What happened at the meeting of the Cheshire and Merseyside ICS on the 27th July 2023? What were the plans made in the context of 7 million people waiting for care, corridor care, maternity crisis and staff discontent?

Our healthcare is badly damaged and still more damage is planned in plain sight. The NHS, last great social achievement of the generation who defeated fascism, is being broken and plundered, and, they plan this in meetings held in public. It is obscene that the administrators of the ICB plan these cuts in the same meeting that they describe the intense poverty of the people whose health they exist to care for.

One quarter of their spending goes to profit for private companies – and that’s just what we can track.

Please read our earlier post for the detailed background. For those readers who might want to see the full text of the documents for the meeting, see here.

All of the agenda items which we listed in the last post went through including, crucially, the finance items. In this crisis situation, the chair of the meeting announced that the ICB meetings would only be held in public every two months rather than monthly. He rudely refused to answer questions about public access to the minutes of the meetings not held in public.

Woven through the agenda are descriptions of intense poverty, and the illness and early deaths this poverty causes. Poverty makes us ill, and poor healthcare makes us poor. The Cheshire and Merseyside Healthcare system is already struggling with long waiting lists (even for cancer care), corridor care, trolley waits, staff shortages, staff overwork, serious maternity issues in most of its hospitals, justified industrial action by staff, worsening life expectancy, and chronic shortage of hospital beds and care home beds.

The cuts in spending this year which were announced at the meeting – Words in italics are from the board papers.

“7.1 The ICB submitted a deficit plan, in line with the level discussed with NHS
England. NHS England still expects the ICB to work to mitigate this in-year and
strive to deliver a break-even out-turn.
7.2 NHS England has stipulated that all ICBs and Providers continue to apply the
following conditions: Recurrent delivery of efficiency schemes from Q3 to achieve full year effect in 2024/25 to compensate for any non-recurrent measures required to achieve
23/24 plans (Non recurrent measures are those items where saving made last year will not be available this year, for whatever reason; our comment).

Full engagement in national pay and non-pay savings initiatives.

Monitoring of agency usage by providers, compliance with usage and rate
limits.

Revenue consultancy spend above £50,000 and non-clinical agency usage
continue to require prior approval from NHS England.

7.3 By the end of quarter 2, the ICB is required to prepare a medium-term financial plan, demonstrating how recurrent financial sustainability will be delivered.

7.4 In addition, for ICBs with a deficit plan, further conditions apply as follows:

The ICB is to review current pay controls.

Vacancy control panel to be in place for all recruitment.

Apply agency staffing and additional payment controls as stipulated.

Ensure an investment oversight panel is in place to oversee all non-pay
expenditure. Non-funded revenue or capital business cases should not be
approved.

Where revenue or capital cash support is required, additional conditions will apply.

The attempt to cut spending on pay makes a mockery of the staff strikes. The vacancy control makes a mockery of staff shortages and difficulty in recruiting and retaining staff.

See also the letter from NHS England on page 199 showing that these cuts must also be implemented by the Trusts/ Hospitals.

Liverpool Women’s Hospital cannot possibly make these cuts (please see the previous article). We suspect that other hospitals cannot make them either but we have the detail on Liverpool Women’s Hospital.

The clarity of the reporting of the poverty in our area made this decision all the more callous.

Other important Items:

The Partnership Board, where councillors are represented, presented a report which was approved (see Page 327 ). In this report the Partnership Board describes itself as “including independent healthcare providers”. Who are these organisation involved with the partnership board? What will their role be? Will they have voting rights? How much money will they be gifted?

Remember that the ICB covers all of Cheshire and Merseyside. Each local authority area is supposed to have a Place Board covering the health and social care issues in their area. We emailed Liverpool Place, and were told access to minutes would only be through the Freedom Of Information Act request route. Yet the latest news about proposalls for the future of Liverpool Women’s Hospital will come through Liverpool Place. How is it right the public will only be able to access this information through the lengthy and complex FOI procedures?

Other items from the meeting:

The closure of Park View Medical Centre in Tuebrook

Before the official start of the ICB meeting, protestors from the Park View Medical Centre in Tuebrook Liverpool spoke about the closure of their medical centre and GP practice against their wishes, and against the needs of the community. Patients have now been allocated to other practices including 900 to Green Lane, where existing patients report having difficulty in getting appointments. The way the decision was arrived at, the patients spokesperson said, was wrong and gave too much power to one person. The protestors handed in their petition but accepted that they had lost this battle, and would form a new patients committee at their new practices.

This was a very sad day for health care and democracy. We fund the NHS, it is ours, but the public has little say. That must change.

The Women’s Committee

There was no report from the Women’s Committee set up to discuss the Carnall Farrar report on the future of Liverpool Women’s Hospital. The report on Liverpool Women’s Hospital’s future is due to go to Liverpool Council’s subcommittee in November, so when will anyone see what is being planned for the place most of the city’s babies are born in? No meeting in August. None in October, so no time at all for the ICB to listen to the women.

There was no strategy put forward to address the maternity issues present across the ICB area and nationally. The issue was scarcely mentioned. The CQC is inspecting all maternity units following the Ockendon report. Birth is important! Everyone has to be born yet it is the Cinderella service, understaffed, under funded and scarcely mentioned in these reports. The future of the largest and most prestigious Women’s Hospital and Maternity Hospital in the Country hangs in the balance here.

What you can do to help the fight for world class healthcare for all, and a return to the original model of the NHS:

Join our campaign. We have campaigners and active groups across Cheshire and Merseyside. We hold meetings, we attend ICB and Board meetings, we leaflet, we attend local festivals and events, and we are planning a demonstration in October. Message us on savelwh@outlook.com or TakebacktheNHS@proton.me or defendournhswirral@gmail.com uniteinchester@gmail.com .westcheshiretuc@outlook.com or your local Trades Council. Join https://keepournhspublic.com but keep in touch with us too.

Ask your union or community group to join our campaign and invite a speaker.

Ask for a meeting with your MP and Councillors (we can help and support you in this). Email your MP and councillors demanding a big campaign to bring back the proper NHS. Power conceded nothing without a demand. To get something you have to ask for it!

Join our demonstration for the NHS and Liverpool Women’s Hospital at 12.30, on Saturday 7th October, 2023, assembling outside the Liverpool Women’s Hospital.

Donate to our funds for leaflets and our other work.