It has taken me a long time to write this post for two reasons.
Firstly, it seemed too political in a health crisis.
And also it was always going to be a dispiriting read for people who frankly don’t deserve to be further dispirited! So I procrastinated.
However, I do firmly believe that scrutiny and challenge must still exist, despite the perilous position that the UK remains in over Covid-19.
It appears that things may have moved on since the meeting as on Wednesday it was announced that NHS Trusts across Devon will have almost £180m of debt eradicated as part of the Government’s plans to help tackle the coronavirus outbreak.
(I am seeking further clarification on this from Devon Clinical Commissioning Group).
The move is many years overdue. And although helpful, I don’t believe it is enough to avoid major service cuts.
So here it is: The situation as of 12 March 2020……………..
Councillors voted down my proposal to ask the government to suspend the requirement for Devon’s NHS to make hundreds of millions of savings, until after the end of the Covid-19 outbreak.
I made the proposal at the last Devon County Council’s Health and Adult Care Scrutiny Committee on 12 March, following a presentation from the Sustainability and Transformation Plan’s chief executive, Philippa Slinger.
The NHS in Devon must make reductions of over £400m by 2024, in order to break even.
A similar amount was cut in previous years, but unfortunately the local NHS has found itself in the similar, or possibly slightly worse financial position.
Here’s the detailed background:
Ms Slinger told councillors on 12 March that to make the funding cuts, there were plans for the following:
- A reduction in agency staff
- More efficiency relating to the number of surgical procedures
- Reducing hospital lengths of stay
- Fewer admissions
- Reducing overnight stays after surgery
- Capping referrals
- Trying to source less expensive pharmaceuticals
- Reducing the cost of procurement, such as replacement hips
- Reducing the number of outpatient appointments by between 60 and 70 per cent
- Doing less work in the independent sector
- Reducing overseas recruitment
- Improving staff retention
- E-consultations in primary care (GP surgeries)
There are also plans to reduce the number of hospital beds further.
I said I was sceptical about whether the savings could be made as we had been here before and there were reasons why people couldn’t be discharged from hospital in a timely manner (not enough paid care workers), why there were so many agency staff (because there were shortages in almost every discipline) and so on…
I said I was concerned that the NHS needed more funding than ever to cope with Covid-19 and I made a proposal that the committee ask the government to suspend the requirement on Devon’s NHS to make the cut until after the end of the epidemic.
But the chair asked me what cuts I was talking about because she hadn’t heard anything about cuts.
I elaborated. But then a number of councillors also said they hadn’t heard anything about cuts either.
Philippa Slinger agreed. She said that she had not been talking about cuts. She was referring to service improvements and service changes.
I suggested that this was semantics and many people would consider much of the above list would look a lot like cuts!
I found this all very odd indeed.
There was then a proposal from the chair, Sara Randall Johnson, that we simply bring the item back to scrutiny in September or November.
I reminded her I already had a proposal on the table.
Some wrangling ensued.
Eventually a vote was taken and I had just one supporter – my independent colleague, Martin Shaw.
There was heckling from the Save Our Hospitals campaign group at the back of the room as the agenda item ended.
You can view Ms Slinger’s presentation and watch the debate from this link. It’s agenda item 7. https://devoncc.public-i.tv/core/portal/webcast_interactive/455423
Photo with thanks to Save Our Hospitals