Cuts compendium

An NHS Burning and in Chaos

Although the rhetoric of ‘choice’ implies patients having a greater variety of health care options from which to choose, the reality is that patients and communities are experiencing a range of closures, cut-backs and disruptions to their local services

The list shown below reveals an NHS in a state of shambles and disorder. No one can argue that the various assaults upon the NHS are the result of patients’ choices or the culling of inefficient services (as claimed by the prophets of market competition). They are the result of a transition from an NHS based on rational, needs-based health planning towards a health service that will increasingly be run by private companies and guided by a capricious and unforgiving market. Centrally imposed demands to meet government targets prior to the last elections have also aided and abetted the disastrous organisational reforms to the NHS.

The Secretary of State for Health is quick to blame financial deficits on individual hospital trusts and PCTs. But a proper analysis of the deficits and their widespread nature clearly points to problems inherent in the government’s own reforms.

The crisis in the NHS, reflected only in part by the list of closures, cut-backs and disruptions shown below, appears to be veering out of control, and is in danger of bringing the NHS to a point of collapse. It is not inconceivable that this is the desired aim of government policy – the more avid supporters of marketisation feel that a proper market will only be established when the NHS disappears.

The following is a list of closures, cuts and disruptions to the NHS collated primarily from local and national newspaper reports. This is unlikely to be a comprehensive and full account of the chaos occurring within the NHS, but it gives a flavour of the crisis. The Department of Health does not collate this information as far as one can tell.

  • East Suffolk PCTs have decidied to close Hartismere Hospital in Eye and to cut 16 beds from Aldeburgh and District Community Hospital. The devastating cuts have also closed day hospitals, occupational therapy centers and clubhouses currently used for the provision of mental health care services.
  • In Oxfordshire, there are plans to close a 15-bed older people's acute unit for mental health care. The Townlands Hospital in Henley, Bicester Hospital in Oxfordshire and the Walnut Tree Hospital in Sudbury are all at risk of service cuts.
  • In Cumbria, County Councillors, with cross party support, are fighting the threat to cut 118 beds at community hospitals in Brampton, Alston, Keswick, Maryport, Cockermouth and Millom. Meanwhile plans for a new hospital to replace the Cumberland Infirmary have already meant a reduction in acute hospital beds that were intended to be part of a shift towards more community-based care. Local GPs have warned that this will leave elderly people in rural areas vulnerable and isolated and will be unlikely to save money due to the knock-on effects. Morecambe Bay PCT proposes shutting two mental health wards at Kendal's Westmoreland General Hospital - one of the wards is for elderly patients. The North West News and Star has launched a petition to save these hospitals. Hundreds of people are already attending meetings, signing petitions and protesting outside PCT offices.
  • In Lincolnshire, hospital wards have already closed in hospitals in Lincoln, Grantham, Stamford and Skegness to reduce a £50 million deficit.
  • In the East Midlands, up to 200 jobs could to be lost over two years from Peterborough District Hospital and the Edith Cavell Hospital in Cambridge because of debts.
  • In Walsall, the PCT has approved the closure of Goscote Hospital, a 103-bed rehabilitation hospital with a stroke unit, despite a long-running campaign by residents. Campaigners collected a petition of more than 16,000 signatures to prevent the closure.
  • In North Yorkshire, the Airedale NHS Trust near Skipton has adopted an "immediate vacancy freeze" and is only admitting patients on the day of their surgery, not the night before. Money is also to be saved from radiology, cardiology and pharmacy services.
  • In Yorkshire, the Yorkshire Wolds and Coast Primary Care Trust is planning to close Hornsea's Minor Injuries Unit, cut the number of beds at the town's hospital from 22 down to 12 and reduce the number of doctors on call after hours. Around Yorkshire, Barnsley hospital has been forced to lose 35 posts. Rotherham hospital is planning to slash pay costs of non-clinical staff by 10%. Hospitals in Sheffield are trying to save £20m due to losses resulting from payment by results and the extra costs of meeting targets, and 30 staff at a Sheffield hospital cardiac unit have been told their jobs are to disappear. Selby and York PCT has predicted debts of £23.7m, and Sheffield's PCTs have deficits of £17; Airedale NHS Trust has had to sell former staff residences and increase car parking charges. Up to 300 physicians, nurses and surgeons could be cut by the Hull and East Yorkshire Hospitals Trust as part of an attempt to make £13.5m savings demanded by the SHA. Scarborough, Whitby and Ryedale PCT, facing a £6.5m overspend, is interrogating hospitals as to why operations are being performed so soon after referral. Staff morale is also reported to be suffering as Bridlington hospital is wound down and patients transferred to Scarborough.
  • In north Lincolnshire, hundreds of operations have been being delayed. 500 campaigners marched through Stamford to demand assurances over the future of the town's hospital after the announcement that 200 jobs are to go from the three main hospitals managed by the Peterborough and Stamford Hospitals NHS Trust.
  • In Gloucestershire, an 11-bed in-patient ward at Tetbury Hospital has been closed
  • In Leicester, Herrick Ward, part of the Brandon Unit of Leicester General Hospital, has been closed with a loss of 30 beds while its future is decided.
  • In Surrey and Sussex, a district auditor's report says that the entire health economy is at risk. The NHS in Surrey and Sussex has a predicted collective deficit of £75m. One hospital in the area has already lost its A& E, and other services have closed.
  • In Hampshire, Southampton University Hospitals NHS Trust has lost 109 beds and 650 jobs in eight months.
  • In Shropshire petitions in defence of Whitchurch, Bridgnorth and Ludlow hospitals with 30,000 signatures have been handed to the Department of Health. 1,000 people protested against the closure of Bridgenorth Hospital. 600 people attend public meeting to halt the closure of Whitchurch Hospital. The closure has been proposed as one element in tackling Shropshire's £36m deficit. There is also a proposal to shut either Shrewsbury or Telford's A& E.
  • In Staffordshire, a number of surgical wards, including gynaecology, are under threat in a review of services at Staffordshire General Hospital. The gynaecology and women's health ward and the orthopaedic ward will close as part of controversial plans to save £600,000. 500 posts are to be shed at the University Hospital of North Staffordshire. North Stoke and South Stoke PCTs are also considering closing hospital beds, cutting health visitor and district nurse posts. North Stoke PCT is reviewing all its services and is set to limit the number of people GPs can send for specialist hospital care. The proposed cuts include the temporary closure of 10 beds at Westcliffe Hospital; a reduction in the number of beds and suspension of X-ray services at Longton Cottage Hospital; and a reduction in services at Haywood Hospital walk-in centre. The financial crisis has led to the closing of four beds at a psychiatric hospital that deals with substance abuse. The community group, North Staffordshire Healthwatch, said the cuts would hit the elderly and the vulnerable particularly hard, but would have knock-on effects for the whole population. In addition, a quarter of the population of the Staffordshire Moorlands have put their name to a 20,000-signature petition urging the government not to merge Staffordshire Ambulance Service. Hundreds of operations are being postponed because of the financial crisis in North Staffordshire. Fifty newly trained nurses at Keele University have had their job interviews cancelled at the University Hospital of North Staffordshire and been told to find work in London instead. In Stoke-on-Trent the PCT has told the University Hospital of North Staffordshire that it will refuse to pay for gynaecological treatment unless the women were kept waiting for the target maximum of six months
  • In Suffolk, the chief executive of East Suffolk Mind has said that the charity might have to reduce services to tackle a possible budget shortfall of £200,000 next year, because of PCT cuts. The West Suffolk Hospital NHS Trust intends to shed a total of 10% of its 2,500 strong workforce. Campaigners are urging West Suffolk PCT to abandon proposed cuts at the West Suffolk Hospital in Bury St Edmunds and Newmarket Hospital, and the closure of the Walnuttree and St Leonard's hospitals in Sudbury. Newmarket Hospital is reducing its number of inpatient beds from 16 to 6. The church is lobbying Suffolk MPs over the funding crisis in the local health economy - 40 chaplains and parish priests from all denominations have shared their concerns over mental health services, poor rural provision and the national distribution of resources. The churchmen say they are having to "pick up the pieces" left by inadequate NHS funding. East Suffolk PCT has decided to suspend certain treatments in an attempt to eliminate a £47.9m deficit.
  • Near Bristol, campaigners are protesting against the closure of Keynsham Hospital until a decision what health services will replace it is made clear. Meanwhile, Bristol South and West PCT has told United Bristol Healthcare Trust, which runs Bristol Royal Infirmary, Bristol Children's Hospital and St Michael's Hospital, that it will only pay for operations that are clinically imperative or where the patient has been waiting for more than five months. Conditions affected by this ‘slow-down’ will include hernias, varicose veins, gall bladder and gynaecological problems.
  • In Chesire, there are fears for the future of Macclesfield Hospital after Eastern Cheshire PCT launched a review that includes children's' in-patient, maternity and neo-natal services. Campaigners are worried that the hospital may be downgraded to cottage hospital status, and that the A & E will be closed.
  • In the Cotswolds, there is a campaign against Cotswold and Vale PCT's decision to cut 15 beds at Fairford Hospital.
  • In Oxfordshire, the Oxford Radcliffe NHS Trust has chosen not to offer cardiac catheter ablations as a cost saving measure. It is also closing down its renowned pain relief centre. Hernia and varicose vein patients have been told they may not be eligible for operations because the NHS priorities forum has ruled that they no longer "fulfilled clinical criteria".
  • In Weston super-Mare, the Weston Area Health NHS Trust is axing 29 jobs as part of its bid to reduce its £5.5m deficit.
  • In Swindon, a leaked copy of Swindon PCT’s financial recovery plan suggests that doctors should make no referrals whatsoever for any routine outpatient appointments to hospitals for a period of time in order to save £350,000.
  • Near Coventry, 50-60 posts are to be cut from the George Eliot Hospital in Nuneaton.
  • In Wiltshire, all the beds at the Malmesbury and Devizes hospitals are due to close in the New Year. Cuts are also planned at Westbury hospital.
  • Near Birmingham, Kidderminster hospital's emergency unit will be closed down at night. There are also proposals to axe vital services at Alexandra Hospital in Redditch. Cut proposals aimed at saving £20m include downgrading the Alexandra Hospital. A council organized vote in Redditch saw a 99% majority against the closure of the A & E.
  • In London, St George's hospital has stopped employing all but the most essential staff and has closed wards. Another group of London hospitals has been told by Harrow PCT to postpone surgery to cut the trust's debt. The PCT, facing a deficit of £8-£12 million, has asked the hospitals treating its patients to do "the minimum required" to meet national targets.
  • In Coventry, Walsgrave Hospital has closed three wards and is to shed 250 jobs
  • In Worcestershire, the Worcestershire Acute Hospitals Trust is facing the closure of 195 beds.
  • In Cambridgeshire, 27 top consultant psychiatrists have written to the Cambridge Evening News warning of the dire consequences of a £3m cut to the mental health budget. A ward for the elderly has closed at Addenbrooke's which will limit the places for people to go, and which has been condemned by local nursing staff.
  • In Wolverhampton, the proposed closure of the Eye Infirmary building in Chapel Ash has prompted local protests from staff and patients alike.
  • Avon, Gloucestershire and Wiltshire SHA has confirmed that its trusts have been forced to make "clinical capacity reductions in some areas" and "reductions in the numbers of staff employed". Despite drastic measures, including closures of wards and services, recruitment freezes and reductions in clinical capacity, deficits remain.
  • In Cornwall, the North and East Cornwall PCT has told all providers of hospital care that for a short period they can fund only urgent cases or patients about to wait longer than maximum waiting times.
  • In Somerset, patients with non-emergency and outpatient appointments will not be referred to hospital throughout January in an effort by North Somerset PCT to save £3.5m.
  • In Leeds, the Leeds Teaching Hospitals NHS Trust has axed more than 150 full-time posts. Nursing shortages now mean the trust - which runs Leeds General Infirmary and St James's Hospital - has a bill for temporary agency and bank workers of around £12m a year.
  • In the North East, more than 100 jobs have gone at the County Durham and Darlington Acute Hospitals NHS Trust.
  • Trafford Healthcare Trust intends to close Altrincham General Hospital, which serves 20,000 people a year in its outpatient clinics and 11,000 people in the minor injuries unit.

Across the country, cutbacks are contributing to an acute shortage of intensive care beds for children; a shortage of specialist nurses and winter increases in respiratory infections have been compounded by the common policy of cash-strapped trusts to ban the use of agency nurses. Over a nine-month period, Birmingham Children's Hospital alone turned away 159 referrals as a result of such problems.

Across the country, the Mental Health Act Commission, the inspection and advisory body for mental health law, says mental health is being squeezed by the financial management crisis in the NHS. It reports that "risky" patients are being sent home, that NHS psychiatry is in a state of "permanent crisis management" and that three quarters of wards breach occupancy safety margins and more than half are overflowing. Rethink, the mental health charity, has announced that mental health services are facing a funding crisis, revealing "worrying cuts" in mental health budgets.

Across the country, the National Childbirth Trust says at least 10 birth centres are now considering closing, or are definitely set to do so due to lack of funds.

Across the country, the reorganisation of PCTs and SHAs, designed to save £250m, will result in the loss of many frontline public health staff. Furthermore, a report compiled by Sir Nigel Crisp and Patricia Hewitt for the National Leadership Network, shown to the Financial Times, has indicated plans to essentially bring to an end the idea of the district general hospital.

Professor Chris Ham, who left the DoH last June and was one of the principle architects of NHS reform, has admitted that health policy has veered into "incoherence" and reforms are dangerously "out of sync" between provision and commissioning. He said it was not clear whether the government was "willing to live with the consequences of the creative destruction" it has unleashed on the NHS.

A Health Service Journal survey of 117 chief executives of NHS trusts revealed the depth of concern about the destabilising impact of government reforms. 75% of chief executives said that the current financial squeeze will adversely affect patient treatment. Two thirds of hospitals had closed wards for financial reasons. 58% of mental health trust chief executives have had to close wards, and nearly 80% said they had implemented recruitment freezes or made redundancies.

Prepared by Alex Nunns, Keep Our NHS Public



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