The Black Report, the NHS Monitor Letter, and the secret assault on the NHS
News spread yesterday morning of the NHS Monitor letter sent to all existing Foundation Trusts and applicants, telling them that they needed to look for ‘savings’ of between 6% and 7% per year, around 50% higher than their earlier projection.
My first thought was to compare this to 1980, when the new Thatcher government deliberately sought to suppress the Black Report, the first ever comprehensive review of health inequalities in Britain, by ordering its publication on a Bank Holiday Monday.
Back then, in the days before rolling 24 hour news, this was a pretty effective tactic. Fast forward 31 years, and I couldn’t quite believe that the government was trying to get away with this kind of thing. Labour HQ obviously felt the same way, and John Healey was wheeled out to be outraged at how the Tories were using the Royal Wedding to ‘bury bad news’.
It turns out, though, that this is much worse than a case of burying bad news which – let’s face it – wasn’t something Labour was averse to.
It’s worth taking seriously the key points that the FT (and ex-Health Service Journal) reporter, who broke the story, makes about the NHS Monitor letter.
First, this isn’t just about a straight 6-7% ‘saving':
Compounded over the five years for which Monitor has published projections, the efficiency target for hospitals is 37 per cent.
The numbers are more than just a description of the financial pressures faced by the NHS, however. They are also the figures the regulator will use from May 1 to assess the robustness of applications from NHS hospitals to become independent foundation trusts and for any takeovers planned.
By, in effect, raising the bar for those assessments, Monitor may have made it more likely that struggling NHS organisations will be offered to private companies rather than merged with existing foundation trusts.
Third, there is absolutely no democratic oversight of these cuts.
NHS Monitor wrote to the Trusts and applicants on 27th April about its new assessment criteria that will be introduced just 4 days later on 1st May.
At least with cuts to local authorities, when they were announced in December they were announced in draft form, and there was an opportunity for councils to comment. While there was an expectation from government that comments should only be about the maths and data used to work out the funding package, some councils e.g. Burnley did take the opportunity to lobby successfully for more funds in the short term.
Here, there is no such opportunity, because cuts are being imposed under the cover of assessment criteria.
There is of course more detail to the emerging story than I can cover here, but the bottom line is that key NHS hospital provision is being run into the ground, ready for sale, and this is being done by a QUANGO far removed from the eyes of the voting public, but at the behest of the Treasury.
Fortunately, we still have investigative journalists like Sally Gainsbury at the FT – fast becoming the best paper around at uncovering Tory misdeeds – or none of us would be any the wiser.
I know what’s going on my last-minute election leaflets.
Update: More from the excellent Richard Blogger on this.