The Independent London Newspaper

 

Hospital’s atrium will cast a long repayments shadow

Published: 2 December, 2011

• JOE Liddane, chair of Whittington Health, has outlined the benefits of foundation trust privileges, which allow hospitals greater organisational autonomy, including control over their own finances (Hospital set-up must change or we will be vulnerable to a takeover, November 25).

These would give local people, including GPs, councils and the community, more say over the hospital’s development.

While Mr Liddane enumerated the advantages of the Whittington becoming a foundation trust – he writes that it has no alternative – Shirley Franklin, chair of Defend the Whittington Hospital Coalition, pointed out a basic, grave flaw in his pro-localisation argument.

The NHS, our national organisation for still largely comprehensive health care, exists to ensure the provision and fair distribution of resources nationwide.

These need to be centrally administered and co-ordinated by a national body, the Department of Health (DoH).

It cannot fulfil these functions if some hospitals are outside its control, running themselves and using their financial resources as they please, without regard – let alone responsibility – for the needs of other hospitals outside their jurisdiction.

The DoH would have limited information about health care coverage and its costs in different localities, preventing it from trying to adjust provisions to bring health care up to equal standards everywhere.

Many health care necessities are shared by institutions nationwide, such as the professional training of medical staff and standardised regulations concerning staff employment conditions, comparative statistics between all the institutions and wholesale purchase of equipment and drugs.

Clearly, such regulation leads to economies of purchasing and clarity of staff employment terms, while ensuring as far as possible equal treatment facilities for patients everywhere.

Mr Liddane’s letter repeatedly stresses the advantages of independent local over central control.

How can disintegrated health provisions through the independence of individual hospitals co-exist with centralised control aiming to provide a fair distribution of services throughout the country?

No wonder the DoH cannot, without total control, accept responsibility for national health
services provision, a frightening withdrawal from the existing guarantee.

The Whittington’s use of its expected foundation trust status has already led to it embracing a hugely expensive private finance initiative (PFI) scheme.

We may admire the vast atrium with views over half of London, whose cost was covered by a PFI contract, but that contract lasts for 30 years.

It was all too tempting to use the PFI “credit card” loan for the instant satisfaction of showing off a handsome design feature, but interest payments on this PFI loan are already a heavy financial burden on the hospital’s finances, threatening increasing staff reductions.

Yet the repayments will be a primary legal obligation on the next generation, before it is free to judge whether it would prefer to spend money otherwise, very likely on medical and paramedical staff.

ANGELA SINCLAIR-LOUTIT
Highbury Hill, N5

• THE recent decision by the management of Whittington Hospital to proceed with a consultation to transfer the management of the hospital to a foundation trust should be a serious worry for residents.

The creation of foundation trusts is part of this government’s strategy under the Health and Social Care Bill, which, if passed, will change our health service into one resembling that in the US.

Islington Hands Off Our Public Services, like the Defend the Whittington Coalition which we support, does not wish to see the future of the hospital jeopardised under the sort of privatised management that will almost certainly follow, despite what the chair and chief executive of the hospital say.

We agree with Shirley Franklin, of the Whittington Coalition, that foundation trust status is a clear step towards privatisation and we oppose NHS funding from our own National Insurance and tax payments going to the shareholders of the health privateers.

We also have concerns about the protection of employment conditions for health workers, who can be expected to lose their NHS agreements on pay and pensions.

This government has imposed a £20billion cut on the NHS by 2014, with devastating consequences for the health service.

We oppose these cuts and the Whittington Hospital becoming a foundation trust, and urge others to do likewise.

To set up a foundation trust, “members” need to be recruited to give it credibility.

If readers know of any such approaches they may wish to consider the future of free health for all at the point of need in Islington.

ANDY BAIN
Chairman, Islington Hands Off Our Public Services

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