How the national NHS crisis affects Liverpool Women’s hospital

front-of-the-march All hospitals are suffering in this regime but Liverpool Women’s Hospital is a small trust. It is an efficient trust. There is no waste to cut out. Liverpool Women’s hospital could be a target for the “ninja” privatisers for some of its services including some of maternity services.

“Levels of efficiency – the Trust is recognised as an efficient provider of services and cannot continue to make the required levels of efficiency as a small specialist Trust”.

The NHS  is facing a deliberately created shortage of funds.It faces a financial crisis and is heading  politically  towards a health insurance system.Such schemes leave many without care and offer an overall lower quality of care.Both finances and services are being run down to make full-scale privatisation acceptable to the public. It is far easier to get the public to accept losing a rundown, struggling service.

There are many quotes from different campaigners and organisations in the rest of this posting but please bear with us. It’s important to get the whole picture.

There is a proposed £22bn cut in NHS funding by 2020

Virgin now has over 300 NHS contracts, and an active litigation department.

They have successfully prevented commissioners in Hull from allowing local GPs to run primary care services, and are facing a legal challenge from the local trust in Kent to their £128 million contract because of concerns about patient and staff safety. Meanwhile Monitor the regulator has now issued 114 private provider licences. The amount spent by local commissioners and trusts on non-NHS providers went up from £6.6 billion in 2009 to £10 billion in 2014. Industry analysts estimate the community services market to be worth £10bn-to £20bn annually. Trade unions have described “a surge in privatisation “.

 Shortage of funds for the NHS is a major problem

 The Kings Fund is a think tank normally supporting right of centre politics. They said “Unaudited figures indicate that NHS commissioners (clinical commissioning groups and NHS England) and providers in aggregate ended 2015/16 in deficit for the second year running.”

“NHS providers and commissioners ended 2015/16 with a deficit of £1.85 billion – the largest aggregate deficit in NHS history.

Evidence suggests that, in recent years, mental health and community services providers have delivered relatively strong financial performance, which may have come at the expense of cuts in staff and risks to patient care.

Over the past two years the financial position of local commissioners has deteriorated sharply.

The scale of the deficit signifies a system buckling under the strain of huge financial and operational pressures.”

“Since 2010 the NHS budget has been almost static, while the UK population has increased by two and a half million and is predicted to grow by 440,000 a year over the next ten years, with a growing proportion living longer and having more  illnesses.I will not be deniedl

 So it is no surprise that NHS hospitals in England look likely to have overspent their 2015-16 budgets by £2.5bn and that even so care quality is now seriously declining.

There is also an acute shortage of GPs; CCGs are announcing cuts in the range of treatments they will pay for; waiting times for treatments, including for cancer, are rising; hospital wards are understaffed; beds are also unavailable because too many are occupied by patients who can’t be discharged because of cuts to social care provision. And Monitor has told seriously overspent trusts to ‘reduce their headcount’.

“The Kings Fund normally gives cautious support to government policy but on 7 April its Chief Executive, Chris Ham, finally broke with precedent and in effect told the government it was in denial in maintaining that services can be maintained and even improved when funding per patient is already too low and is planned to drop fairly rapidly over the next five years:

“NHS leaders have never felt this target was credible and are now wondering when the emperor will be seen to have no clothes. Many feel as if they are living in a parallel universe in which they are striving to sustain existing services in conditions of adversity while politicians promise improvements in care that cannot be delivered with available resources”.

Click to access CHPI-STP-Analysis.pdf

 The NHS needs much more money; Women’s health needs more money. Maternity needs more money.

 “the latest figures for 2015/16 show that nearly two-thirds of all trusts ended the year in deficit. Nearly three-quarters of trusts in deficit were acute hospitals”. (King’s Fund)

If NHS spending simply level-pegged with our GDP, it would have £16bn more. We have fallen to 13th out of the original 15 EU states. But had we stayed at their average level, the NHS would be getting £43bn more, according to the King’s Fund’s chief economist, Professor John Appleby. Once sums get that big, it can be hard to grasp how transformative that would be.

As one of our face book comments put it “This is ridiculous. If the odd few had deficits, you could argue management of budget but when barely any trusts are operating within their budget you have to look at the budget. Clearly they are not getting enough money!!

Hit the NHS once with ongoing privatisation, then slap it with lack of essential money, then hit it with the Sustainability and Transformational plans

Nationally the scale of the pressure on the NHS is enormous

The first tension that becomes apparent on reading the Mandate, planning guidance

and other documents is the sheer enormity of the task facing the NHS and the

timescales within which it is expected to achieve it, a consequence in part of

the late publication of the Spending Review.”

The Liverpool  Clinical Commissioning Group

has posed the idea that the deficit at the Liverpool Women’s Hospital could be absorbed by one of the other trusts if the Liverpool Women’s Hospital became part of another hospital. But none of them have enough money.

Liverpool Women’s hospital has a deficit  mainly because the government does not pay enough for maternity care. The  maternity tariff is not enough to pay for sufficient  midwives to provide safe care, so the hospital will always have to run a deficit until that is solved.

Birmingham Women’s Hospital  is paid an enhanced tariff by its local Clinical commissioning Group because the hospital deals with complex cases, as does Liverpool Women’s Hospital  but without the additional tariff.

The women of England need to be campaigning for a much enhanced Maternity Tariff and the protection of our maternity services. This is not just a Liverpool issue it affects hospitals and midwife lead units across the country. In another post we will publish all the maternity hospitals and units under threat or already closed.







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