Not In My Name

Yesterday our media was full of secret plans to merge NHS services, to close A&E Departments, to merge stroke and maternity services and to even close some hospitals (1). What was most shocking about these plans were that they were all drawn up in secret. The managers tasked with drawing them up were told by NHS England not to release them to the public, even to deny any freedom of information requests (1).

The NHS has to find £22 billion in “efficiency savings” by 2010/1 (2), but calling them “efficiency saving” is a lie. All the big efficiency savings were found years ago, these are cuts. The government is demanding that the NHS give back £22 billion, money that will be cut from the NHS’s yearly funding, and the only way to achieve this is to cut services.

NHS England tasked managers of the 44 regions throughout English to draw up Sustainability and Transformation Plans (STPs), but to draw them up in secret. These STPs are the plans to save money in these different regions. Their proposals include:

• The North Tees to centralise specialist services, including A&E, on two sites. It would lead to services being downgraded at one of the three major hospitals in the area.
•  In Devon bosses are looking at whether to close some A&E, maternity and stroke services at hospitals across the county so they can be centralised at bigger sites.
•   In Merseyside there has been talk of merging four hospitals - the Royal Liverpool, Broadgreen, Aintree and Liverpool Women's - to plug a £1bn shortfall, according to leaked documents.
• Plans in Birmingham and Solihull involve reorganising maternity services with fears this could result in fewer units.
• Bosses at North Central London have talked about a consolidation of services on fewer sites (1).

These STPs were exposed by a Kings Fund report (3) and their findings make for uncomfortable reading. These STPs were forced “Top Down” from NHS England, were carried out in secret and did not involve any healthcare professionals or members of the public. Nobody who actually runs and manages these services were consulted, neither were anyone who uses these services. These plans propose huge changes and upheavals to local health services and yet there were all drawn up in secret, healthcare professionals and patients were not consulted.

What is most shocking about this report is the lack of involvement of anyone but the senior managers carrying out the STPs. GP, local councils, clinicians and patients were not involved in this process, the people who provide these services and the people who use these services were not consulted. One person, who was interviewed by the Kings Fund for their report, described STP meetings as: “I’ve been in meetings where I’ve felt a little bit like, you know, where are the real people in this?” (4)

As a nurse, as a clinician who provides healthcare services, I am disgusted that plans have been drawn up to cut services without consulting the people who actually run these services. As person who also uses NHS services, I am angry that plans have been drawn up to cut and close NHS services without consulting the people who actually used these services and need these services. Once an NHS service had been downgraded or closed it is nearly impossible to get those services back. Closed hospitals do not get re-opened. A&E services that have been downgraded to Minor Injuries Units do not get turned back into A&E Departments. Once a service has been “centralised” it never returns to its local buildings.

What has Jeremy Hunt said about these STPs? He says they are “vital” (5). Yet these cuts are only to save money, only to enable this government to cut NHS funding, they are not to benefit patient care.

But who is concerned about what is happening to our NHS? This all was front page news yesterday but today it had almost been forgotten about by our media, they are now wrapped in a leaked memo that Theresa May is clueless about how to organise Brexit (6). Again NHS funding is being cut by this government and there is barely a ripple in our country.

Not in my name. These NHS cuts are not in my name. I was not consulted about them, no one informed me about them (Until the Kings Fund published their report (4)), and I will not stay quiet about them. We need to make as much noise as possible before they rip our NHS apart.

Drew Payne