Is Wigan Council’s solution a question of Out of the Wholly Owned Subsidiary frying pan, into the Accountable Care fire?

A Wigan Council press release (below) says the Council has made the Wrightington Wigan & Leigh hospital trust a financial offer that has averted the Trust’s transfer of its support staff into a Wholly Owned Subsidiary.

While it is great news that the Wigan hospitals staff are to remain as NHS employees and that the cost-cutting Wholly Owned Subsidiary is not happening, there is no public information about what the Council’s solution and funding option are.

What are people’s thoughts about Wigan Council’s solution to the Wigan hospitals trust Wholly Owned Subsidiary?

I’m hoping it’s not Out of the Wholly Owned Subsidiary frying pan into the Accountable Care fire.

The Trust had just threatened striking staff with dismissal without rights or compensation, if they refused to be TUPE’d over.

Now the Trust says it will no longer set up the Wholly Owned Subsidiary, which it was doing in order to cut costs. So the strike’s been called off.

Unions welcome the solution.

press release

 

To find out what the Wigan Council deal is with the WWL hospitals trust, I’ve sent Wigan Council this Freedom of Information request:

With regard to the attached Wigan Council press release, please would you tell me the details of the financial offer the Council has made to the WWL hospitals Trust, that has enabled the Trust to drop its plan for setting up a Wholly Owned Subsidiary?

Specifically:

  • How much money has the Council come up with?

  • Where has it got the money from?

  • What cost-cutting service transformations is the hospital Trust to invest this money in?

  • How much money will these service transformations save?

  • What is the evidence that the financial savings are achievable and will not damage the quality and safety of NHS services?

Wigan’s cost-cutting Sustainability and Transformation Plan aims to “manage demand” for NHS and social care services

The Wigan Locality Plan for Health and Care Reform (ie the Borough’s Sustainability and Transformation Plan) says:

“Constrained funding means that all partners in the borough are facing an unprecedented financial challenge…

“The Wigan Locality Plan describes a wide-ranging programme of change to close a local financial gap of £87m by 2020…we must achieve a transformational reduction in demand for services.”

This involves the set up of an Integrated Care Partnership/Organisation –

“a new alliance of providers…based around primary care…with a stake for each organisation (including the hospital) in the scaled reduction of demand.

This is to be delivered through “place-based integrated working”,  involving 5 large scale GP practices each serving between 34,000-54,000 patients, with increased reliance on voluntary sector organisations to attempt to deal with social problems that cause ill health and lead to people’s need for support from public services.

Closing the financial gap also relies on standardisation of acute hospital services, and a “transformational programme” called “Enabling Better Care which involves estates strategy, workforce reform, aligned commissioning and ‘share to care’ “.

If the cost-cutting “service transformations” that the Trust is to invest Council money in are in line with those in the Wigan Locality Sustainabiity and Transformation Plan, they will be geared to “reducing demand” for the hospital’s services.

Is it possible to do this without denying and restricting patients’ access to the full range of NHS treatments?

New Public Management – running public services like private companies

Wigan Council’s chief exec Donna Hall is also Wigan Clinical Commissioning Group’s Accountable Officer.  A Wigan resident has told me on social media he thinks this may have something to do with the Council’s “solution” to the Wholly Owned Subsidiary problem.

The June 2018 Local Government Information Unit Briefing: Health, public health and social care round up, says there will be a pooled Wigan Council/Wigan Clinical Commissioning Group budget and a joint commissioning committee, including councillors and clinicians, to oversee spending. A single commissioning function is part of Wigan’s local plan as part of the Greater Manchester health devolution deal. Adult social care will be joined with community nursing and GP clusters alongside the police and other functions to establish joint solutions to local priorities.

This is Donna Hall’s view of public service reform in Wigan.

She seems to be completely on board with the New Public Management agenda of using private sector management techniques and practices. These include various forms of decentralizing management within public services (such as the creation of autonomous agencies and devolution of budgets and financial control), increasing use of markets and competition in the provision of public services (contracting out and other market-type mechanisms), and increasing emphasis on performance, outputs and “customer” behaviour change.

Drivers of New Public Management include the rise of neoliberal ideas from the late 1970s, the development of information technology, and the growth and use of international management consultants as advisors on reforms.

As applied to the NHS and social care, all this seems to be not only against the Labour Party’s Composite 8 motion, passed at the 2017 Labour Party Conference.  It is also against the Composite NHS Motion unanimously passed at the recent national Trades Councils conference in Manchester.

This motion calls on the TUC to take action to oppose Accountable Care Systems (rebranded by NHS England as “Integrated Care Systems”) and Sustainability and Transformation Plans/Partnerships; and to support the campaigning activity of Keep Our NHS Public, Defend our NHS, 999 Call for the NHS and Health Campaigns Together.

Which does make me wonder what the point is of such motions, as they seem to have no traction on what’s going on.

Unless, of course, it turns out that Wigan Council has come up with a solution to the cost-cutting Wholly Owned Subsidiary that does not involve tightening the Accountable/Integrated Care ratchet and further cutting patients’ access to NHS services.

I’ll  post the answers to the Freedom of Information request when I receive them, which should be by 6th August at the latest.

Posted from London, England, United Kingdom.

One thought on “Is Wigan Council’s solution a question of Out of the Wholly Owned Subsidiary frying pan, into the Accountable Care fire?

  1. see the concessions made in the Social Partnership Forum.
    “The Social Partnership Forum (SPF) and the NHS Five Year Forward View, New Care Models Programme Team have agreed the guidance for partnership working with trade unions to support the development and implementation of new care models and other forms of system transformation. Both the SUbco and local STP (healthier wigan partnership) involve the TUPE transfer of staff to the private sector. Therein lies a clue.
    References
    [1] “The SPF is supporting effective partnership working in system transformation, including changes arising from new care models, integrated care and the Sustainability and Transformation Plans (STPs)”.
    Source: https://www.socialpartnershipforum.org/priority-areas/supporting-system-change/