By Ajanta Silva
Hundreds of patients, hospital workers and members of the public recently demonstrated in Poole against the slashing of health services in the county of Dorset, England. The rally was called by the Keep Our NHS Public (KONP) organisation.
This followed a protest by thousands of people and hospital staff who marched against the closure of the Kingfisher ward and Special Care Baby Unit at Dorset County Hospital this summer.
Tens of thousands of people have given their verdict on proposals by Dorset Clinical Commissioning Group (CCG) to gut public health services by signing petitions opposing them and taking part in protests.
Dorset CCG, which faces an annual £158 million deficit by 2021 due to Conservative government National Health Service (NHS) funding cuts, revealed its plans in a recently published “Clinical Services Review” (CSR). It aims to downsize two major Accident and Emergency (A&E) departments in Poole and Dorchester and close children units, maternity units and more than a half dozen community hospitals delivering inpatient care.
Thirteen community hospitals, which mainly operate as rehabilitation units and significantly lessen the pressure on acute hospitals, are going to be replaced with a handful of “Community Hubs,” many without beds. According to the CSR, three community hospitals—St. Leonards, Alderney and Westhaven—will shut and the sites will be used for “other purposes.”
Dorset CCG is carrying out a simultaneous review of mental health services called “Mental Health Acute Pathway” and “Primary Care Strategy” for General Practices (GPs, doctors’ surgeries). One can expect nothing but a further destruction of services from these. Mental health services will see attacks on what remains of the scarce facilities in the county, following the closure of Kings Park Hospital mental health unit in Bournemouth and the Chalbury Unit for highly specialised dementia needs in Weymouth. Shutting Alderney Community Hospital will also threaten two mental health wards.
The GP review takes place under conditions in which GP services are being slashed nationally. Last month, a leaked NHS England letter revealed the government wants struggling GP surgeries to be allowed to fail and “wither by the system.” At the same time, a pilot Uber-style private GP service, Doctaly, is to be rolled out nationally
Dorset’s population of more than 750,000 are going to lose hundreds of inpatient beds, despite acute hospitals already being overwhelmed with high inpatient volumes. Hospitals are already struggling due to lack of beds, staff shortages and scarce resources.
These devastating proposals, hatched behind closed doors over the last two years, are to undergo a bogus 12 weeks “public consultation” exercise in November before being implemented early next year. The CCG has already despatched its public relations agents to sell the proposals to NHS workers, with some meetings being held with the tacit support of the trade unions. The AGM of the Royal College of Nursing (RCN) Dorset branch, held in Bournemouth Hospital last month, featured a guest CCG speaker brought in to “explain” the plans.
The CCG’s promise to improve community integrated services is lip service, as the scrapping of community palliative services in Poole and Bournemouth has vastly increased the workloads of already shrunken district nursing teams and other community intermediate teams. Their claim to have “more care home beds in community” is equally a fraud, as such facilities do not exist and there are no concrete proposals to build them in the CSR. They expect nothing but having beds from privately run care homes, further outsourcing the services.
The CSR has nothing to do with providing improved, well-funded health services. Rather, it is a mechanism of NHS management in Dorset to impose its share of cuts, as part of the government’s overall plans to extract £22 billion in “efficiency savings” from the NHS via its Sustainability and Transformation Plans (STPs). England has been carved up into 44 “local health and care systems,” each of which has to submit cost-cutting STPs. That this is the aim was revealed when NHS Providers CEO Chris Hopson called for a debate on what services ought to be sacrificed.
This was a cynical announcement designed to cover up the fact that rationing of vital health services by CCGs is already the order of the day. Many hospital trusts are being forced into mergers, leading to loss of services and jobs. A&E departments, maternity units, heart units and ambulance services are facing downsizing or closures across the country.
Many CCG board members nationally, who have business interests in private companies, intend to exploit the opportunity to enrich themselves at the expense of patient care, as well as pay, terms and conditions of health workers.
Parallel to the CSR in Dorset, a “review” in Cumbria has come up with similar draconian cuts to NHS services in order to curb the looming deficit of £163 million a year by 2020. Its plan, too, includes the removal of consultant-led maternity care from the West Cumberland Hospital in Whitehaven and closing down three community hospitals—Alston, Maryport and Wigton.
In one case, leaked STPs show that in north-west London, 500 hospital beds are to be cut.
In West Yorkshire, there are proposals to close the equivalent of five wards in the Leeds Teaching Hospitals Trust and a “major reconfiguration” of frontline NHS services in Wakefield, North Kirklees, Calderdale and Huddersfield.
In the West Midlands region, there are plans for major changes to frontline services at Midland Metropolitan Hospital, including the closure of the hospital’s A&E unit and the closure of two District General Hospitals as part of a planned merger.
Growing opposition from clinicians, other hospital staff and people across Dorset County further repudiates the claims of the CCG that their plans are a product of the views of clinicians and the public that they met over the last two years during their “road shows.”
The fact is many clinicians and members of the public did not even bother taking part in these bogus consultations, already knowing that the outcome would disregard their views with the plans imposed anyway. The CCG admits in a bullet point in the document: “number of responses not high enough to be conclusive.” Even with a limited public engagement, they could not find any support to slash services. Instead, they found “strong support for care closer to home.” Hence, with these attacks the CCG is trying to enforce the opposite of what those who responded asked for.
The reorganisation plans of Dorset CCG, as in other parts of the country will inevitably deepen the plight of patients, including the most vulnerable sections of society, and continue to worsen the pay and conditions of its 31,000 workforce.
Workers and young people throughout Dorset, alongside hospital workers, have as in other areas nationally shown their desire to fight back against these attacks. The government is only able to impose its agenda, aimed at the break-up and privatisation of public health care, due to the treacherous role played by the trade unions and the Labour Party.
They have done everything possible to avoid a unified offensive of the working class against slashing of services. Unison, Unite, GMB and other health unions have not only been silent over the cuts in Dorset and nationally, they are complicit in implementing them.
KONP trades the illusion that the NHS can be defended by appealing to the very politicians who are committed to its destruction. KONP, which gravitates around the Labour Party and includes members of various pseudo-left outfits, backs the NHS Reinstatement Bill brought by the Labour in July. The Bill called for a reversal of the recent attacks made on the NHS by the Tory government. However, fewer than 50 MPs turned up to debate the Bill, which was presented as restoring the NHS to public ownership, ensuring it fell. Those not present included Labour’s “left” leader Jeremy Corbyn, and his close allies John McDonnell and Dianne Abbott.
Hospital workers, patients and working people in Dorset and throughout the UK must turn to the building of action committees, independent from the unions, to wage a genuine political struggle against these attacks and the Tory government carrying them out.