The creation of NHS Foundation Trusts put hospitals beyond the effective scrutiny of local MPs. This means that the last people to hear about and be involved in changes to their hospitals are the people who use them – and pay for them.
The case of Halifax and Huddersfield A & E is an example of this. Calderdale CCG’s Chief Officer Matt Walsh said at the CCG Governing Body meeting on November 14th that CCCG had asked Calderdale and Huddersfield Foundation Trust (CHFT) to commission the National Clinical Advisory Team to review urgent care and to report on recommendations for the CHFT to consider. This review took place over the summer and autumn, within the CHFT.
CCCG expects CHFT’s recommendations to come through to its Strategy Review committee some time in December.
Dr Walsh said,
“Significant change needs to be made in ways services need to be delivered. So Calderdale CCG will listen to the provider’s [CHFT’s] recommendations and then consult with the public on their decision on the provider’s recommendations.”
What kind of consultation is it that involves telling the public about the CCG’s decisions on the CHFT’s recommendations? For months, the Halifax MP and Calderdale Councillors were trying and failing to find out what was going on with the NCAT review of CHFT A&E. We need to bring back the NHS to democratic accountability.
This means restoring the duty of the Secretary of State for Health to provide comprehensive, universal healthcare that is free at the point of need. The Health and Social Care Act removed this responsibility – meaning that the NHS buck no longer stops with the Secretary of State, who has to answer to MPs, and so to the public.
“…the Health and Social Care Act guarantees that almost every decision on the development and configuration of services is now being taken without any regard to the views of local people, or even in the teeth of popular opposition…with only sketchy, tokenistic attempts to address local concerns over the closure of hospitals and A&Es.” (NHS SOS, p 25)
Until the New Labour government set up NHS Foundation Trusts, hospital managers had reported to the Secretary of State. In turn, the Secretary of State was accountable to Parliament, so MPs could ask questions about their local hospitals. But once NHS Foundation Trusts were set up, hospitals were no longer accountable to NHS management structures, or to the Secretary of State.
Before NHS Foundation Trusts were set up, NHS trusts that ran hospitals, mental health, community or ambulance services held their board meetings in public, published board papers and had an obligation to consult on major changes. But NHS Foundation Trusts are run as businesses (‘independent Public Benefit Corporations’). Their boards are free to meet in secret, can choose not to publish their board papers and can take big decisions without reference to anyone except Monitor, the national healthcare market regulator. (Info source: NHS SOS, p 26)
The result is that our hospitals and primary care health services (GPs, opticians etc) are now run by secretive NHS Foundation Trusts with no democratic accountability