NHS bosses have started to implement the £20 billion savage cuts programme, officially described as ‘efficiency savings’, that the new Tory government insists must be carried out by 2014.
The cuts are being decided behind closed doors in ‘virtual secrecy’ and include directives to Primary Care Trusts (PCTs) to dramatically reduce the number of hip and knee replacements, cataract operations and orthodontic treatment by requiring ‘case by case’ approval.
Sutton and Merton PCT agreed last Thursday to more than £50 million ‘savings’ over the next two years.
These ‘savings’ include plans for ‘reducing length of stay’ in hospital for the terminally ill and advising terminally ill cancer patients on how to manage their own symptoms at home.
Mid-Yorkshire Hospitals NHS Trust agreed two weeks ago to ‘savings’ of £55 million over two years, including 500 job cuts. This is despite warnings of staff shortages.
A ‘turnaround’ plan drawn up by Peterborough PCT envisages almost £100 million ‘savings’ by 2013.
These ‘savings’ will mean sending 500 fewer patients to hospital every month, cutting £17 million from Accident and Emergency and acute services and shutting nursing homes and services for the mentally ill. And Hertfordshire PCT will this week discuss cutting spending by rationing more than 50 medical procedures.
Other cuts being made include cuts to children’s and maternity services, IVF treatment, surgery for obesity and services that provide respite breaks for long-term carers.
The details of the cuts are being carried out behind the backs of the general public, buried in hard-to-find appendices to policy and strategy documents.
Katherine Murphy, from the Patients’ Association, described the cuts at the weekend as ‘astonishingly brutal’, while Royal College of Nursing (RCN) leader, Dr Peter Carter, said the cuts were ‘incredibly’ worrying.
A spokesman for the doctors’ union, the British Medical Association (BMA) said: ‘It is essential that any efficiency savings don’t affect the quality of patient care and are made in consultation with clinicians in an open and transparent fashion, and if that is not happening then we would have strong concerns about that.’ At this year’s consultants conference, Dr Mark Porter said that we feared cuts were not going to look at individual cases, that there were large-scale blanket directives coming in, and we would have strong concerns about that. This is something we have lobbied against.
‘This is not the way to go ahead. We don’t want patient care to suffer and we are opposed to the way the economic situation is being taken out on the NHS.’
When cases of different cuts being made by health authorities were put to the BMA’s spokesman, their spokesman replied: ‘We have lobbied against such stringent cuts and against any cuts that go ahead without consultation with clinicians.’
Asked about GPs being pressured or incentivised not to refer patients to hospital, the BMA spokesman added that GPs should be allowed ‘to use their clinical judgement’ and patients should be referred to hospital on the basis of their individual need.