Letters to the Editor: éirígí: ‘Health Service Shake-Up, or Shake Down?’
On Tuesday 20th March 2012, the Tory-led British government succeeded in passing its Health and Social Care Bill in Westminster. The Bill represents the greatest upheaval of the NHS since its formation in 1948 and and proactively facilitates a further opening up of the service to private companies.
Richard Branson’s Virgin Care is currently on a shortlist to take over core children’s health services in Devon, England, with a recent report by Corporate Watch finding that many private corporations involved in managing NHS services, who unsurprisingly also lobbied heavily in favour of the new Tory bill, are skilled tax dodgers.
It’d be enough to make you thankful that the Six Counties has a devolved administration, except that Stormont’s evolution-denying, creationist health minister Edwin Poots is planning his own major shake-up, or should that be ‘shake down’, of the NHS. Speaking to a group of nurses and midwives at the Ward Sisters conference in Newtownabbey on Wednesday [March 21], Poots announced that he wanted to see 95 per cent of A&E patients discharged or admitted within four hours, and that no-one should have to wait longer than 12 hours in Accident & Emergency. He also announced some measures that might, he claimed, go toward achieving this goal.
This statement was undoubtedly in response to the outcry that a man had recently died unnoticed on a trolley in the Royal Victoria Hospital in Belfast. Unfortunately for Poots, these targets have already been in place for five years as part of the department of health’s ‘Priorities for Action’ [PfA]. Worse still, in that time results have steadily declined. In December 2007, 91 per cent of A&E patients were admitted or discharged within four hours and less than ten patients had to wait over 12 hours.
In December 2011 however, the percentage of patients being dealt with in less than 4 hours had dropped to 85 and the number of people forced to wait over 12 hours had increased to almost 1,000. Among Poots’ first decisions as health minister was to reduce the A&E opening hours at Lagan Valley hospital and close outright the A&E department at Belfast City Hospital. These actions have only worsened the current healthcare crisis. Since the closure at the City, the RVH has reported a 50 per cent increase in the number of patients attending A&E, placing already pressured staff under ever increasing strain.
In November of last year, Poots announced a review of health and social care provision. The consultation on the review included private sector and business interests such as the Confederation of British Industry and yet excluded the trade union movement, which represents tens of thousands of workers in the health sector who might have had something to say about the work that they do and where they felt change was required.
The review was also to take account of Reshaping the System, the report by private US consultancy group McKinsey and Co., written in 2010, but which only came to public attention in April 2011. Focused on financial matters, the report argued that health and social care could operate within budget constraints through implementing recommendations such as slashing around 10,000 jobs, withdrawing certain procedures, reducing the use of medication, and charging for patient transportation and hospital stays. When the report was first made public, politicians were quick to distance themselves from its recommendations.
Nonetheless recommendations made by McKinsey were to be found in the completed review, published as Transforming Your Care, but probably better known as the ‘Compton Review’. The main points from the review, which dominated the discussion, were the reduction of the number of acute hospitals in the Six Counties from ten to between five and seven, and the recommendation of cross-border co-operation for the counties straddling the partition line.
On Wednesday [March 21], the Irish News reported that health minister Poots is currently mulling over aggressive proposals to cut £78 million from the health service over the next 12 months. Among the cost-saving measures being proposed are the loss of 500 nursing jobs, the closure of hospital beds and wards, the reduction of chemotherapy, radiotherapy and dialysis treatment slots, and a ban on replacing staff who leave over the next year.
Commenting on this, John Compton, the chief executive of the Health and Social Care Board and the main figure behind the Compton Review, said: “Every public sector organisation in Northern Ireland has to live within their means.”
He can say that though as, with the £145,000 salary he receives as head of the HCSB, Compton can easily live within his means. For the rest of us, however, for all of us who are dependent on the public provision of health, these proposals must be fought strenuously and successfully.
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