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Indignation over health cuts consultation


NIC-ICTU, WRDA, consultation, Department of Health, cuts, open letter, shamThe cuts are ‘not driven by necessity and are completely at odds with the needs of service users’.

In August the Department of Health (DoH) asked the five Health and Social Care (HSC) Trusts in Northern Ireland to develop draft savings plans totalling £70 million to ‘deliver an annual balanced financial plan’ in 2017/18.

This despite the DoH budget being ring-fenced and supposedly protected from cuts for the next year

Following a series of Trust Board meetings held on 24 August, the Trusts’ savings plans were published for public consultation for a period of six weeks, and closed on 5 October 2017.

Responding, Claire Ronald, vice-chair of the Health Committee of the Irish Congress of Trade Unions – Northern Irish Comittee (NIC-ICTU), which leads on the health policy development for the wider trade union movement, said at a briefing for colleagues: “The latest funding crisis facing the Health Service in Northern Ireland is the consequence of a political crisis.

“The funding crisis which has caused such turmoil across NI’s five Health Trusts will not be resolved until our NHS has a locally accountable Health Minister and a functioning NI Assembly to scrutinise their decisions.

“The longer-term issues facing the Health Service can be better resolved using the methods and structures outlined by Professor Bengoa a few months ago, involving the representatives of staff and patients at the very heart of the tactical and strategic direction of the people’s NHS.

“That is why the trade unions believe that the trusts have been put in a difficult position by the Department of Health but we believe they have made the situation worse by actively side-lining the health trade unions.

“If they had involved the unions at the point that they received a communication from the department, we could have been working far more collectively against this situation.

“We represent the people who deliver these services and yet we are seen as just a tick box of people who they have to consult with, not a true partner in the process.

“They have all been working on their savings plans and trying to manage resources based on an anticipated level of savings, but there was no involvement with the unions until this public consultation is suddenly required, based on a suddenly more significant reduction in their budgets.

“It is also telling that they will consider what is said but unless alternatives can be offered the release the same amount of savings I see little changing

“Moreover, how can trade unions or the public give realistic suggestions when we do not have access to the full financial information and have only 6 weeks within which to make recommendations?

“This makes the consultation seem even more of a sham as we have been given limited information with which to fight back.

“The thing to bear in mind is that these cuts are supposed to kick-in at the start of November, the time of year when health costs dramatically increase, as winter bites and the elderly and vulnerable need the services of the NHS.

“There was a strong emphasis at some of the five Health Trusts’ briefings about the plans being temporary and there was a focus on not closing services.

“The fact remains that these cuts will still see people left without treatment.

“We have seen temporary changes before that have still to be reversed it is often the way of making unpalatable changes without going through a full and robust consultation and plan.

“What is both unfair and unreasonable is this sham exercise in consultation.

“The public are being asked to choose from a selection of cuts.

“There is a pressing need for the very opposite, decent investment in infrastructure and skills and proper wages for the staff who deliver health and social care to the people.

“Our colleagues across the Health Service are unanimous in calling for our service to be overseen by locally elected politicians and run collaboratively using the strength and skills of the entire workforce.

“But in the absence of an return to Stormont, the responsibility must be placed at the top of the Department of Health and the only ministerial oversight we have, and that means the Secretary of State James Brokenshire.”

She was referring to the fact that Northern Ireland has been without a devolved government – and a health minister – since the power-sharing institutions collapsed in January after a dispute between the DUP and Sinn Féin about a botched green energy scheme.

The Women’s Resource and Development Agency (WRDA), a charity which provides support for women’s groups and networks across Northern Ireland, has submitted evidence to all 5 consultations.

And WRDA has joined with the trade unions in calling on the Department of Health to halt this process and access the money that has already been committed to investing in health and social care services.

The letter, dated 5 October 2017, runs:

Dear Chief Executive,

This response to the consultation on the Financial Planning Savings Plan 2017/18 is on behalf of the Women’s Resource and Development Agency.

The Women’s Resource and Development Agency (WRDA) is a regional organisation operating across Northern Ireland, with a mission to advance women’s equality and participation in society by working to transform political, economic, social and cultural conditions.

The organisation was established in 1983 and focuses on working with women and community organisations located in disadvantaged and rural areas.

WRDA is a membership organisation with over 190 members including women’s groups, organizations and individual members.

As a leadership organisation within the women’s sector we aim to present the concerns of women in the community and evaluate policy with a view to ensuring women’s rights and equality are protected.

As we consider the current proposals that the Belfast Trust has presented we are deeply concerned.

It is our view that the £70 million of in year cuts demanded by the Department of Health are not driven by necessity and they are completely at odds with the needs of service users.

WRDA echoes the position expressed by the trade unions through the NIC-ICTU Health Committee who have directed their response to the Permanent Secretary of the Department for Health and challenged his decision to impose these cuts on the trusts.

We share their disgust that the decision making of the Department appears to not only breach their own Equality Scheme but also comes at a time when we know additional funding has been committed for health and social care services.

In addition to the recent announcement of increased spending on the Health Service in England which would translate to an increase in the Northern Ireland allocation, these cuts come in the aftermath of a promised £200 million for health and social care in the DUP/Conservative deal at Westminster.

We are also mindful of the agreement by the Executive back in May of last year to spend an extra £200 million on health each year and the £40 million already agreed to address the transformation issues raised in the Bengoa report.

For years now anti-austerity voices such as the women’s sector having been highlighting that the narrative which suggests there is no alternative to cutting public services is a false one.

Never has there been such as stark example of the unnecessary, political nature of spending cuts as this current crisis in the health service.

The public are not fooled – it is clear from the examples above that there is money to spend on these vital services and it is simply not being accessed by those with decision making power.

For this reason WRDA supports the position of NIC-ICTU that the public consultation is no more than a sham.

Asking worried and vulnerable service users to argue against the loss of the services that will most affect them is irresponsible and quite disgusting in light of the political backdrop and the unnecessary imposition of the in-year cuts.

We are calling on you as Chief Executive, along with your colleagues in the other trusts, to demonstrate the leadership that is required to halt this current process.

We will be writing to the Department for Health in recognition of the responsibility held by the Permanent Secretary for this current crisis.

We will also be calling on all political representatives to end the political stalemate that has led to this vacuum of accountability for public spending.

But we would also like to see the Chief Executives take a similar approach to that of the school principals who in April of this year refused to implement the Department of Education’s budget.

They wrote a public letter outlining their opposition to the budget which they described as ‘untenable’ and ‘seriously damaging their pupils’ education’.

These principals had the courage to risk their own reputations as they were effectively declaring that they would have to plan for ‘deficit budget positions’ in order to meet their children’s needs.

They told the department they would be spending what was required and put the ball back into their court to come up with a ‘meaningful and sensible budget.’

What is needed at this crisis point in the health service is not a conversation about which services should be cut first.

The delivery of health and social care is already at breaking point due to chronic underfunding.

To make further cuts as the winter months approach is alarming and unacceptable.

What we need is for leaders in health and social care to demonstrate courage and send a message to the Department that this process will place you in breach of your own equality schemes and your duty to your service users.

Yours sincerely,

Kellie Turtle

Women’s Sector Lobbyist

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