KOSHH in the news! Featuring Tom Brake MP making curious statements...

KOSHH has made it to the front page of today's Sutton Guardian. It is always encouraging to get coverage in the media although we wish the future of our local health services was assured and we didn't have to keep waking people up to the real threats to St Helier Hospital, as well as other hospitals in south-west London and Sutton.

Click here for the link to the Sutton Guardian article.

It is curious that Tom Brake, Liberal Democrat MP for Carshalton and Wallington, is only now saying the £219m earmarked for St Helier Hospital's redevelopment is off the table. Has he been paying attention? This has been the case for quite some time now. Click here for a story on this from 2012 and click here for another story about the £219m from as far back as 2010.

The letter Brake received in August from Jeremy Hunt should surprise nobody.

Given that it is well known that local Clinical Commissioning Groups (CCGs) have been tasked with making "efficiency savings", it should come as no surprise to anybody who is paying attention that this money is not likely to be forthcoming. While it would certainly be more responsible to spend money properly upgrading St Helier Hospital instead of building a whole new hospital on the old Sutton Hospital site, at the expense of Epsom and St Helier Hospitals, as per the "traingate" leak, it is now apparent that we won't see a massively overhauled St Helier Hospital any time soon.

Yesterday was the closing date for public comments on the Epsom-St Helier Trust Estates Review document via the trust's website*. This document mentions £500m worth of investment is required. This would still work out cheaper than building a whole new hospital, along with the necessary road and public transport upgrades, for a new hospital on the Sutton site. That is a ridiculous plan which would mean at least 400 less beds for the local area and a hospital in a less convenient location than Epsom or St Helier.

It is also curious that Tom Brake described George Osborne's response to his question in the House of Commons about the future of St Helier Hospital as an "almost cast-iron guarantee". Leaving aside the metallic mystery as to what "almost cast-iron" is, a quick read of Hansard reveals that George Osborne simply gave a typical politician's answer in which no specific commitment was made and in which he was very careful to not actually mention the £219m sum.

Why did Tom Brake not make a bigger fuss about George Osborne's completely unsatisfactory non-answer at the time?

St Helier Hospital remains in limbo, with smaller upgrades taking place, but no overall plan in place to improve the site overall.

Furthermore, given that Tom Brake voted for the Health and Social Care Act 2012, which led to the creation of CCGs in the first place, why does he never attend CCG meetings to ask hard questions of the decision-makers who are spending our money? It would also be nice to see Tom Brake at Epsom-St Helier Trust board meetings too.

The CCGs, as well as the Epsom-St Helier Trust, need to be held publicly accountable for the way our tax pounds are spent and for their plans for the future of our essential local health services.

It is not just Tom Brake who should be doing this but all local MPs, regardless of political affiliation, and all local councilllors, especially those who campaigned on a platform of saving St Helier Hospital.

As we reported earlier this week, Merton CCG Chief Officer, Adam Doyle, was not prepared to make any public commitment to any of our local hospitals at last Thursday night's AGM. There are six CCGs, as part of South West London Collaborative Commissioning, involved in making decisions about our local health services. The lack of commitment to preserving our hospitals by Merton CCG is, most likely, the tip of the iceberg.

This story is far from over.

* A more detailed blog post on the Epsom-St Helier Trust Estates Review is coming soon.







Photography by Piotr Siedlecki

Merton CCG AGM: KOSHH's concerns

We attended the Merton Clinical Commissioning Group (CCG) Annual General Meeting last Thursday night and our concerns for the future of St Helier Hospital remain as strong as ever. The AGM organisers called for questions in advance. Despite this, the only questions submitted were from KOSHH.

Our first question was whether all members of Merton CCG have read the Epsom-St Helier Trust Estates Review document. As this is a possible blueprint for the future of both Epsom and St Helier hospital sites, we expect everyone involved with all relevant CCGs to have read it. This is not an unreasonable expectation.

Adam Doyle, the Chief Officer, confirmed that all members of the governing body have read the Estates Review but not all members of the CCG. This is disturbing to say the least. Why wouldn't all CCG members be compelled to familiarise themselves with a document that will have far-reaching implications on local health services?

We asked if anyone from Merton CCG could share their thoughts on the review but nobody on the panel was prepared to offer any comment.

We then asked if the CCG members see the Estates Review as a threat to the future of St Helier Hospital. Despite this being a yes-or-no question, no yes-or-no answer was forthcoming.

Most critically of all, we asked if Merton CCG is committed to the preservation of all services at St Helier Hospital. Again, this is a yes-or-no question but we started to get an answer that talked of challenges, issues and the need for repairs at St Helier Hospital but no definite response.

We asked for a yes-or-no answer and were told that the CCG could not commit to preserving the services at any hospital.

Our final question was to ask if Merton CCG was going to prepare a response to the Estates Review and whether it would be made public. Given that 30 September is the closing date for responses, this is also a pressing matter. Adam Doyle confirmed that Merton CCG would respond to the Estates Review and that their response will be made public in November.

It is hardly surprising that members of KOSHH did not leave the meeting feeling relaxed and comfortable about the future of vital services at St Helier Hospital. Given that the meeting repeatedly made the point that the area has a high birth rate and a growing population, it is shocking that Merton CCG is not prepared to make a strong and public commitment to preserving vital services at any of the local hospitals, including A&E and maternity.

KOSHH campaigners will be meeting with Merton CCG on 13 October and we will share the outcome of that meeting in the interests of full transparency and keeping the public informed on the threats to our local health services. We have been accused of scaremongering in the past but we maintain our position that the threat to St Helier Hospital's vital services remains and it has only been through the tireless campaigning of dedicated members of the community over many years that we still have this essential facility.

Merton CCG is not the only CCG responsible for making decisions that will affect the future of our local hospitals. KOSHH campaigners will also be holding the other CCGs that make up South West London Collaborative Commissioning to account.

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?

CCGs (or why campaigning to save the local hospitals is so hard...)

Campaigning to save your local health services often feels like being at the foot of a mountain. You start to climb, you feel like you've made some progress, and then someone at the top of the mountain drops a giant bucket of mud down the slope and you're pushed back where you started from. And you're covered in mud so you might feel a bit demoralised as well.

Additionally, it can be hard to know where to direct your complaints, demands and questions about threats to your local health services. And, even if you do know, it can be hard to then mobilise people en masse to join the fight.

It is all well and good to be angry at the government and the Health Secretary. But we also need to be aware of how NHS England now works as a result of the Health and Social Care Act 2012, which was voted in by the Conservative and Liberal-Democrat MPs in the last parliament.

This act created the Clinical Commissioning Groups - the CCGs.

CCGs operated in every region of the country. They make the big decisions. They hold the pursestrings. They have been allocated budgets and it is they who make the decisions about what health services the NHS will fund in your local area.

When you see the phrase "postcode lottery" bandied about in the mainstream media about patients being denied treatment or patients receiving treatment that may be perceived as a poor use of public money, it is the CCGs that are making these decisions.

The postcode lottery situations we see today are a result of the Health and Social Care Act 2012.

Therefore, it is somewhat curious that when the media reports on postcode lottery NHS stories that this pernicious act of parliament is never mentioned. This week, the Daily Mail screamed at us about "Doughnuts and pizzas on the NHS"! This is the sort of journalism that relies on short attention spans and people not properly reading articles. This report, about patients with coeliac disease receiving gluten-free food on prescription, mentions how the system works but only in passing with a "NHS rules for prescribing food vary area by area" and the occasional "some NHS trusts" thrown in for good measure.

No mention of the role of CCGs in all this. That'd be the CCGs created by a government the Daily Mail supported then and, in its Tory outright majority form, supports now.

And it's not just the Daily Mail offering poor information on this story. Carole Malone writes a context-free opinion piece for the Mirror that seems to imply that the NHS has degenerated into a profligate cake shop for all. And the Daily Express fumes in a similar manner with no mention at all of how gluten-free food on prescription varies from region to region.

It also comes as no surprise that the Daily Telegraph, a long-time cheerleader for the Conservative Party, did not mention regional variations, CCGs or the Health and Social Care Act.

The Independent offers an opinion piece from a coeliac patient which at least calls out the reporting as "alarmist" but there is still no mention of CCGs or the Health and Social Care Act.

The BBC this morning, to its credit, did indeed mention CCGs when reporting on this story on the breakfast programme. But if you didn't happen to be tuned in to BBC1 at around 8.30am today, you probably missed the lesser-spotted CCG mention.

So what on Earth does all this have to do with saving Epsom and St Helier Hospitals?

Quite a lot, actually. The media hysteria over gluten-free food on prescription, while certainly a topic worthy of discussion, has become part of the NHS-bashing narrative of the mainstream media. As long as there is a drive to denigrate the NHS at every opportunity by a compliant media, the CCGs, and indeed the whole system that has created them in Westminster, will go unchallenged.

The mainstream media cannot be bothered to remind the public about how the NHS is now structured with CCGs or how that happened when they report on such stories, even though this is 100% relevant.

And here, in our end of South-West London/Surrey, we have been challenging the local CCGs, which are grouped under the umbrella of South West London Collaborative Commissioning, about their plans for Epsom and St Helier Hospitals as well as their declarations of interest.

If only the media would join us in this endeavour.






Photography by Maliz Ong

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!