Letter to the Editor (unpublished!)

On Friday 26th August the national media and 38 degrees woke up to the existence of STPs, which we have been warning about for months – see other posts on this page. They only partly got it, focussing as ever on the risk of hospital closures.

This is the letter we sent to The Guardian. Though they did not publish it there was one from our campaigning colleagues in sohf in the paper yesterday 30th August. Our letter read:

“We in Brent Patient Voice are pleased that the Guardian, 38 Degrees and the BBC have at last caught up with the huge threat to the NHS represented by the Sustainability and Transformation Plan (STP) process. In fact the NW London STP of 30 June has been in the public domain since 5 August and signposted on our website www.bpv.org.uk . We have been posting stories about this semi-secret initiative since the end of May, including an earlier version of the Plan submitted in April. Despite what spokespersons for the NHS are saying today, the NW London STP has not been prepared by clinicians or councillors, but by NHS and local government officials without any public debate. There are no clear proposals for consultation or public meetings arranged.

While today’s reports focus on the potential for hospital closures, these are essentially the highly controversial proposals issued in 2012 and misnamed Shaping a Healthier Future. So far these have been implemented by the closure of A&E Departments at Hammersmith and Central Middlesex Hospitals and the Ealing Maternity Department. As a result A&E waits at both St Mary’s Paddington and Northwick Park Hospitals are among the worst in the country and acute beds are under enormous pressure. This is the context for STP proposals to remove 592 acute beds which was mentioned in an early summary but has now been expurgated for fear of frightening the horses.

However what is new and barely understood at all by the public or even the GPs who will be at the heart of it is the “transformation” aspect of the STP. GPs are being paid to form themselves into legal companies called “federations” in order to be awarded (with other providers) single contracts to provide all primary services in, say, a borough. The jargon title for this concept, Accountable Care Providers, comes straight out of the American healthcare system textbook but it is completely untested at the scale envisaged in the STP. Ordinary GPs who can barely cope with patient demand for routine care have no idea what it is all about. Is not NHS chief Simon Stevens intelligent enough to see that such a major upheaval, even if justified (which we doubt), cannot be implemented safely and produce savings in the space of two years?

Robin Sharp CB, Chair Brent Patient Voice

26th August 2016″



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