Last update 22nd. June 2005



Accelerating backwards

EVER the optimists, staff at the department of health have come up with a "failure strategy" to keep open the emergency departments of hospitals that go into financial meltdown as a result of "new" Labour's asset-stripping policy, which allows private companies to compete unfairly with the NHS.

Health secretary Patricia "I saved Rover and I'll save the NHS" Hewitt says she "would not want patients to use services they don't want". In reality patients will be funnelled towards Independent Treatment Centres (ITCs) in preference to the NHS, as they have been given guaranteed five-year contracts.

Patients may like the idea of having their operations in spanking new, MRSA-free buildings; but as ever with Labour, the fix is short term. None of the ITC companies currently has any obligation to train UK surgeons, but the crisis this is precipitating is forcing the government to consider paying them to do so. As ITCs already get 20-25 percent more per case than the NHS, and cherry pick the simple procedures, an additional training tariff will send costs spiralling. Proof, if nothing else, of how much the NHS used to do for so little.

THE race is on to find which hospital is in the direst financial straits, with South Tees hospital trust projecting an impressive £32m debt by 2007. Managers are currently trying to claw back savings on hospitality and, um, stamps. Meanwhile the deputy chief executive and finance director of Shrewsbury and Telford hospital have been sent on gardening leave after "concerns about the trust's financial position" (ie £10m in debt). And the chief executive and chair of Queen Elizabeth hospital King's Lynn trust have resigned over an £8.5m deficit. Elsewhere, Bedfordshire hospital trust is also £8.5m down; Surrey and Sussex strategic health authority could be anything from £29m to £341m the red by the end of the year with the Royal West Sussex trust alone projecting a £142m loss by 2007-08. West Hertfordshire hospital is £13m light, Selby and York PCT is staring at a £28m debt while Kensington and Chelsea PCT is just £14.5m under.

So where on earth is the extra £50bn of NHS investment going? Not all in the right places, according to an NHS configuration poll of 80 chief executives. Only 9 percent strongly agreed that improvements matched expectations and 35 percent said gains were not proportional to investment. Even the health department is starting to doubt itself after a survey of 200 NHS staff at all levels found staff are "sick to death of change being rammed down our throats", relations between organisations are "almost bankrupt" and patients are being "processed like peas".

As the NHS Confederation policy director Nigel Edwards put it: "What people seem to see is an overwhelming number of things happening without any compelling story about why. That's a real problem." And Hewitt's response? "I am acutely conscious that a lot of staff feel very alienated from the changes... But I'm keeping my foot flat down on the reform accelerator."

Close your eyes and it could be Blair.

M. D. Private Eye No 1135