Update on personal health budgets in South-West London/Surrey

We received an excellent response to our blog post on personal health budgets, the poor media reporting of these budgets and what they may mean for health services in our area. Thank you to everyone who took the time to read the blog post and share it.

We have now put in freedom of information requests with all six Clinical Commissioning Groups responsible for our end of South-West London/Surrey.

These are the questions they have been asked:

1. How many patients in the CCGs which come under SWLCC's administration are on personal healthcare budgets?

2. What is the average amount spent per patient on these budgets?

3. Can you provide a demographic breakdown of who uses these budgets?

4. Without naming patients, is there information available on what sort of treatments these budgets are funding?

5. What happens to a patient if their personal budget runs out and their health has not improved?

The six CCGs have 20 working days to respond to the FOI request. As such, we will report back on September 29 on any responses we have received.

Summer houses on the NHS? Cutting through the news reports with questions for our CCGs!

Sky News led its bulletin this morning with attention-grabbing headlines about summer houses, holidays and sat-navs being funded by the NHS. Sky News didn't actually research the story themselves - that was done by Pulse magazine, which investigated how personal healthcare budgets are spent. Plenty of other media outlets have also run this story including the BBC, the Mirror,

At least the Guardian, the Telegraph and the Independent mentioned that it is Clinical Commissioning Groups - or CCGs - that are allocating the money courtesy of the personal healthcare budgets. That would be the CCGs created under the Health and Social Care Act 2012. But you'd sooner find a report about the colonisation of the moon by unicorns wearing saddles made of cheese than ever see a news report mention this act, which was passed in the last parliament by the Conservative and Liberal Democrat MPs.

Of course, the truth is rather more complicated than any of these reports imply. Credit where credit is due though - the Daily Mail, while not accepting comments on the article online, had the insight to run a decent Press Association report. This report featured an interview with a professor who pointed out that while personal healthcare budgets may seem attractive on the surface, they do reflect an ideology that is "consumerist and individualistic" and not evidence-based.

But the way this story has been largely reported serves insidious dual purposes.

1. It demonises patients in the same way that stories about misuse of A&E departments and GPs demonise patients. While misuse of A&E and GP services creates problems, it makes for cheap headlines that ignore the bigger funding issues. It is easier to mock the person who rocked up to A&E with dog poo on their shoe than get properly angry about things like the cost to the taxpayer of rotten PFI deals and administering the NHS marketplace, both of which squander billions of pounds each year.

While personal healthcare budgets are not compulsory, can we be sure that patients, especially vulnerable and elderly patients, are not pressured into joining this scheme? It has echoes of Jeremy Hunt's plan to put the price of medications on the packaging so we know how much we are costing the NHS every time we take a pill that we need to get better. This plays into the "mustn't be a burden" mentality, the fear of wasting NHS time, even if someone is in genuine need of care.

If these budgets are targeting the vulnerable, it becomes questionable as to whether they really meet the goal of helping people take responsibility for their health and wellbeing.

2. It is more NHS-bashing by the media, feeding into the public appetite for cuts. By highlighting summer houses, holidays and sat-navs, it makes people angry about profligate NHS spending and removes any subtlety from the discussion. A holistic approach to healthcare is important - and defenders of personal healthcare budgets will use this argument - but holistic treatments need to be evidence-based, especially when they are publicly funded.

Are personal healthcare budgets a sneaky way to funnel more money to the private sector right under our noses? Will patients be encouraged to use their budgets to fund private health insurance?

The Pulse report does not mention our local CCGs, which fall under the umbrella of South West London Collaborative Commissioning. But in the interests of full transparency, we have some questions for them about how they use personal healthcare budgets. As we are still fighting to keep essential services, such as A&E and maternity as well as entire hospitals open, these questions need to be answered.

If a representative from SWLCC could respond to the following questions in the comments section of this blog post, that would be much appreciated:

1. How many patients in the CCGs which come under SWLCC's administration are on personal healthcare budgets?

2. What is the average amount spent per patient on these budgets?

3. Can you provide a demographic breakdown of who uses these budgets?

4. Without naming patients, is there information available on what sort of treatments these budgets are funding?

5. What happens to a patient if their personal budget runs out and their health has not improved?

KOSHH raises awareness at the Morden Family Fun Day

Dave Ash, Philippa Maslin and Colin Crilly spread the word about the threat to our hospital.

KOSHH campaigner Philippa Maslin writes about our presence on the weekend at the Morden Family Fun Day, an annual event held in Morden Park.

Sunday 19 July 2015 was the Morden Family Fun Day and KOSHH were extremely pleased to be a part of it. Thank you very much to Andy Butcher for his help in making this happen.

The KOSHH stall drew a lot of attention throughout the day, with many people interested to know the latest news regarding the hospital, and to sign a petition addressed to South West London Collaborative Commissioning (SWLCC). This petition asks that SWLCC protects, maintains and improves not only St Helier Hospital, but also Epsom Hospital, St George’s Hospital, Kingston Hospital and Croydon Hospital. 

In addition, quite a few people donated £1 in exchange for a lovely KOSHH badge, and ‘a regular’ at St Helier Hospital bought one of our equally lovely T-shirts.

People who were born at the hospital, people whose children were born at the hospital, people who have attended A&E, people whose life was saved by hospital staff, and people who are regular patients – we met them all and, by gosh, did some of them have some moving stories to tell. It was clear that the local community’s high regard for and loyalty to the hospital remains undiminished, and that ongoing threats to the hospital are perceived as deeply unjust.

It was particularly notable that a number of visitors to the stall recalled a BBC London news report, from April, which unearthed a secret plan to replace St Helier Hospital and Epsom Hospital with a new medical centre in Sutton – a centre which would not be built until at least 2020, but which would have just 800 beds, as opposed to the current 1,200 beds. 

What was especially striking was that no one seemed to be aware of the Estates Review being conducted by the Trust, or that the Review’s recommendation that £500m needs to be spent on rebuilding St Helier Hospital and St Epsom Hospital stands in direct contradiction to the massive ‘efficiency savings’ that both the Trust and SWLCC say that they are being asked to make. 

Visitors to the stall were completely shocked by this latest development, with several saying that it was bad enough when the £219m that was promised to St Helier Hospital was suddenly returned to the Treasury.

Of course, the uncertain future of St Helier Hospital is part of a wider picture of NHS cuts, closures and privatisation, and KOSHH exists to fight for the whole NHS, as well as our local hospital. It was, therefore, heartening to hear from the Mayor of Merton, David Chung, that he was going to try to help us arrange a screening of an extremely important and powerful documentary about the horrific destruction of the NHS, Sell-Off: The Abolition of Your NHS (2014), in Merton Civic Centre. His support is most welcome and we look forward to working with him. 

KOSHH would like to thank absolutely everybody who took the time to visit the stall. We really enjoyed meeting you all!

A victory with the CCGs!

We have achieved a victory this week with the local Clinical Commissioning Groups (CCGs)! The six CCGs which make the big decisions for Epsom and St Helier's health services are grouped together as South West London Collaborative Commissioning (SWLCC).

For a long time, we have asked that the meetings of all six CCGs, which are open to the public, be better advertised. The SWLCC website did not make it easy to find out when the meeting times are for the CCGs and the individual websites for each CCG were not much better. But after much agitation of the SWLCC Twitter account, we are pleased to report that the SWLCC website home page now has direct links to meeting times for all six CCGs.

All you have to do now to find out when the meetings are on is click here and scroll down.

We thank SWLCC for making this small but important change to the website.

It is so important that information about meeting times is easy to find and that people are aware of the role of CCGs in our health system.

Our next request is for at least half the meetings of the CCGs be held in the evenings to allow more people to attend. At present, meetings are generally held in office hours which makes it impossible for many working people to attend. If the CCGs could look at addressing this issue in the interests of transparency, that would be much appreciated.

Additionally, we have been disappointed but not entirely surprised that local MPs have not been vocal on issues of transparency with CCGs. We urge all MPs to attend CCG meetings whenever possible, or to send representatives to ask questions on their behalf when they cannot make it because of other commitments. This is where the big decisions are being made about Epsom and St Helier Hospitals so it is vital they are well informed and challenge CCGs on how our money is spent.



Image by Piotr Siedlecki