Monthly Archives: July 2014

Privatisation begins of A&E at Royal Shrewsbury Hospital

A key council committee was dramatically divided today (14^th July) in a vote on approving a major change to A&E services at the Royal Shropshire Hospital.

Shropshire CCG – the body that runs NHS services – has decided to close the Monkmoor Walk-In Centre in Shrewsbury, used by 34,000 people a year. The private company running the Walk-In Centre, Malling Health, will be given a contract extension – but will run a sharply different service instead: an Urgent Care Centre to be based alongside the A&E Department at the Royal Shrewsbury Hospital. The decision on the Urgent Care Centre pre-empts the work of the Future Fit NHS reorganisation plans, which have not yet been consulted on.

The Council’s Health and Adult Social Care Scrutiny Committee split by 5 votes to 4 on supporting the plans. An alternative motion to defer for more information and consultation was lost by 4 votes to 5. A central concern for the councillors who voted against the plans was the lack of consultation.

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Shropshire Defend Our NHS has always been concerned that the whole exercise of consultation around Future Fit has been a sham – and that the key decisions have already been made. The latest decision of Shropshire CCG is proving us right. The CCG are seeking approval for opening an Urgent Care Centre at the Royal Shrewsbury Hospital site with only a few days notice to the public, with the Shropshire Star of 10^th July reporting that “a decision will be made on July 14”. It is of huge concern, too, that the CCG have decided to give the work to a profit making private company, Malling Health. This is to be a new service, resulting in a fundamental change to how the existing A&E department at the Royal Shrewsbury Hospital works. This cannot be seen simply as the extension of an existing contract.

The absence of consultation is shocking. We have been told repeatedly that no decisions have been made yet about how to implement the local ‘Future Fit’ proposals for major reorganisation of NHS services. There is supposed to be public engagement about a short list of options in the autumn of this year, and a formal public consultation after next year’s General Election. Now, though, the CCG are simply bypassing all of their own commitments to consultation and are steamrollering ahead with their plans.

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I’ve recently been fitted with NHS hearing aids. I was given a choice of audiology services – I could go to a high street shop, or I could have an appointment at my local community hospital. I believe in the NHS. I’m opposed to people making a profit out of healthcare. So I plumped for the local hospital.

Imagine my surprise when I discovered, at my appointment, that it wasn’t an NHS service at all. Shropshire Clinical Commissioning Group have commissioned a private company, Regional Hearing Specialists (RHS), to provide audiology services.

On the face of it, RHS are a small company with headquarters in Cornwall, and only formed in March 2013. But they are a subsidiary of a large conglomerate. In the UK they are owned by Bloom Hearing Specialists who run a chain of high street stores selling hearing aids and accessories. Bloom, in turn, are owned by a Danish company, Widex. According to the Financial Times, “Widex is among the world’s six largest manufacturers of hearing aids, with a global market share of about 10 per cent.”

So my choice wasn’t really between a high street shop and the NHS – it was between two massive commercial chains.

Why does it matter? Well, the hearing aids are free, but the private companies make their profits from the fees they get from the initial testing and fitting. Providing NHS aftercare, a key benefit of NHS services, just eats into their profit margins. I was offered a home repair kit at £20 so I could do my own maintenance on my hearing aids. And I was given an order form to take away so I could mail order cleaning materials from RHS. It wasn’t suggested that I buy stuff from voluntary organisations. Action on Hearing Loss (the new name for the Royal National Institute for the Deaf) offers similar items to RHS but they cost a third less. RHS don’t want me to come back with any maintenance issues – they want to sell me over-priced “accessories” instead.

RHS prominently display the NHS logo on all their materials. Patients could be forgiven for thinking that they really are the NHS. If the NHS tells us we need to buy expensive cleaning tissues, many of us will, even if we can’t really afford to. So the service moves from “free at the point of delivery” to “additional charges at the point of delivery.”

That breaks all the ethos of the NHS. As the doctor’s journal, the Lancet, said in an editorial in the 1940’s during the debate on the founding of the NHS:

“The truth is that the doctor-patient relationship in its modern form needs improvement rather than preservation: it can never be wholly satisfactory while the doctor is not only a friend in need but also a friend in need of his patient’s money; nor while there is competition rather than co-operation between him and his colleagues.”

Successive Governments have brought competition and a quest for profits into the NHS. The Lancet was right over 60 years ago. Healthcare is too precious to be left to the market.