15th March 2010

Proper public consultation needed on 'management cuts' at Primary Care Trust

Christian Vassie has expressed concerns about the management cuts review currently taking place at the York Primary Care Trust.

The recent review of the appalling healthcare problems at the Mid Staffordshire NHS Foundation Trust between 2005 and 2009 have highlighted the risks that relate to health trusts becoming fixated on money and targets at the expense of everything else.

“There is a real risk that vital services may be affected by this process,” said Mr Vassie. “Over recent years NHS job descriptions have changed and the word 'manager' is now used all over the place. For example, Ward Sisters or senior ward nurses are now called Ward Managers. Do we really want to lose ward sisters from our hospital as part of a programme of 'management' cuts?”

“While it is inevitable that all public services must tighten their belts in this economic crisis great care must be taken to avoid a negative impact on vital front line services.”

“If for example, Bootham Park hospital were to lose it's special care ward, it is easy to imagine that great disruption would be caused to other patients. Where and when is public consultation taking place on this and other issues?

The recent news that money given to NHS trusts to improve respite care was not ringfenced and was not spent on respite care highlights the risks to services.

“Mental Health Services and respite care have historically been underfunded. Sweeping management cuts risk further erosion of these services because losing nine managers from a team of thirty has a different impact to losing one manager from a team of three. The public needs to be assured that consideration is being given to the particular circumstances in different parts of the service and that there will be flexibility in the PCT's response.”

“We also need clarity about what the PCT is doing to consult with partner agencies, patient groups, and the local authority to ensure a co-ordinated approach? Are impact and risk assessments being carried out with stakeholders to protect frontline services or is all discussion only happening in-house?

Background

The NHS' constitution requires public consultation on changes to local services.

Rough figures indicate that around £140 million of PCT's total budget over around £1.2 billion goes on mental health and community services [including health services to children in care, for example], about 12% overall of PCT budget.

Community and mental health services are vulnerable because they are provided in-house. The Trust has a better overview of services these services and may feel that it is easier to cut these services because it has more control over them.

I understand a board meeting to decide on services and Bootham Park hospital is imminent [days or weeks away and not months].

This is not just about York. It will affect health services across North Yorkshire.