"Devastating" cuts planned for NHS in north London

A document leaked to the Guardian newspaper has revealed the "devastating" scale of cuts that are being proposed for NHS services in the five North Central London boroughs - Enfield, Barnet, Haringey, Camden and Islington.

These cuts proposals are being developed as part of the "sustainability and transformation plans" process and would be implemented over the next four or five years.

More locally, and in the short term, there are proposals to restrict access to a list of surgical and other procedures to Enfield residents.  The ongoing consultation about this ends on 30th June and the final public meeting will be on Friday at the Ruth Winston Centre.

"Unprecedented cuts"

The Guardian report, published yesterday, says that "Patients will be denied treatment, waiting times for operations will lengthen and A&E and maternity units may be shut under secret NHS plans to impose unprecedented cuts to health spending".

The document that was leaked to the Guardian says that "these choices may be difficult for a number of reasons [because they include] ... options that impact on quality of care [and] options that would be difficult to implement”.

Changing people's behaviour

Central to the North Central London Sustainability and Transformation Plan is the idea of reducing the need for people to attend hospital and preferably preventing them becoming sick in the first place.  Achieving this would undoubtedly be beneficial but the proposals involve changes to people's behaviour (eg reducing stress, improved diets, less smoking and drinking, more exercise, cleaner air etc) and much improved access to primary care (eg more GP appointments). 

The plan hinges on the assumption that these radical changes can be achieved quickly, after which the demand for hospital and other expensive treatments would fall away.  The trouble is that those changes to people's behaviour will take decades to bring about (if they are actually possible) and the availability of primary care is actually falling and will continue to do so because of GP retirements and because the EU referendum result has deterred the recruitment of overseas primary care personnel.

Holding a gun to the head

It's more than likely that many of the people developing these plans are fully aware that this assumption is completely untenable, but they have no choice but to go along with the idea because the government, through NHS England, is holding a gun to their head in the shape of "capped expenditure processes" and "accountable care organisations".  These will mean that once the inadequate sums allocated to them are exhausted, local NHS organisations will simply have to stop providing elective (non-emergency) care.  Because the proportion of GDP spent on the NHS has fallen so much compared with the past, the result will be that many types of treatment will no longer be available on the NHS.  Exactly which treatments will vary across the country (the "postcode lottery").  People who can afford it will begin to take out policies with BUPA and other insurers and the private medical industry will prosper.  People who can't afford it will simply have to "like and lump" the rump NHS services.

The question arises:  Is the inadequate funding of the NHS by the government just another example of "austerity" cutbacks being applied without much thought about the consequences (eg as with funding of the police, schools, fire services, building inspectors etc), or is there a deliberate plan to open up health care opportunities to for-profit (and big profits at that) businesses?