STPs are looking even grimmer than I predicted back in August this year.
The desperate and short-sighted approach by government to limit costs under any circumstances will undoubtedly put people at risk – both professionals and patients. Prime minister Theresa May’s apparent jealousy that the NHS has been spared cuts compared to departments such as her last one, the Home Office, will result in a scarred health economy that may never recover.
GPonline STP coverage has included reports that GP numbers could drop by a third in one area, and that the first full plans released - for Birmingham - were labelled 'undeliverable' by local GP leaders amid concerns over the amount of work that would be transferred to GPs from hospitals.
Meanwhile a recent poll by the Health Service Journal found that almost half of NHS authorities are drawing up plans to cut hospital beds, and one third intend to close A&E departments.
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In addition, one in five expect to close consultant-led maternity services, forcing women in labour to travel further, more than half intend to close or downgrade community hospitals. One quarter anticipate job cuts in hospitals, and almost as many intend to close inpatient paediatric departments.
When you add these rapid changes, which will have little time for consultation, to those involved in moving to new models of care across the NHS - which also have had virtually no public discussion - we see the future of a shrunken, consolidated NHS. With all the procurement rules still in place, we can expect to see significant opportunities for privatisation.
However, it may not be a fait accompli if GPs and CCGs with local authorities fight these shocking changes. We are seeing a number of local authorities who reject the plans, and other key players in the field must do the same.
I understand that the BMA will be asking CCGs to refuse to endorse their local STP plans. We have common ground here. Nobody wants to see this kind of a future. This may be a moment when LMCs can combine forces with others to really show that the NHS will be protected – by all of us.
The Socialist Health Association will be happy to assist those areas who want to challenge plans that harm patients and communities.
- Dr Brian Fisher is a GP in Lewisham, east London, and honorary vice president of the Socialist Health Association.
Photo: Dan Wootton
