan Turing to decode that as meaning “significant” cuts for an organisation which ran out of “efficiency savings” some time ago.
The report confirms that few further savings can be found just from QIPP: the acronym for Quality, Innovation, Productivity and Prevention, an opaque way of saying efficiency savings.
Better joint working practices might yield more “efficiencies”, and that sees the dark shadow of a hospital closure being cast over this part of south London. NHS managers have been looking at the possible closure of St Helier Hospital for two decades, with that possibility raised previously by something called the South West London Sustainability and Transformation Plan.
But with Inside Croydon being told by a leading local GP of a “ruthless” approach being taken by the CCG, cuts to medical care are on the cards for Croydon’s residents.
Enforcing compliance to existing treatment policies will see patient care ended abruptly. The CCG will try to stop patients going to places of medical excellence outside Croydon – for example, potentially stopping cancer patients electing to seek expert advice from consultants at the Royal Marsden.
And some kinds of medicine may be stopped altogether, though our GPs and council do not trust the public sufficiently to share with them what treatments are likely to be surgically removed, because those details are all hidden away in the secret, Part B of the report to tonight’s committee.
The CCG says that there are 398,000 prospective patients in the borough.
A growing Croydon population with inadequate funding is one of the problems that the local NHS faces.
It seems that Croydon’s health services have been chronically underfunded for years. Government figures showed that in 2013, annual funding fell short by 10.4 per cent of budget, or £46 million. These underfunding rates accumulate every year, further compromising medical care for Croydon people. Over four years the underfunding comes to £138.8 million. The funding gap has been closed this year, down to £18 million less than what it needs to spend, and the government says that’s close enough to what Croydon should get and so it will not provide any further cash.
What this all adds up to is that each and every Croydon resident has been denied £348.74 of medical care over four years.
And in addition to the savings that Mayday Hospital has to find under its own “special measures” regime, the CCG has got to find an extra £5.7 million savings as well as the £18.4 million it was trying to save this year.
With 40 per cent of the CCG’s spending going to Mayday, it seems likely that in addition to the cuts they already have planned, they will need to find more than £9 million-worth of further savings to pass to the CCG.
With Croydon’s health services facing a slow death by a thousand cuts, the time has long since past when the borough’s politicians need to do more than just conduct-data scraping petitions expressing the desire to “save” the local NHS?
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