Labour to end NHS restructuring over hospital closure fear

A Labour government would halt NHS plans intended to better co-ordinate local services because of concern they are a vehicle for cuts, closures and privatisation, the party has said.

Shadow health secretary Jonathan Ashworth will announce on Wednesday that Labour will halt and review all 44 "Sustainability and Transformation Plans" (STPs) currently being worked on across England if it wins the General Election.

Describing them as "entirely discredited", he will say STPs have been driven by the need to meet financial targets amid a government squeeze on NHS funding – rather than clinical need.

STPs are intended to deliver more co-ordinated and efficient health and social care by requiring local authorities, hospital trusts, clinical commissioning groups and other care providers to work together.

NHS England says they are an attempt in particular to address the strains caused by an ageing population with more complex needs and close the gap between health and social care provision, which has contributed to the unprecedented pressure on NHS services last winter.

Critics, however, see the plans as a vehicle for cuts and privatisation, with draft plans drawn up by some STPs outlining proposals to close or downgrade services including hospitals and A&E departments.

"Labour supports the principle of redesigning health and care services to deliver greater integration of care and to spend money more efficiently," said Mr Ashworth.

"This latest top-down re-organisation doesn’t have the support of the public or those who work on the frontline in the NHS. What’s more, big changes to NHS services are being taken behind closed doors… in secret. And in the context of the big Tory NHS funding squeeze, it’s just not right."

The review will be carried out by a new body called NHS Excellence, created from the merger of two existing NHS divisions.

It will assess STPs against three standards: excellence, quality and safety. And it will ensure they have not been driven by financial constraints.

STPs have hitherto been the preserve of NHS bureaucrats, policy wonks and health economists – but they could deliver a profound change in the shape and size of the NHS and the way care is delivered.

They are the flagship programme of Simon Stevens, NHS England’s chief executive, who developed them in part as a response to the Government’s demand to cut £22bn from the NHS budget.

Essentially, they are an attempt to work around the divisions created by the restructuring of the NHS under the Conservative-led coalition government health secretary Andrew Lansley.

The aim is to force the disparate parts of the health system to work more closely in each region without introducing new legislation – and deliver better care while saving money.

STPs have no statutory basis, however, which means there is no new money to make them happen, the shape of each plan is in the hands community-based groups, and accountability is ill-defined.

Some proposals have strong support from practitioners, though.

In one STP examined by Sky News, a clinical commissioning group and the local authority have agreed to pool their social care budgets in order to treat more patients in the community and discharge others more quickly from hospital.

More controversially, there have been plans to focus funding on more specialist services, particularly where STPs have proposed closing or downgrading existing facilities.

Establishing how many services could be affected is difficult – not least because STPs are not directly accountable for the decisions made by the bodies that sit around the table.

Labour cite a recent study by Health Service Journal, which found 46 general hospitals, acute hospitals and A&E units could be closed or downgraded.

Supporters of the programmes will tell you downgrading a facility does not necessarily mean patients will suffer. Some clinicians would support losing a small A&E department in order to invest the money in a larger more specialist unit that could treat more patients.

But the health worker unions are not among them.

Rehana Azam, GMB national secretary for public services, said: "GMB welcomes Labour’s pledge to halt the Conservative cuts and closures to hospitals.

"STP is a drastic re-organisation that is seeing our health service cut to the bone – opening it up to privatisation under the sinister guise of efficiency savings."

(c) Sky News 2017: Labour to end NHS restructuring over hospital closure fear