Brexit: education and health spending rerouted to fishing and farming

“Cabinet ministers are being told that some of their most prized projects cannot be developed because so many officials have been diverted to delivering Brexit, it has emerged.

Ministers’ priority programmes have fallen victim to “re-prioritisation”, according to internal government warnings seen by the Observer.

Government insiders said they knew of examples of officials usually dealing with schools and hospitals who were now redeployed to work on farming and fishing as a result of the scramble to prepare for all Brexit outcomes, including no deal. “It’s a real worry now that things are being held up and not happening,” said one senior Whitehall source. “We are really starting to see it as the Brexit process drags on and on.”

A memo to a senior minister, said: “In the context of ongoing cross-government re-prioritisation exercises, departments have not yet been able to resource the necessary cross-government team to deliver the work.”

The government’s plans for resolving the crisis in social care and a review of university finance are among the major policy proposals that are said to have been held up by Brexit, while many other areas have suffered due to the lack of parliamentary time and political instability. …”

https://www.theguardian.com/politics/2019/feb/17/health-and-rail-plans-sidelined-ahead-of-brexit-deadline

Newton Poppleford GP surgery: lost, never to be regained

This means that, should the NHS ever regain the funding and doctors it needs, and should the local surgery then be in a position to open a secondary surgery in Newton Poppleford, it can never happen.

Anyone buying a new Clinton Devon Estates house at Newton Poppleford (particularly if they have children, or a chronic health condition or are elderly) might want to think twice if this is a suitable location for them.

And EVERYONE should beware “promises” from developers.

A Devon development site once earmarked for a “much needed” GP surgery is being turned into housing instead – much to the disappointment of residents.

People living in Newton Poppleford have to travel miles for medical care.

It comes as a report from the government watchdog, the National Audit Office, has criticised how community infrastructure projects for healthcare, education, and transport are often abandoned once planning permission’s been granted.

In a statement, the developers Clinton Devon Estates said the withdrawal of the surgery plans was understandably very disappointing, but the decision was made by a local medical practice due to circumstances beyond their control with unexpected changes to NHS policy.

https://www.bbc.co.uk/news/live/uk-england-devon-47170553

Ottery Town Council (particularly Councillor Carter) makes itself a laughing stock (again)

Owl says: It is well-known that Councillor Carter (one of the Greendale Carters) has no love for independent councillors!

https://eastdevonwatch.org/2018/11/07/majority-of-ottery-town-council-remarkably-unconcerned-about-the-future-of-their-hospital/

https://eastdevonwatch.org/2019/02/08/decision-overturned-to-set-up-ottery-hospital-working-group/

From the blog of Independent Councillor Claire Wright:

“Ottery St Mary Town Council revisited the contentious issue of whether it should support setting up a group to ensure the future of Ottery Hospital at yet another fraught meeting on Monday 4 February.

A bit of background information – at the town council meeting on 6 November a similar proposal was agreed by three votes to nil. Subsequently the town council abstainers (who thought that they had won) called for an extraordinary town council meeting to overturn the decision, which took place on 29 November.

Subsequently it became known that two members of the Health and Care Forum had established a limited company whose purpose is unclear.

I still find it hard to believe that a proposal to set up a working group to help retain the hospital, by a councillor – Geoff Pratt, who was asked as to help by the Health and Care Team Chair, has resulted in a bitter row lasting four months.

Our offer of help has been sullied, dragged through the dirt and subject to chicanery by political opponents who appear to be engaging in some kind of strange game of cat and mouse. I have been insulted on social media and mine and the town’s residents continued efforts over the years to retain the hospital and its beds have been rudely ridiculed and dismissed.

Myself and Dr Margaret Hall, who was also subject to unpleasantness, have both pulled out of any potential group as a result. It was difficult to believe the level of vitriol from a minority of people.

On Monday evening the town council finally agreed to meet with the hospital League of Friends Chair, Adrian Rutter, who came across as the voice of reason on Monday evening. However, as soon as the row seemed to abate, Cllr Paul Carter bizarrely decided to reignite it by insinuating that our offer of help was a bid to cause trouble.

One councillor announced that she didn’t think Mr Rutter should be allowed to speak as he hadn’t asked to do so at the beginning of the meeting!

Cllr Carter then accused me of smirking (I was doing anything but smirking!) and the mayor refused to let me respond. I did, however, manage to ask Cllr Carter why he was trying to reignite the row again.

Once again there were raised tempers, including from members of the public. One of whom told me afterwards it was one of the worst town council meetings he had ever attended.

It was not very clear what was agreed, but I believe the town council deferred a decision to establish the working group.”

http://www.claire-wright.org/index.php/post/ottery_town_council_to_meet_with_league_of_friends_chairman

“Decision overturned to set up Ottery Hospital working group”

What IS going on at Ottery town council? Sounds like a nest of vipers! AND a nest of political chicanery … Who IS it (or who are they) fomenting this silly behaviour – and why? If you can’t work together for the good of the community – should you even be a councillor at all?

“A proposal to create a working group to safeguard Ottery Hospital has been overturned following more heated debate over how to save it.

A motion was submitted on January 24, signed by councillors Glyn Dobson, Ian Holmes, Anne Edwards and Lynn Harding, to re-examine the decision to support or rescind a motion to set up the group.

The proposal was passed in November, with many councillors abstaining due to a lack of information or because they felt it would duplicate the work of the town’s health and care forum.

Residents had their say at an extraordinary meeting on November 29, when a motion was first made to re-examine the motion.

The decision was deferred until February to allow organisations involved in saving the hospital to meet and gather information.

Speaking at Monday’s town council meeting, Councillor Roger Giles, who supported the group, said: “The purpose of the working group was to bring all sorts of organisations and good people together to embrace the skill and expertise and energy of the LOF (League of Friends).

“I really can’t see why we are not doing something – we need to campaign, we need to get as many services as we can in Ottery Hospital.

“Fill it up, get it used to capacity, and ensure its future. That’s the essence of what I am trying to achieve.”

Adrian Rutter, chairman of the hospital League of Friends, said everyone had the same aim but did not share a way of working together.

Mayor Paul Bartlett offered to meet representatives from the health and care forum and League of Friends to discuss any problems between the two groups.

Members voted to rescind the group by five votes to three.

Following the vote, Deputy Mayor Paul Carter said he was ‘disappointed’ members were failing to pull together.

He said: “If you have expertise that can help what’s already happening, why not help and join in?

“I cannot believe we’re all grown-ups down this table and we keep going down different avenues.

“I would very much like, going forward, to try and pull together and look down the same road.”

He added: “We do not need to be going on independent routes to be a collective and a team.

“I always say we’re stronger together.”

https://www.sidmouthherald.co.uk/news/decision-overturned-to-set-up-ottery-hospital-working-group-1-5883068

Chilling report on NHS sustainability – it isn’t sustainable

Owl says: anyone who cares about the NHS should read EVERY PAGE of this 58-page report, which is written in clear and accessible language.

Every page signals a death-knell for the NHS sooner rather than later.

It is hard to pick out anything – every page tells a story of (deliberate?) mismanagement, underfunding and chaotic accounting.

For example:

“Key findings

The funding settlement for the NHS long-term plan

8 The long-term funding settlement does not cover key areas of health spending. The 3.4% average uplift in funding applies to the budget for NHS England and not to the Department’s entire budget. The Department’s budget covers other important areas of health spending such as most capital investment for buildings and equipment, prevention initiatives run by Public Health England and local authorities, and funding for doctors’ and nurses’ training. Spending in these areas could affect the NHS’s ability to deliver the priorities of the long-term plan, especially if funding for these areas reduces. The government will consider proposals in these areas as part of its 2019 Spending Review. In addition, without a long-term funding settlement for social care, local NHS bodies are concerned that it will be very difficult to make the NHS sustainable (paragraphs 2.27 and 2.28).

9 There is a risk that the NHS will be unable to use the extra funding optimally because of staff shortages. Difficulties in recruiting NHS staff presents a real risk that some of the extra £20.5 billion funding will either not be used optimally (more expensive agency staff will need to be used to deliver additional services) or will go unspent as even if commissioners have the resources to commission additional activity, health care providers may not have the staff to deliver it (paragraphs 1.19 and 2.29).

10 From what we have seen so far, the NHS long-term plan sets out a prudent approach to achieving the priorities and tests set by the government, but a number of risks remain. The long-term plan describes how the NHS aims to achieve the range of priorities and five financial tests, set by the government in return for the long-term funding settlement, which NHS England believes are stretching but feasible. As with all long-term plans, it provides a helpful indicator of the direction of travel, but significant internal and external risks remain to making the plan happen. These risks include: growing pressures on services; staffing shortages; funding for social care and public health; and the strength of the economy. Our reports have highlighted how previous funding boosts appear to have mostly been spent on dealing with current pressures rather than making the changes that are needed to put the NHS on a sustainable footing (paragraphs 2.24 to 2.26).

Financial and operational performance of NHS bodies

11 In 2017-18, NHS commissioners and trusts reported a combined deficit of £21 million. This was made up of:

The combined deficit of £21 million does not include adjustments needed to report against the Department’s budget for day-to-day resources and administration costs.

12 It is not clear that funding is reaching the right parts of the system.
The overspends by trusts and CCGs were broadly offset by the underspend by NHS England. In 2017-18, NHS England’s underspend included: £962 million from non-recurrent central programme costs, including efficiencies from vacancies;

a £280 million contribution to the risk reserve and £223 million from centrally commissioned services, mostly specialised services (paragraphs 1.4 and 1.8).

13 Most of the combined trust deficit is accounted for by a small number of trusts, while the number of CCGs in deficit increased in 2017-18. The net trust deficit hides wide variation in performance between trusts, with 100 out of 232 trusts in deficit. In 2017-18, 69% of the total trust deficit was accounted for by 10 trusts. NHS Improvement has committed to returning the trust sector to balance in 2020-21, but it is difficult to see how this will be achieved for the worst-performing trusts under current arrangements. Although support provided to trusts in NHS Improvement’s financial special measures programme has been successful in improving the position of some trusts (by £49 million in 2017-18), the financial performance of the 10 worst-performing trusts deteriorated significantly in 2017-18. Between 2016-17 and 2017-18, the number of CCGs reporting overspends against their planned position increased from 57 to 75. The NHS long-term plan sets out the national bodies’ aim that no NHS organisation is reporting a deficit by 2023-24 (paragraphs 1.6 and 1.11).

14 There are indications that the underlying financial health in some trusts
is getting worse. In 2017-18, trusts reported that their combined underlying deficit was £4.3 billion, or £1.85 billion if the Provider Sustainability Fund (which replaced the Sustainability and Transformation Fund in 2018-19) is allocated to trusts in future years. There is no historical data on the underlying deficit that takes account of one-off savings, emergency extra cash and other short-term fixes that boost the financial position of the NHS, so it is not clear whether this position is getting better or worse. However, indicators such as cash support and one-off efficiency savings suggest the position has not improved. For example, in 2017-18, the Department gave £3.2 billion in loans to support trusts in difficulty, up from £2.8 billion in 2016-17. In 2017-18, 26% of trusts’ savings were one-off. Trusts will need to make additional savings in 2018-19 to replace these one-off savings (paragraphs 1.13, 1.14, 2.13, 2.17 and 2.18).”

https://www.nao.org.uk/wp-content/uploads/2019/01/NHS-financial-sustainability_.pdf

“NHS and councils full of financial problems, says watchdog”

“National Audit Office shocked by state of bodies including police and fire authorities.

The number of NHS and local government bodies with significant financial weaknesses in their ability to give value for money is unacceptably high and increasing, according to Whitehall’s spending watchdog.

The National Audit Office has examined the financial statements from nearly 937 local health authorities, councils, police and local fire bodies which are responsible for about £154bn of net revenue spending every year.

Auditors conclude in a report published on Wednesday that the number of local bodies with significant weaknesses increased from 170 (18%) in 2015-16 to 208 (22%) in 2017-18.

It follows the publication of an International Monetary Fund report in October which found that the UK’s public finances were among the weakest in the world after the 2008 financial crash.

Sir Amyas Morse, the head of the NAO, said he was shocked by the persistent high level of qualified audit reports at local public bodies.

“A qualification is a judgment that something is seriously wrong, but despite these continued warnings, the number of bodies receiving qualifications is trending upwards,” he said.

“Let us hear no cries of: ‘Where were the auditors?’ when things go wrong. The answer will be: ‘They did the job, but you weren’t listening.’

“This is not good enough. Local bodies need to address their weaknesses, and departments across government should ensure they are challenging local bodies to demonstrate how they are responding.”

Each year, local auditors give an opinion on whether local public bodies have produced financial statements which comply with reporting requirements and are error-free, and conclude whether local public bodies have arrangements to manage their business and finances.

Wednesday’s report examined accounts from 495 local authorities, local police and local fire bodies in England; and 442 local local NHS bodies in England, which include clinical commissioning groups, NHS trusts and NHS foundation trusts.

In the NHS, the number receiving qualified accounts rose from 130 (29%) to 168 (38%) across the same period. The number of local government bodies receiving qualified conclusions was 40 (8%) in 2015-16, but 18% of single-tier local authorities and county councils received a qualification in 2017-18.

Meg Hillier, the chair of parliament’s public accounts committee, said: “It is deeply concerning that local auditors are raising increasing numbers of concerns about local bodies’ arrangements to secure value for money, but these are often not being listened to and there is no consequence for the local bodies themselves.

“With ever-stretched public services, citizens deserve to know that there are effective arrangements in place to make sure they are getting value for money.

“Local auditors should be using the full range of their powers and local bodies should be acting on their findings transparently, with departments holding them to account.”

https://www.theguardian.com/society/2019/jan/10/nhs-and-councils-full-of-financial-problems-says-watchdog

NHS: the REAL cost of privatisation

“The biggest emergencies-only hospital in Europe will take three years longer than expected to build and cost nearly twice its original budget.

The Midland Metropolitan Hospital was intended to treat 170,000 A&E patients a year from this summer but will not open until 2022. It will also cost at least £605 million, despite originally being priced at £350 million.

The problems were highlighted after Theresa May unveiled a ten-year strategy for the health service that included a £20 billion spending boost by 2023. The delay and increased costs were caused by the collapse a year ago of the construction company Carillion, halting building under the private finance initiative. The failure forced the NHS to implement contingency plans in 14 hospitals to maintain essential services delivered by Carillion.

The new 670-bed hospital in Smethwick, West Midlands, is meant to replace large parts of Sandwell Hospital and City Hospital, Birmingham. Carillion was paid £205 million towards the project before the firm’s collapse.

Toby Lewis, chief executive of the Sandwell and West Birmingham Hospitals NHS Trust, told its board last month that more than £400 million would be spent completing the hospital and keeping emergency services running at the Birmingham hospital.

The trust is paying Balfour Beatty, the construction company, £10 million to “winter-proof” the new hospital, which was left open to the elements. It is poised to seek bids from companies to complete the building, although some have already made clear that they are not interested.

John Spellar, Labour MP for Warley, said that outlay on maintaining existing hospital facilities had been cut in anticipation of the new building and that the delay was affecting recruitment and training. He said that civil servants were to blame for transferring too much risk to the private sector when they had “no concept what it actually means”.

A parliamentary inquiry into the failure of the multinational contractor with liabilities of almost £7 billion found that its “business model was an unsustainable dash for cash. The mystery is not that it collapsed but how it kept going for so long”.

Carillion was also building the Royal Liverpool Hospital, which features in a BBC Two documentary to be broadcast tomorrow. Aidan Kehoe, chief executive of the Royal Liverpool, tells the Hospitalprogramme: “I am very angry at the way Carillion have behaved. To leave us in this position is, I think, just unacceptable. These people are taking huge bonuses that they are not paying back and they are leaving the people waiting years more for a hospital. Serious questions have to be asked about the way Carillion have behaved.”

The £500 million Liverpool hospital building was due to be finished two years ago but is not expected to be completed until next year.

Jayne Halloran, an associate director at the Royal Liverpool and Broadgreen University Hospital Trust, said that it was expensive to maintain the partially built hospital, where 14 staff work full time turning taps on and off to stop legionella bacteria from growing. “It takes six days to complete that for the whole building,” Ms Halloran said.”

Source: Times, pay wall