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?

Diary date! Free TTIP film screening

The Transatlantic Trade and Investment Partnership - or TTIP - will have far-reaching implications on the NHS. To find out more, come along to a free screening of The Trouble With TTIP, a one-hour documentary.

Linda Kaucher from the Stop TTIP campaign will be on hand to answer your questions about what can be done to stop this secret US/EU trade deal.

Date: Thursday 3 September

Time: 7.30pm

Venue: Gorringe Park pub/cinema, 29 London Rd, Tooting, SW17 9HW. The pub is right next to Tooting Railway Station between Amen Corner and Figges Marsh.

Click here to find the event on Facebook.

Here is a short video to tell you more:

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 speaks out on CCG staff taking lavish trips

The Epsom Guardian today reported that staff from Surrey Downs CCG and North West Surrey CCG went on a luxury spa trip to Germany funded by a pharmaceutical company.

Click here to read the story online.

We were asked to comment and, in short, we smell a rat. Why would it be necessary to go to a luxury spa in Germany to discuss a constipation drug? We understand that the NHS needs to buy drugs from pharmaceutical companies. It would be impractical for the NHS to start manufacturing every single drug it requires, obviously. But we do not understand why Clinical Commissioning Group staff would accept lavish hospitality from these companies?

The CCG system is problematic. It is undemocratic. It is clearly part of a larger agenda to privatise the NHS. There are members of CCGs with vested interests in healthcare. How can anyone who stands to win an NHS contract be in a position to commission such contracts?

Now we have supposedly independent commissioners taking luxurious trips at the expense of pharmaceutical companies. How is this OK?

The Surrey Downs CCG Director of Commissioning and Strategy, James Blythe, defended the trip. He said that Cosmocol, the constipation drug discussed on the trip, had already been commissioned before the trip took place.

But Cosmocol is not the only drug in Stirling Anglian Pharmaceuticals' range. Click here to see what else they have on offer. They also sell an osteoporosis drug. And who's to say the company won't add more products in the future?

Surrey Healthwatch communications officer, Lauren Ter Kuile, said that nobody has been in touch to suggest there was anything untoward about this trip.

Lauren, now we know about this and we thank Chris Longhurst from the Epsom Guardian for informing us, we are indeed suggesting that there is plenty that is untoward about this trip.

Will this lead to a change in policy? Are more CCG members taking trips at the expense of private companies? The public deserves to know and deserves better.

Asking questions of the Epsom-St Helier Trust: Part II

We are still asking questions about the Epsom-St Helier Estates Review document via Twitter. This is not a simple review of bricks and mortar, it is a review with far-reaching implications for our local hospitals.

Click here to download your copy of the Estates Review. It is essential reading for anyone who is concerned about the future of our local health services.

In our online discussions with the trust, we have asked about how they plan to publicise the review and the feedback period. One of the methods that was mentioned was leaflets. As a small campaigning group, we know how hard it can be to distribute leaflets widely to raise awareness.

However, we thought that a hospital trust might have a few more resources for widespread distribution of leaflets in the catchment areas for Epsom and St Helier Hospitals. A cursory Google search reveals that leaflets can be delivered from £25 per 1,000.

We asked the trust how the leaflets will be distributed. Will they be sent to every household, for example?

Here is the response:

If you see one of these leaflets, please let us know!



Photography by Piotr Siedlecki

Asking questions of the Epsom-St Helier Trust, Part I

Yesterday, we informed the public that the Epsom-St Helier Trust's Estates Review document is not a benign document about mere bricks and mortar. It is about the very future of our local hospitals.

KOSHH campaigners are systematically going through the document and we have already started asking questions of the trust via our Twitter account about the review, the consultation process and how it will be publicised. We are disappointed that our local MPs and councillors are not publicly scrutinising the Estates Review or asking questions of the trust on behalf of the people who use Epsom and St Helier's NHS hospitals.

Today, multiple campaigners have asked the trust questions about the online questionnaire process attached to the Estates Review and how widely this will be publicised.

Questions from Twitter, Wednesday 30 July, 2015

The trust confirmed yesterday that the online questionnaire would be open until September 30. Here are some more questions from KOSHH campaigners and answers from the Epsom-St Helier Trust from today:

Q: Can you tell me the purpose of seeking views on the estates document? What is the objective?

A: Simply to find out what local people want from hospital buildings and facilities in the future.

This answer doesn't really tell us much. Surely local people want to continue to receive healthcare services from hospital buildings and facilities and for these buildings and facilities to be properly maintained so they are hygienic and safe?

So we asked another question...

Q: That's *what* you intend to discover. My question is why? For what purpose?

A: Do you think it might be best to have a conversation about this? We can organise a chat with one of our execs. Easier for you and us to share info that way!

We are finding it perfectly easy to ask questions via social media. We like the open forum, we like that the public can see the answers as we receive them. We will continue to ask questions about the Estates Review publicly in the interests of transparency.

The Epsom-St Helier Trust has expressed reservations about answering our questions via the 140-character format of Twitter. We agree that this has its limitations. With that in mind, we invite the trust to use the comments section of this blog if they would like to answer our concerns with more than 140 characters. This blog is set up so anyone from anywhere in the world can comment.

Raising public awareness about the Estates Review

KOSHH campaigners are deeply concerned about how widely publicised the Estates Review and the online questionnaire will be. We are quite sure that very few members of the wider public are aware of this review or that they can download the document and give their feedback to the trust. As such, we asked the following questions:

Q: Will you make the general public aware of this questionnaire about their local hospital? Do you want a wide response to the questions? Will you publicise it?

A: We'd love a wide response! Have asked GPs, councils, Healthwatch and community groups to take part.

Q: What about people outside of those groups?

A: We've been promoting it on the web, Twitter, public meetings and leaflet will be with us shortly!

Waiting for more answers

As yet, we have not received a direct answer from the trust on these questions:

Q: What will be done with the information garnered via the online questionnaire?

Q: In regard to the promised leaflets, how will they be distributed? Mailed out to all residents?

As soon as we have responses to these questions, we will share them via Twitter, Facebook and this blog. Spokespeople for the Epsom-St Helier Trust are more than welcome to respond to these questions in the comments section of this blog post.

We look forward to getting more answers as we carefully analyse the Estates Review document and we will share the answers as we receive them.



Photography by Charles Rondeau

KOSHH campaigner in the news!

It has never been easier to write to your local newspaper in this era of email. And with newspapers now online, the reach of newspapers goes beyond the traditional audience of people who actually buy newspapers or have them delivered. We urge everyone to be heard via the letters pages of our newspapers - it does not take long to send an email.

KOSHH campaigner, Philippa Maslin, features at the top of the letters page in today's Sutton Guardian. She expresses perfectly our frustrations with our MPs and the conflicting messages thet are sending out over the future of Epsom and St Helier Hospitals.

The Epsom-St Helier Trust Estates Review: This is not a drill! This is the future of our hospitals!

The Epsom-St Helier Trust has released the Estates Review document. At first glance, it seems like a harmless enough report on the bricks and mortar of our local hospitals. It might even be a bit boring.

But the reality is that the Estates Review document is rather serious indeed. It is a report on the future of our local hospitals, Epsom and St Helier. We cannot underestimate the importance of this document or the need for people to read it carefully and respond to it.

Click here for the link to the report. You will have to download a PDF of the report to find out what the findings are and what this might mean for our vital health services.

At the end of the link is a questionnaire so members of the public can respond to the Estates Review. The Epsom-St Helier Trust has assured us this is not the official public consultation. We should hope not - this has been released with minimal publicity over the summer holiday period when many people are away. The closing date for submitting your comments via the online questionnaire is Wednesday 30 September.

We would be horrified if this was the official consultation period and the process was just an online questionnaire, given that the report could provide a road map for the future of our hospitals.

KOSHH campaigners will be reading the Estates Review document very carefully as we have serious concerns about what it contents mean for the future of our hospitals. Rest assured that as we go through this document, we will be asking hard questions of the Epsom-St Helier Trust and we will be making our questions and their responses public. 

KOSHH goes to the pub!

KOSHH campaigner, Colin Crilly writes about yesterday's stall at the Morden Brook:

On the afternoon of Sunday 26 July, KOSHH had a stall at the Morden Brook pub*, as part of their event to raise funds for the Great Ormond Street Hospital. I was joined by Sandra Ash, David Ash and Dave Ash - we nicknamed ourselves CASH!**

We leafleted most people in the pub about the screening of Sell-Off, which will be held this Wednesday night. Click here for more information about the screening - this will also be held at the Morden Brook. We also got a few more petition signatures, which are always welcome. Additionally, more badges were sold, and we gave out quite a few KOSHH window posters. Click here for more information about how to get your hands on one of these lovely posters. 

After more than three hours, we packed up, and posted the remaining leaflets about the Sell-Off screening through letterboxes of a nearby street. As I left the pub, I met a lady by the name of Sandra, and gave her a leaflet - it turned out that she is a leading figure at the nearby church. She has promised to attend the screening and inform other members of the congregation about it. We have also been invited to be part of the church's open day in September.

Any actions like these, no matter how small, are always worthwhile. Every leaflet given out, or discussion participated in could be of pivotal importance. It all helps to get the message out that not only are our local health services under threat but also the wider NHS.

* Many thanks to the Morden Brook for their ongoing support with meeting rooms and event-hosting. Click here to "like" them on Facebook.

** Many thanks to Philippa Zielfa Maslin and Chris Stanton for their assistance in dropping off some essentials to the stall as well.