Concerns about trust mergers

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Hospital trusts around the country have been merging to create larger trusts.  This is an aim set out in the NHS Long Term Plan. This post describes why we have so many concerns about trust mergers.

The plan reverses a process of greater localisation that was introduced in the Health and Social Care Act 2012. It is  another top down reorganisation just like the Health and Social Care Act.  David Cameron pledged  in his 2010 manifesto there would be no more of these reorgainsations that ‘get in the way of patient care’.  That is before he announced the Health and Social Care Bill  after becoming Prime Minister.  The Long Term Plan will as Cameron said once again get in the way of patient care.  Worse still it will create an environment for far greater marketisation of the NHS.

The Plan lays out a proposal for Foundation Trusts to take over other trusts that may be struggling.   It sounds like an excellent idea to get the successful helping out the less successful.  But how do we judge success?   If we judge an organisation as successful by their finances then that may not indicate the standard of the service they offer.  It may simply mean they pay their staff too little or they fail to invest in new equipment etc.

In Sussex there are currently plans to merge Western Sussex Hospitals NHS Foundation Trust (WSHNFT) with Brighton and Sussex Universities Hospital NHS Trust (BSUHNT).  The only reason the Brighton and Sussex trust is not a foundation trust is because the Royal Sussex County Hospital is a regional trauma centre.  As a trauma centre it demands more investment than it receives because of the nature of its work.  These two trusts have been in a ‘buddying’ arrangement for some time now.  The merger seeks to formalise this arrangement.  The trust conducted a very short survey of public opinion before Xmas but are not planning to have a public consultation. They have told us it will not constitute a major  change in service delivery,

We feel very concerned about this merger for a number of reasons. Initially we understand it is unlikely  it would constitute a major change to the provision of services.  But we believe from the Long Term Plan this will be the precursor to major changes further down the line.

The Long Term Plan proposes reducing the number of A&E units but having Urgent Treatment Centres at smaller hospitals.  The likelihood of us seeing smaller District General Hospitals downgraded is high.  Through the creation of Primary Care Networks and Integrated Care Systems the plan aims to cut 30m outpatients appointments from hospitals. The creation of Integrated Care Systems is a major building block in the plan and threatens to cement US style marketisation into our NHS.  Insurance companies, drug companies and other private corporations own the Integrated Care Systems in America.  This is where the big money lies. The Long Term Plan will  also encourage the mergers of different hospital service.

On 1 July 2013 Royal West Sussex merged with Worthing and Southlands Hospital NHS Trust to form the WSHNFT.  The Trust then promptly downgraded Southlands Hospital.  Shortly after they declared 2/3 of the building to be ‘surplus to requirements’.  The trust sold it to private developers  to convert into luxury appartments.  Now patients from Shoreham who once would have been treated at Southlands have to make a 50 mile round trip to Chichester.

We fear if this merger takes place we will see services cut from hospitals.  Patients and staff  will then have longer journeys to get to hospital.  We would expect to see many hospitals in the region losing A&E units and possibly maternity units.  Both A&E and maternity units are financially riskier to run so will not be favoured in our newly marketised style NHS.  It also raises questions about the employment contracts of staff.  It is quite possible that if staff have contracts transferred to the new trust they will see their pay and/or working conditions change.

We have already said that we must all pay attention to what is happenning in the surrounding areas.  But plans also exist for this merger to take over the running of truama, cancer and neuro-surgery in East Sussex.  Already many people in our area have to travel to Brighton for these services but certainly not always.

The plans have been vague and have only included the short term proposals.  The public survey ran for less than a month and received just 4000 respondents out of a possible 1.2m people who would be affected.  We are working as a campaign group with campaigns from West Sussex and Brighton and Hove.  This regional campaign group sent a letter to the CEO of WSHNFT, Marianne Griffiths, to ask for a formal public consultation on the merger.  In it we also asked that they carry out impact assessments before any merger takes place.

We have been seeking clarification on the details of what will happen after the merger.  Campaigners have also been issuing press releases and promoting greater awareness of what is happening in the population.  It is important we continue to place pressure on the CEO of the WSHNFT Marianne Griffiths to answer our questions.  We all need to be aware of not just what they are telling us will happen but what we know will happen afterwards.

This constant rearranging of our NHS only ever serves to allow more people to make more profit on the back of the suffering of others.  If you are not horrified by that thought then here is another.  What happens to the people who get ill but their treatment will not be financially lucrative?  Or the people who need A&E or Maternity when hospitals are all deciding it is too financially risky to provide?

Are you interested in getting involved with the regional campaign against the merger?  If so please get in touch with us by placing a message in the comment boxes below.

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