Two weeks ago I wrote about a reorganisation to our health service which has emerged with a whimper rather than a bang. Known as Sustainability and Transformation Plans (STP) these have created new strategic organisations that will coordinate health care. They are formed using the building block of the Clinical Commissioning Groups (CCG), and there are 44 of them across England and Wales. If I have understood this correctly, the CCG replaces the Primary Care Trust and the STP replaces the Regional Health Authority. On Wednesday the Labour Party organised an opposition day debate on the STPs which appears to have been a bad tempered affair. However there were some important statements (or as I prefer to call them lies) made.
Diane Abbot opening proceedings and throughout her speech on the theme of a lack of transparency over this reform, Tory ex Health Minister, Simon Burns constantly tried to interrupt. However Abbot refused to let him speak. Then Tory Health Minister Philip Dunne responded to the debate and he allowed Burns to speak who simply wanted to explain how Abbot was wrong to suggest there had been no failures to communicate. Dunne then went on (the underlined sections are my own):
“I am grateful to my right hon. Friend, who has a great deal of experience in this area, having served in the Department for many years. He has pre-empted what I am about to say, which is that all the STPs will be subject to full and appropriate public consultation once we are in a position to do that. As part of its annual planning round in 2015, NHS England published planning guidance last December—nine months ago—calling for clinical commissioning groups to come together with their providers across entire health economies to develop a collective strategy for addressing the challenges in their area. Those are the sustainability and transformation plans. There are 44 areas, which were agreed six months ago in March. They cover the whole of England, bringing together multiple commissioners and providers in a unique exercise in collaboration. Their geographies have been determined not by central diktat but by what commissioners and providers felt made the most sense locally. Each area has also identified a strong senior leader who has agreed to chair and lead the STP process on behalf of their peers. They are well respected, credible figures in their local health economies, and we and NHS England are committed to supporting them to bring people together to agree a shared plan for how best to improve and sustain health services for their local populations. Local authorities, too, are fully engaged in the development of the plans.”
It might be assumed from this statement that the 44 areas will make sense to local residents and therefore we don’t need to be consulted. The footprint for the Sussex STP is shown above. It includes a small part of Surrey which is hard to understand and it does not take into account locations such as Tunbridge Wells were many Sussex residents go for their hospital treatment. As I wrote previously, wherever boundary lines are drawn, the people on either side of the line risk being badly served. Unless residents are included in deciding how the boundaries are drawn on the map, those near boundaries will have no confidence in them at all. This emerged from comments made by Maria Caulfield, Conservative MP for Lewes who also pointed out some additional problems with the process:
“Does my hon. Friend agree that if staff, whether nurses, doctors, physios or pharmacists, had been involved right from the start of the process, that would have helped staff morale in the NHS, which is struggling, and that they probably have the best ideas of anyone as to how the STPs could progress?”
she later said
“Before I start, I wish to declare an interest as a registered nurse. I welcome this debate this afternoon as STPs are a really important issue and, as many Members have said, they have a huge potential to transform care at a local level, bringing in social care and third sector organisations. They represent a huge opportunity, and not one that we want to get wrong. However, because many of these 44 STPs have not shared or consulted on their plans, there is a suspicion, rightly or wrongly, that they are an excuse to bring in cuts or to bridge financial deficits. I would welcome the Minister’s thoughts on this, and a signal that consultation will happen. That consultation is not happening at the moment, which is part of the problem. It enables those who want to perpetrate this myth and this fear that this is all about cuts to have some breathing space. My area, which falls into the Sussex and East Surrey STP, has not published its STP. Although it makes great claims to be working with hospitals, clinical commissioning groups, local councils, GPs and HealthWatch, no one I know, and certainly no local MPs, has been involved in discussions about the process. I am very disappointed that some of our key community groups in Lewes and Seaford, such as our senior forums, Families for Autism and many other groups have not been consulted. My constituency does not have a hospital. We depend on either the Royal Sussex county hospital in Brighton or Eastbourne district general hospital.”
The two hospitals mentioned fall within the Sussex STP which is good news for Maria’s constituents, but many in the neighbouring Wealden constituency look to Tunbridge Wells and risk being badly served by the Sussex STP. The STP plans need to be halted and even reversed whilst communities are consulted, not just on the priorities within them but also on their format. Sadly all of the Conservative MPs including Maria voted against the motion proposed which would have at least caused the Government to consider its approach. Once again the liars have won the day!