JAMES KILLDARE, our health correspondent, on the latest step towards the privatisation of health service provision through the erosive withdrawal of NHS services
Having already made the decision to close the women’s mental health facility at Foxley Lane as part of the additional £5 million-worth of cuts inflicted on the area by NHS England, today Croydon’s Clinical Commissioning Group, together with South London and Maudsley NHS Foundation Trust (which glories in the acronym of SLaM), announced that they are consulting the public to provide themselves with a chimera consensus and approval for the closure.
Inside Croydon was the first to report last month on how Croydon residents are to be subjected to a postcode lottery of health care provision, where the booby prizes are closed beds, axed services and another round of millions of pounds’ worth of Tory cuts.
Croydon’s main hospital, Mayday, and the Croydon CCG – clinical commissioning group, the body which manages funding for the area’s GPs – have both been placed on special measures by NHS England for over-spending. This is “over-spending” in an NHS administered by Tory health minister Jeremy Hunt where, according to the CCG’s latest report to the Croydon Council, “Funding for healthcare in Croydon for 2016/17 reflects underfunding of -3.71% circa £18m.”
Among the treatments to be cut, therefore, is IVF fertility treatment; older patients requiring orthopaedic treatment will be provided with cheaper, less long-lasting equipment; milk will no longer be prescribed for any infants growing up in Croydon; and Foxley Lane’s eight-bed in-patient facility for women with mental health issues is to be closed.
According to the report submitted to Croydon Council’s health scrutiny committee a fortnight ago, “Foxley Lane has formed part of the acute care pathway for acute in-patient services since October 2010… The service is run by women for women on a day-to-day basis and has a male consultant who visits the unit for clinical review meetings. It was initially set up as a dedicated crisis facility for women in Croydon…
“Comparable services are not provided in any other of the four boroughs that SLaM serves.”
Note that: Foxley Lane is the only women-only in-patient mental health facility in Croydon, Lambeth, Southwark or Lewisham.
The report also states: “Foxley Lane provides assessment, treatment and care to people who are in a position to recognise the signs of their own deteriorating mental illness and are able to request the service themselves…
“Admissions to Foxley Lane are typically complex and multi-factorial and would not meet the threshold for a mainstream respite episode. The most comparable service is the Drayton Park Women’s Crisis House (Camden and Islington). No other SLAM facility operates as a dedicated crisis service.”
Such a facility may be used by women suffering a mental health crisis, potentially due to abuse. At Drayton Park, where mothers who are admitted are sometimes allowed to bring their children with them, they say, “Women report that having access to a women-only environment greatly enhances their ability to feel safe at a time they are feeling unsafe. They also state that having women to talk to allows them to speak of past or current experiences of abuse”.
Here in south London, our NHS can no longer afford to provide such in-patient respite care, apparently, and so the Croydon CCG has justified its decision to close Foxley Lane on the grounds that they can try to provide mental health treatment in the community. Largely on the grounds that it will cost less.
In a press release today, the Croydon CCG stated: “The local NHS aims to reduce the reliance on in-patient services as mental health specialists and patients agree that supporting people near to where they live is the most effective way of helping people to get better quicker.”
Croydon CCG says that since 2014 it has spent (they refer to it as “invested”), “more than £9million to improve access to mental health services and develop community care services so that patients can be treated in their own homes and communities”.
They also state: “The local NHS is proposing to close the services currently provided at Foxley Lane so that they are provided as individual care packages in people’s homes by a range of community mental health services in the future.”
None of this is really about providing a better service, or treating more people who might need such help. After all, why else would Dr Hugh Jones, SLaM’s clinical director, say: “Foxley Lane is valued by the women who have been treated there and the service receives very positive patient feedback”?
It is all about cost-cutting and doing it on the cheap. As the CCG press release states, “Last year 55 women were treated at Foxley Lane. By treating patients in the community rather than at Foxley Lane the local NHS could save over £500,000 a year.”
Dr Tony Brzezicki, the clinical chair of NHS Croydon CCG, underlines that point. He said: “This proposal is about making sure that people in Croydon receive the right care, in the right place at the right time for the money that is available.”
“For the money that is available”. This indicates that this is an NHS closure that would not be happening if it was not for the additional budget cuts that have been imposed by the Department of Health.
“The NHS in Croydon has to find savings of millions of pounds over the next few years,” Dr Brizezicki said. “This has meant that local GPs have had to assess every service the local NHS provides and the benefits of them to our service users.”
The physicians given the shitty task of deciding which services to cease providing under the NHS in Croydon are quite clear: “Because of the relatively small number of women who are treated there it is no longer sustainable or value for money for the NHS given the limited resources we have for local healthcare,” Dr Jones said.
Nothing in the press release today mentions any income from a possible sale of the Foxley Lane property. Large houses in that part of Purley typically sell for between £800,000 and £1.2 million. So there may be an additional budget benefit for Croydon CCG down the line if they close the Foxley Lane facility.
But with the fate of Foxley Lane as a mental health refuge already decided, the CCG has now begun a “consultation” process. “It is vital that the future of the service is informed by the people who use the service and their carers and families, and over the coming weeks we will be asking local people to have their say.” Yeah, yeah, yeah…
What they call “the engagement period” runs until January 6. “Following this, NHS Croydon Clinical Commissioning Group will consider the feedback gained from local people at a meeting in public of their Governing Body early next year.”
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