‘Super managers’ could weaken local accountability, writes Mary Burnett
Waltham Forest Save Our NHS is campaigning against changes being pushed through in our health service.
These are changes that threaten both the health of residents and our local democracy, and Waltham Forest Council has similar concerns.
Last month both the leader of the council and the portfolio holder for health wrote to the chair of Waltham Forest Clinical Commissioning Group (CCG), the organisation which provides local NHS services. They asked the CCG not to agree on a controversial proposal to create a super manager, called a ‘single accountable officer’, across all seven CCGs in north-east London, stretching from Hackney to Havering.
The letter raised concerns that there hadn’t been any consultation about the proposal. It said a single accountable officer – the person with ultimate responsibility for CCG decisions and finances – could weaken local accountability and that “a reduction in accountability could mean a reduction in health services for people in our borough”.
CCGs were created in 2012 to give doctors greater influence in planning and commissioning local health services. The same legislation gave councils new duties to improve how local health and social care services work together. All this was meant to improve the say local people had in their health service.
But last year NHS England pushed through – without any Act of Parliament – new arrangements for NHS planning called Sustainability and Transformation Partnerships (STPs). England is now divided into 44 NHS areas and Waltham Forest is in the north-east London area covering seven boroughs, plus the City of London. Our STP has been rebranded as the ‘East London Health and Care Partnership’.
But STPs were set up to force through spending controls and cuts, despite the opposition of many local authorities, including Waltham Forest. In north-east London ‘savings’ of over £500million by 2021 are being planned despite us having the biggest population growth in London. All STPs intend to achieve these cuts by reducing hospital costs and beds, and pushing more ‘care in the community’.
The STPs have no legal status and no duty to consult the public. Yet, driven by NHS England, they’re taking more control over local decisions to make sure spending controls and cuts are implemented. The single accountable officer will head up the East London Health and Care Partnership, making it easier to push through the cuts.
There’s also a real threat to the redevelopment of Whipps Cross Hospital. The government plans to withhold capital funding for equipment such as scanners to force hospitals to sell ‘surplus’ land quickly. The first hospitals to sell their land will be rewarded with extra capital funding.
Barts NHS Trust, which runs Whipps Cross, has the biggest financial deficit in the NHS. It’s likely that there will be enormous pressure to sell land on the site before proper plans for its redevelopment are agreed. Alarmingly, the East London Health and Care Partnership has now also taken control of decisions for the overall redevelopment of the hospital.
The chair of Waltham Forest Council Health Scrutiny Committee wrote that the changes being pushed through are “driven more by funding cuts than by service improvement”.
Despite local opposition, and the council’s concerns, all seven CCGs, including Waltham Forest, agreed to the single accountable officer proposal; their agreement was required by NHS England as a condition for ‘transformation funding’
Anybody working in the NHS, or trying to see their doctor, or needing hospital treatment, will know our health service is under enormous pressure. Waltham Forest Save Our NHS has no doubt that this government is knowingly starving our health service of funding, breaking it up, and extending the role of private companies.
We applaud the council’s stand, and its support for a review of the proposal to close the A&E at King George Hospital in Ilford.
This article was written as a collaboration with Waltham Forest Save Our NHS. To find out more and to support the campaign: