SUSSEX HEALTH BULLETIN

Whats happening to our NHS? February 2014

Sussex Defend our NHS WORKERS, CAMPAIGNERS, COMMUNITIES TOGETHER
defendthenhs@gmail.com
In this newsletter we look at three local issues which are representative of what is happening throughout the NHS generally. The first is the Brighton and Sussex University Hospitals trust bank nurses dispute a blatant attempt by BSUH management to cut the pay of some of the lowest paid workers. The second is the integration of the Sussex Community NHS Trust with Capita: a private company with a long and tainted history of involvements with government contracts and the public sector. Many would argue that at least our community health services, as has happened in so many areas, havent been handed over to a private conglomerate. As we show, a combined public / private sector venture still holds untold risks for patients and staff pay, terms and conditions. We take another look at the commissioning activities of Brighton and Hove Councils Health and Well-being Board in relation to the Substance Misuse and Sexual Health and services; the response of Caroline Lucas MP; how you can help fight the proposed privatisation. Below in the email we sent to Caroline Lucas we detail the sequence of emails received on Friday. Please come to the support the lobby of the Health and Well-being Board this coming Wednesday.

Urgent developments - call call to all supporters - email to to Caroline Lucas

We felt in the light of our previous correspondence, Caroline should be made aware of information received today re council decision-making processes in relation to the tendering of the Sexual Health Services. We appreciate that Caroline is understandably reluctant to intervene in council matters but the email and sequence of events outlined below feel like a blatant suppression of the public right to hold councillors and council officers to account and indeed to effect any public influence on Council decisions. One of our group has today received this email from Giles Rossington, Acting Head of Scrutiny, Health and Wellbeing Board Business Manager, Brighton and Hove City Council. I note that youve submitted a public question to next weeks HWB meeting on the issue of B&H sexual health services and whether these services ought to be taken out to tender. I spoke to the Director of Public Health in order to get a response to your question and have been told that the issue is due to be decided at the next (Feb 13) council Policy & Resources (P&R) meeting. Under the councils constitution it is currently P&R rather than the HWB that is responsible for this type of decision. Given that proximity of the two meetings and the fact that decisions on sexual health recommissioning lie with P&R, I do not think it would be appropriate for the HWB to commit to any particular course of action in advance of the decision being made by P&R members on Feb 13. Although your question is a good one and raises some very important points, I think it unlikely that members would wish to take a stance on these issues in advance of another council committee making a substantive decision. I will therefore be advising Cllr Jarrett that he should respond to your public question by referring to the forthcoming P&R item rather than addressing the substantial points you raise. If Cllr Jarrett accepts my advice Im not sure whether you would still want to put your question next week? It is up to you, although I dont think that theres much point in asking a question to which there will be no substantive answer. End of email

At the same time we have it on good authority that there is no Green majority on the Policy and Resources committee and that therefore opposition councillors could well drive a decision through on the tendering out of Sexual Health services. We hope we are mistaken but are highly suspicious. To intensify our suspicions on asking for an urgent meeting with Councillors Jarrett and Shanks we were offered 14th February - the day after the (according to Mr Rossington) definitive Policy and Resources decision on the tendering process!!!! We are obviously adapting our campaigning strategy re Sexual Health Services in line with these developments. We would very much appreciate your perspective.

Upcoming meetings
Tues 4th Feb 4pm Health Overview and Scrutiny committee Council chamber Hove Town Hall Wed 5th Feb 4pm Health and Well-being Board Council Chamber Hove Town Hall Gather at 3 45 outside main entrance of Hove Town Hall Thurs 13th Feb 4pm Council Chamber Hove Town Hall Crucial meeting of the Policy and Resources committee lobby and attendance at meeting. Thurs 13 Feb 7pm Forum Whats happening in Sexual Health? GMB offices, 49 Church Rd Hove BN3 2BE Tues 25 Feb 7pm Organising meeting, Prince Arthur, Dean Street Thurs 13 March Forum 7pm Working with Efficiency savings, GMB office Tuesday 25 March 2014: 2 to 5 pm The Auditorium, ground floor, Brighthelm Centre, North Road Public governing Body meeting of the CCG Tues 25 March 7pm Organising meeting, Prince Arthur

Stop Press Fantastic News!

We have just heard from Lewisham campaigners that they have won yet another major battle in their fight to stop the privatisation of their local health services. Hundreds of people turned up to demonstrate outside a recent meeting the Lewisham and Greenwich CCG where they were about to agree private healthcare company SERCO taking over the CCGs procurement function. 30 people went into the meeting. The CCG decision was overturned !! Massive respect !!

Pay of Brighton and Hove Nurses slashed

(from Argus article, 4th January 2013 http://www.theargus.co.uk/news/10852347.Brighton_nurses_pay_slashed/

BSUH Trust management are seeking to introduce changes to the pay of 2,200 nurses and other workers who are registered with the nursing bank which provides cover for vacancies, sickness and special leave, such as maternity. Many of these nurses are already employed by the Trust and use bank shifts as overtime. However 550 workers, including nurses and healthcare assistants only work bank shifts and do not have the benefit of sick pay or holiday pay. Some bank workers are facing wage cuts of 30%. A member of staff said: A lot of people are very upset about this. It is not good for morale, especially at such a busy time of year. Those who only work on the bank are being told to take a pay cut and those who use it for overtime shifts are not going to want to work them if they don't get the benefits they are used to. This could cause problems in providing cover for the wards. In a message to staff, chief nurse Sherree Fagge said: For many it will be an opportunity to become a substantive member of BSUH staff with all the security and benefits you don't get when you work full-time on the bank. But I also know, and am genuinely sorry that this could mean some of you get less money each month at a time when everything else is getting more expensive.

Statement from the GMB

- The Trust is cutting the pay and overtime rates of some of the lowest paid workers in the hospital, at a time when its employees have had effective pay cuts year on year, with pay awards below the rate of inflation. There is massive inequality in pay within the Trust, from 14,298 to 98,453. Cutting the salaries of workers towards the bottom of the pay scale will only increase pay inequality. - 8% of substantive posts (with standard AFC terms and conditions) are vacant. We could suggest this is due to low morale, overwork, inadequate resourcing and consequent stressful relations between employees and their managers. If the Trust is serious about filling these posts it should offer candidates attractive rates of pay and conditions which encourage them to stay. Isnt that the argument for paying the Chief Executive a salary in the region of 180,000? - The Trusts attempt to cut costs by further impoverishing its staff will have a detrimental effect on recruitment, retention and sickness levels. It also continues the government schedule of 20 billion in cuts to NHS services, dismantling the NHS and transferring it to the private sector. We feel it nave to believe that the Trusts attempts to reduce its labour costs will stop with the bank rates. For these reasons we oppose them. At a recent meeting BSUH Trust officials stated that the GMB is in support of their proposals and has agreed them, when they know full well this is not the case. The GMB officer was refused entry to a meeting where the issue was discussed. GMB members who were able to attend the meeting did not feel there was meaningful consultation over the proposed changes to their terms and conditions. The GMB does not support or agree to any cuts in pay, staffing or service provision in the NHS and we oppose all privatisation.

Bank Monday Holidays GMB meetings have so far seen staff opposed to cuts and calling for a campaign of Monday Bank Boycotts, commencing Monday 3rd Feb.

Support the GMB Campaign say NO to Bank rate cuts!

Watch out for more details

Sussex Community NHS Trust joins forces with Capita

This trust, the largest community healthcare provider in the South of England has roughly 4,400 employees in Brighton and Hove and West Sussex, including health visitors and community nurses and therapists. The vast majority of the trusts 8,000 or more patients are cared for in their own homes. The trust does not own any facilities and operates out of rented offices, clinics and other centres.

The future
For some months, discussions and community consultation have been going on about the future of SCNT, with management wanting it to become an NHS Foundation Trust. According to a recent announcement by Capita: Capita has today agreed a strategic relationship with Sussex Community NHS Trust to support the Trust in its aim to drive change and improve the quality and sustainability of its patient care services. http://www.capita.co.uk/news-and-opinion/news/2013/capita-partners-with-sussexcommunity-nhs-trust.aspx#sthash.xRDvYgrm.dpuf

According to a Sussex Community NHS Trust spokesperson the move to being a foundation trust would: allow greater freedom for the trust to go to the financial market to raise money to put back into better ways of mobile working and so improve patient care. At the moment, the trust must go to the Department of Health for capital investment monies, not an easy ask in the current financial situation.

Achieving Foundation Trust status untethers NHS organisations from the public sector with all the dangers that entails. It is not too different from the encouragement, in some cases blatant forcing of state primary and secondary schools to become academies. One of the primary aims of the planned arrangement (according to a Capita statement) is to help the Trusts procurement team to identify opportunities for delivering better value for money from non-salary expenditure so that savings can be reinvested into patient care. Better value for money . reinvested in patient care. So Capita are providing these services out of the goodness of their heart? Are extortionate contract fees, shareholder dividends or bonuses going to be sacrificed for patient care? What do we think? That certainly hasnt been the experience of the London Borough of Barnet or Birmingham City Council (see the next article). Indeed, these Councils have not even been unable to find out details of Capitas financial arrangements. Staggering!

What Next? Community Accountability

Foundation Trusts are supposedly accountable to their local communities through their members and governors and via their commissioners through contracts. Very unfortunately for employees of the SNCT, Capitas failings elsewhere will almost certainly be repeated in Brighton and Hove. All of us - trade unionists, community and campaigning activists need to watch this arrangement like hawks. We need to be prepared to ask awkward questions, raise matters with the public and in the press and defend staff employed by SCNT and especially Capita. This service has to be defended.

Capita
Suffice to mention here a few of the companys questionable involvements A key player in the deeply unpopular privatisation of Barnet council. The company responsible for outsourced court translation. The company running Birmingham Citys call centre, IT infrastructure; Library of Birmingham IT; support and collection of debts and council tax until 2020. Between 2005 and 2010 this cost 55 million-a-year spiralling to 120 million-a-year. In an extraordinary statement, Birmingham City Council have claimed that members were being deterred from getting a grip on the nuts and bolts of their complex deal with Capita because the facts were unclear. The biggest issue is transparency, we have little idea of what is going on.
http://www.newstatesman.com/uk-politics/2013/08/nine-spectacular-council-outsourcing-failures

This is the Birmingham City Council faced with possible bankruptcy. Capita has been involved, along with French company ATOS, in the persecution and systematic impoverishment of people with disabilities and more specifically administration of PIP Personal Independence Payments (which are very controversially replacing the Disabled Living Allowance). Where do you start with the critique? The main contractor responsible for the Home Offices iniquitous illegal immigrant go home text messaging campaign, alongside the Immigrants go home vans. Capita dont seem attractive to anyone do they? Despite all the glaring evidence they have been contracted to provide services in our city. Let us know what you think about this?

What is happening to our Sexual Health Services?

Currently Brighton and Sussex University Hospital NHS Trust has the contract to run the Claude Nicol clinic (Genito-Urinary Medicine); and Sussex Community NHS Trust has the contract to run the Morley Street contraception and sexual health clinic (CASH). As a result of the Health and Social Care Act 2012, Brighton and Hove City Council have now been given responsibility for Public Health. Both services are due to be put out to tender. Specialist HIV/Aids treatment is provided from the Lawson Unit, located in and sharing consultants with the Claude Nicol clinic.

We understand specialist HIV/AIDS service will continue to be commissioned by NHS England. But GUM and CASH services are being combined, put out to contract and may be passed to a private or third sector provider.

Why we oppose contracting out these services

The councils main rationale for the tendering out of sexual health centres is that it would integrate the city-wide service. Integration one of those new NHS buzz words, can result in a private company taking over a service -and then sub-contracting parts of it. But integration doesn't have to involve contracting out. In our view what is being proposed is not real integration because specialist HIV/AIDs services are likely to be further separated. If GUM and CASH services are privatised, HIV/AIDs services will struggle to maintain provision and standards independently from GUM, and vice-versa. - The British Association for Sexual Health and HIV (Bashh) and the Royal College of Physicians (RCP) argue that tendering poses several "key threats", including reduced access to clinics and treatment, a fall in the quality of patient care and the undermining of existing services. (http://www.theguardian.com/society/2013/dec/28/sexual-health-clinicsdoctors-fear-future-private). - Private companies are likely to cherry-pick services such as automated testing, and do lucrative deals on leasing or purchasing our clinic buildings. Remember, their motive is profit! - Private companies wont have the motivation or the infrastructure, experience, skill and access to HIV/AIDs consultants to provide for complex cases. Nor will they be able to counsel, test and treat victims of rape or assault, nor to spend time persuading patients to give contact cards to their sexual partners. - The successful bidder will be in competition with other sexual health clinics: it wont be in their interests to collaborate on controlling the spread of GUM and HIV epidemics. - Problems with data! Patient information for GUM and HIV is on one system. Thats workable and beneficial because both services are run by the NHS; but if GUM is privatised, it would either have to treat with no historical data clearly detrimental and dangerous to returning patients; or it would have to negotiate access to the present database, raising complex ethical and financial questions. - Theres been a lack of meaningful consultation with staff and service users. The current online survey doesnt do the job (see below) - Local unions (see http://www.gmb-southern.org.uk/sexual-health-services-in-brightonface-privatisation/) fear a deterioration in staffs pay and conditions it has happened in every case of privatisation - and to the quality of the service. Already in anticipation of change these clinics are starting to use more bank staff, whose pay is currently threatened. See page 2.

What can you do?

If you are a health worker, ask your colleagues and Union shop stewards to join you at our next Forum meeting where you can discuss these arguments and plan a fight back: What is happening to our Sexual Health Services? Thurs 13 February. 7pm. GMB Offices, 49 Church Rd, Hove BN3 2BE. All health workers and supporters of the NHS welcome. Join Defend the NHS and Keep Our NHS Public supporters to demand the withdrawal of the decision to tender these services: Come to Come to the Health and Well Being Board (Feb 5th, 4pm Hove Town Hall). Gather at 3 45 outside the main entrance of Hove Town Hall. Respond to the Councils survey (use the points above if you wish). http://consult.brightonhove.gov.uk/portal/nhs/sexual_health/survey

Caroline Lucas MP on the proposed tendering out of Sexual Health Services and commissioning regulations
I have urged the council to do its utmost to try to keep services in public hands. I think this is the surest way to ensure that patients can access high quality, convenient and costeffective services. According to Monitor negotiating a better arrangement with the existing provider is an alternative to tendering - just one option I hope the Council will consider. Under the terms of the Health and Social Care Act, sexual health services became the responsibility of the council when Public Health transferred to the council in April 2013. An existing contract for the services with BSUH Trust and the Sussex Community Trust passed to the council and is due to expire, hence the timetable for procurement. There are some circumstances where commissioners don't have to go out to tender eg where there is only one provider capable of delivering their requirements; if the outcome of tendering would be the unbundling or fragmentation of services. Some argue that going out to tender would deliver a better service for patients, because it would allow services to be integrated. But there's also ample evidence to prove tendering has massive downsides for patients. It's also, of course, opening a door to the private sector, something to which I am totally opposed. The new regulations are a minefield and commissioners are treading new ground, sometimes without any clear precedent or complete understanding of the outcome of their decisions. (We will be looking at these regulations in a future article). The council has told me it's seeking legal advice about whether it needs to go out to tender. I've made it clear I think it shouldn't and that the tendency of lawyers to be risk averse needs to be balanced by a clear instruction to find ways to avoid going out to tender eg the possibility that any benefits would be offset by disadvantages. The indications so far are quite positive. I promise I'll keep doing all I can to protect the NHS locally, as well as nationally, and I really appreciate all that Defend Our NHS and KONHSP are doing to that end too.

Thats it for this time.

Spread the word..

Defend our NHS contact email - defendthenhs@gmail.com

Please note all the information and views expressed in this newsletter are accurate as far as we have been able to ensure. We welcome any corrections, which will be published.