argyrotsipi/train-dataset huggingface dataset:
NHS Sustainability and Transformation Plans — House of Commons, 2016-09-14
Topic: Health
Diane Julie Abbott (Labour, Centre-left): I entirely agree with my hon. Friend. All STPs should publish who is on them, what their financial interests are, and how far advanced they are in planning. However, thanks to the work of organisations such as Open Democracy and 38 Degrees—and, frankly, thanks to leaks—the picture of what STPs will mean is becoming clearer We know from the information we have been able to glean that the reality of STPs is quite concerning. For instance, in the black country there are plans for major changes to frontline services at the Midland Metropolitan hospital, including the closure of the hospital’s accident and emergency. The plans also propose to close one of the two district general hospitals as part of a planned merger. We know that by 2021 the health and social care system in the black country is projected to be £476.6 million short of the funds it needs to balance its books. [Interruption.] Government Members may shout now, but they are going to need an answer for their constituents when the reality of some of these proposed closures becomes apparent In Leicester, Leicestershire and Rutland, there are apparently plans to reduce the number of hospitals in the area from three to two. By 2021, the health and social care system in the area will be £700 million short of the money it needs to balance its books. In Suffolk and north-east Essex, the STP plan refers to the "reconfiguration of acute services within our local hospital, Colchester Hospital University Trust". The whole House knows that, historically, reconfiguration in the NHS has meant cuts. There are also plans to close GP practices The context of these plans, of which I have given an idea, is the current NHS financial crisis. Most recently, we have heard from NHS providers about this financial crisis. They represent the NHS acute, ambulance, community and mental health services. NHS providers say that despite the best efforts of hardworking staff, including junior doctors, hospital accident and emergency performance is the worst it has ever been. Waiting lists for operations, at 3.9 million, are the highest they have been since December 2007. We ended the last financial year with trusts reporting the largest deficit in the history of the NHS: £2.45 billion.
NHS Sustainability and Transformation Plans — House of Commons, 2016-09-14
Topic: Health
Diane Julie Abbott (Labour, Centre-left): I have to make a little progress Many STPs will be facing a large financial deficit. [Interruption.] I have to say to Government Members that they do not seem to be taking this debate seriously. When their constituents come to them asking about these cuts and closures, they will have to take it seriously. Many STPs will be facing a large financial deficit, which is subject to "control totals"—that is, cuts. In the case of north-west London, which does not have the largest projected deficit by any means, spending on acute care is projected to fall in nominal terms over a six-year period, despite a population that is both increasing and ageing, and despite cost pressures such as the sharply rising cost of drugs STPs have made an assessment of their own deficits by 2020-21. Researchers have disclosed that approximately 29 of the 44 STPs have projected substantial deficits.
NHS Sustainability and Transformation Plans — House of Commons, 2016-09-14
Topic: Health
Diane Julie Abbott (Labour, Centre-left): I need to make some progress The King’s Fund has said: "There are some concerns that NHS leaders have focused their efforts on plans for reconfiguring a few hospital services, despite evidence that major acute reconfigurations rarely actually save money and sometimes fail to improve the quality of care." The BMA has said the same thing. The King’s Fund has also said: "The cuts under the STPs are eye-watering".
NHS Sustainability and Transformation Plans — House of Commons, 2016-09-14
Topic: Health
Diane Julie Abbott (Labour, Centre-left): I am anxious to complete my remarks so that Conservative Members will all get a chance to intervene in the debate The Health Select Committee's recent report on the impact of the 2015 spending review stated: "At present the Sustainability and Transformation Fund is being used largely to ‘sustain’ in the form of plugging provider deficits rather than in transforming the system at scale and pace. If the financial situation of trusts is not resolved or, worse, deteriorates further, it is likely that the overwhelming majority of the Fund will continue to be used to correct short-term problems rather than to support long-term solutions".
NHS Sustainability and Transformation Plans — House of Commons, 2016-09-14
Topic: Health
Diane Julie Abbott (Labour, Centre-left): Let me now draw my speech to a close. It is absolutely right that health and social care stakeholders should come together to plan for the future. It is absolutely wrong that social transformation plans should be hatched in secret and used as a cover for cuts and hospital closures—and it is increasingly clear that STPs may be a stalking horse for more privatisation. Conservative Members may not take this issue seriously—[Interruption]—and Conservative Members’ response may be to shout, but I stress to the House that the consequences of these STPs will be very material for all our constituents.
NHS Sustainability and Transformation Plans — House of Commons, 2016-09-14
Topic: Health
Diane Julie Abbott (Labour, Centre-left): They will also be very material for those who work in the NHS. I take this issue seriously. [Interruption.] That is why we have called the debate, and I wait with interest to hear what Ministers have to say.
NHS Sustainability and Transformation Plans — House of Commons, 2016-09-14
Topic: Health
Catherine Elizabeth West (Labour, Centre-left): I thank the Minister for giving way and hope he does well in his first performance here in the House. What percentage of acute trusts are in deficit, and what proportion of clinical commissioning groups are in special measures?
NHS Sustainability and Transformation Plans — House of Commons, 2016-09-14
Topic: Health
Maria Eagle (Labour, Centre-left): It is clear from the leaked document that Merseyside and Cheshire are looking to save £1 billion by 2021. In that context, does the Minister not agree that there will be an outcry when the secret proposals—which have now been leaked—to merge much-loved hospitals and cut services in Liverpool, for example, are finally consulted on? Does he acknowledge that they will have no chance of receiving any support?
NHS Sustainability and Transformation Plans — House of Commons, 2016-09-14
Topic: Health
Gareth Thomas (Labour, Centre-left): I am grateful to the Minister for giving way. He was very generous the last time I had an opportunity to intervene on him Part of the concern in my constituency about the north-west London STP relates to the fact that Harrow receives less NHS funding per patient than any other part of London. For some months we have sought a meeting with a Health Minister to discuss that issue. Is the Minister prepared to receive a delegation from our clinical commissioning group?
NHS Sustainability and Transformation Plans — House of Commons, 2016-09-14
Topic: Health
Alexander Cunningham (Labour, Centre-left): I met a young surgeon at my north-east hospital in a personal capacity last week. She was excellent and caring and was clear in what she had to explain to me. She was so dedicated that it made me proud that she worked for the NHS. I was not proud, however, to hear about the facilities with which she has to work following the cancellation of our new hospital project in 2010 by the Tory-Lib Dem Government. Does the Minister agree that we can have as many plans as we like, but if we do not have the infrastructure, we cannot deliver the care required by some of our neediest communities?
NHS Sustainability and Transformation Plans — House of Commons, 2016-09-14
Topic: Health
Andrew John Gwynne (Labour, Centre-left): I have some sympathy with what the hon. Lady is saying. Does she agree that that integration will not happen if any one part of those partnerships is severely underfunded? For example, she mentions local authorities. Many of the pressures in the NHS today are solely as a result of the severe underfunding of adult social care. Do we not need to ensure that the finances are in place for these STPs to work?
NHS Sustainability and Transformation Plans — House of Commons, 2016-09-14
Topic: Health
Heidi Alexander (Labour, Centre-left): I am grateful for the opportunity to speak in this debate. Sustainability and transformation plans—what are they, should the public be concerned, and are the plans good, bad or a mixture of both? As we have heard, over the last eight months or so STPs have been drawn up in 44 areas in England by a range of people involved in the running of the NHS and local government. As far as I can work out, they have come about because NHS England could see that in the chaos following the previous Government’s Health and Social Care Act 2012, there was no obvious body responsible for thinking about how best to organise NHS services at a regional and sub-regional level, so NHS staff and local government officials were tasked with assessing the health and care needs of their local populations, considering the quality and adequacy of the provision to meet those needs, and developing ideas about how those needs might be better met within available resources So far, so good, we might say, but there are three big problems. First, the current financial pressures on the NHS mean that the plans are likely to be all about sustainability, not transformation. Secondly, this is a standardised process to define and drive change, so we run the risk of good proposals being lumped in with bad ones, and of some plans simply focusing on the achievable, as opposed to the necessary and the most desirable. Thirdly, it is an inescapable fact that these plans are being developed when there is huge public cynicism about the motives of a Tory Government when it comes to change in the NHS. If the Government want to deliver change, the debate with the public needs to start in the right place—not behind closed doors, and not using jargon that no one understands. It needs to be focused on patients and their families, not on accountants and their spreadsheets I think most people understand that the NHS cannot be preserved in aspic. They understand that compared with the 1950s, we now use the NHS in a very different way. At the moment, they simply see an NHS under enormous pressure. They are waiting longer for an ambulance, to see a GP, to be treated in A&E and for operations. They see staff who are stressed out and who are on the streets in protest. When Ministers and NHS leaders talk about sustainability and transformation, the public are therefore dubious. For sustainability, they read cuts, and in some cases they will be right—it will mean cutting staff, closing services and restricting access to treatment. No matter good the plan, how thorough the analysis or how innovative the solution, we cannot escape the basic problem of inadequate funding for the NHS and social care.
NHS Sustainability and Transformation Plans — House of Commons, 2016-09-14
Topic: Health
Heidi Alexander (Labour, Centre-left): That is the story we hear from all over the country. This is not profligate overspending on the part of NHS bosses or local government leaders; it is chronic underfunding on the part of Government. There was much fanfare associated with last year’s comprehensive spending review and what it meant for the NHS, but when we look at that financial settlement, along with the one in the last Parliament, we see a flatlining budget to deal with soaring demand. As a country, we have a growing and ageing population. The reality is that in the last 10 years, the number of people living beyond the age of 80 has increased by half a million, and the NHS and social care are buckling under the strain. Although we should never give up on trying to organise the NHS in the most efficient and effective way possible, we have a choice. Do we want to cut services to match the funding available, or do we want to pay more to ensure that our grandparents and our mums and dads get the sort of care that we would want for them? If the NHS is to provide decent care for older people we need not only to fund social care adequately, but to find better ways of organising services to keep people out of hospital for as long as possible That leads me to the next problem. STPs are being used as a catch-all process to bring about change in the NHS, but many run the risk of focusing on the wrong things. They are being used as a vehicle to do different things in different places, and although some may lead to better treatment and better outcomes, the danger is that there will be knee-jerk, blanket opposition to everything. Some proposals will inevitably be controversial—the closure or downgrading of an A&E or maternity department will never be easy—but, in other cases, the plans may end up focusing on something that is not the burning issue Let me take my local area as example. The STP for south-east London proposes two orthopaedic elective care centres. The sites for them have yet to be decided, and the STP plan has yet to be signed off by NHS England. On the face of it, there is little wrong with the proposal to create centres of excellence so that all hip and knee replacements are done in one of two places. The problem is that when the front page of a national newspaper talks about the "secret" STP plans under which A&Es will close, my constituents fear the worst. "We’ve been here before," they will say. They will smell a rat, even where one might not exist.
NHS Sustainability and Transformation Plans — House of Commons, 2016-09-14
Topic: Health
Catherine Malloy Hollern (Labour, Centre-left): I have serious concerns about the lack of transparency in the process. If there had been more consultation, it would have been far more transparent. The plans’ only aim is to fit funding, rather than to examine and improve services Hospitals are under huge pressure in Blackburn and the surrounding Pennine area—as I am sure you are aware, Mr Deputy Speaker—with the closure of the A&E at Chorley hospital. Coupled with the huge burden facing local authorities, the Pennine Lancashire health authority has the challenge of finding £238 million over the next five years. With the best will in the world from local authorities, NHS trusts and communities, I fear that the change will not be for the better under that kind of financial pressure Let us not forget the savage budget cuts that local authorities have faced. Blackburn with Darwen Council alone has already had to cut £100 million from its budget, with another £48 million to cut by 2020. I am not opposed in theory to a system approach of hospital trusts and local authorities working together. In fact, that was always one of our main aims during my many years as leader of Blackburn with Darwen Council, but it was used to improve services. It is not fair that that council has effectively been handed the task of improvement with vanishing resources The exemption of adult social care from STPs has caused concern in local authorities across the country. It is not helpful that they have been told to leave that bit out of their submitted plans because it does not quite fit in with the budget. That will certainly not produce a more efficient and better service. The funding gap in adult social care is a real crisis that local authorities must face, but no remedy to fix it is currently forthcoming. Many pressure groups, experts and even the chief executive of NHS England, Simon Stevens, have publicly advised the Government to make extra funding available for social care, yet the Government have been silent. They have made no commitment to make additional funds available in 2017 to support adult social care. I would like to give them an opportunity today and will happily give way to a Minister if they are prepared to clarify that point. Will the Government make additional funds available to ease the burden on adult social care, leading to better transformation of services Like many of my constituents, I seek clarity on whether additional funding will be made available, because if it is not, STPs will fail miserably. If we really want a transparent process and improved services, before we move on to transformation I suggest that my colleagues and I are at least made aware of what the plans contain or are assured that resources will be available to stabilise NHS and local authority services.
NHS Sustainability and Transformation Plans — House of Commons, 2016-09-14
Topic: Health
Christopher Paul Farrelly (Labour, Centre-left): This so-called transformation process has been going on in fits and starts in Staffordshire since 2014. By 2020-21, the deficit will be £347 million, including social care, according to the draft STP presented behind closed doors in Whitehall in July. The Secretary of State has refused to publish that plan, of course, but what is important is that the menu being cooked up behind the scenes is already being dished out in practice, with no meaningful public consultation, playing fast and loose with NHS guidelines. It is being driven by cost-cutting, bullied through by NHS England, not rational planning for better integrated care in the future, even if that means that, in the short term, the pressure on patients is increased, particularly at our local Royal Stoke University hospital, where the wretched sight of trollies queuing up in A&E corridors is now commonplace Before the summer, the closure of ward 4 at the local Harplands hospital took away a safe place of discharge for patients with mental health problems. Cuts to the county’s better care fund threaten the viability of drug, alcohol and other services, as well as respite and rehab facilities such as those at Brighton House in Newcastle. Last month, we learned that both wards at Cheadle community hospital will close, further affecting discharges, while social services struggle to cope. Children’s A&E at Stafford has shut, and last week staff at Newcastle’s community hospital, Bradwell, learned that three of its wards are to close this winter or next spring. As a result of all that, the pressures on our local acute hospital will simply continue to multiply As a county, Staffordshire does not fit together as a healthcare whole. While the north and west look to Stoke, the south engages with Birmingham, Wolverhampton and even Worcester, and the east with Derby. Rather than plan integrated care along those pathways, I understand that a county-wide merger of everything is now on the cards. That monolith has been called, with no sense of irony, an accountable care organisation, yet the health and care transformation board has been anything but accountable so far, not least in relation to the pay that senior executives are raking off from this process The parachuted-in programme director, Penny Harris, is being paid a salary of £168,000 a year for a four-day week, and her deputy, Sarah Carter, is on £172,000 for a five-day week. The lead finance officer, Neil Chapman, is on £244,000 a year. Add in two other people on the Staffordshire board who are on £131,000 and the annual bill for just five of them comes to £846,000. Another £675,000 is going to KPMG, which means that more than £1.5 million is being paid by the local NHS. These people, quite simply, are devouring what is left in the pot for transformation.
NHS Sustainability and Transformation Plans — House of Commons, 2016-09-14
Topic: Health
Ruth Margaret Cadbury (Labour, Centre-left): I draw attention to my entry in the register of interests. My husband is a non-executive board member of Chelsea and Westminster Hospital NHS Foundation Trust Like many Members, I have had a very large mailbag about today’s debate because so many of my constituents rely on the NHS to keep them and their families in good health, and they want the NHS to carry on providing good, appropriate services that are accessible and timely, and free at the point of entry. They want funding not only to address the deficit, but to invest in improvement of services. Those who work in the NHS care deeply about its future and want to be able to do their best for their patients Like the constituents of my hon. Friend the Member for Hammersmith (Andy Slaughter), people in my constituency are deeply concerned about the future of Charing Cross hospital—a large general hospital with a busy A&E department in the neighbouring seat which serves many of my constituents. The hospital’s future has been uncertain for at least five years, since the north-west London NHS first proposed closing A&E there and in four other north-west London hospitals People are extremely worried about the travel times from Chiswick to the nearest A&E, about the inevitable downgrading of the other services on that site once A&E goes, and about the capacity of neighbouring hospitals to cope with the inevitable additional pressure. The issue has been ongoing for a while for us The STP comes at a time when we have a £1 billion funding gap in north-west London. It is proposed to close 500 beds and a 40% cut is proposed in face-to-face consultations. This is against a background of rising population and increased health needs and in the context of our services currently missing many targets. Social care cuts are crucial to the argument. How can STPs have any credibility if the NHS cannot plan nationally when the other main services relevant to people’s long-term health are funded and controlled in a different place and in a different way and are being cut and cut and cut The north-west London STP, as I said, proposes cutting beds. We all want treatment to be less dependent on spending nights in hospital beds, and some reduction in acute beds is inevitable with changes in modern health provision, but 500 beds is a staggering number proposed to be cut in west London, where the population is rising and ageing I will end by responding to Members on the Government Benches about the funding gap in the NHS. The NHS would not have a funding crisis if this country matched the health funding per head of similar countries. The King’s Fund has shown that the UK public purse spends a smaller proportion of GDP on healthcare than countries such as Portugal, Japan and the Netherlands. If those countries value health in this way, surely so can the UK.
NHS Sustainability and Transformation Plans — House of Commons, 2016-09-14
Topic: Health
Margaret Greenwood (Labour, Centre-left): To understand the significance of the Government’s creation of the sustainability and transformation plans, we need to be aware of what has gone before and consider the extent of the financial crisis. In 2012, the coalition Government passed the Health and Social Care Act, paving the way for the privatisation of the national health service and removing the duty of the Secretary of State to provide and secure a comprehensive health service in England. I believe the STPs are a key part of the Government’s plan to drive through privatisation.