Defend our health service

NHS cost-cutting is damaging patient care

Karen Seymour, Mansfield Socialist Party
NHS demonstration to save the Whittington hospital in north London,16 March 2013 , photo Paul Mattsson

NHS demonstration to save the Whittington hospital in north London,16 March 2013 , photo Paul Mattsson   (Click to enlarge: opens in new window)

Last autumn it emerged that 120 breast cancer test errors had happened between 2004 and 2010 at Kings Mill Hospital in Mansfield, Nottinghamshire. This caused great anxiety to the women affected and their families.

Now a new report concludes that “decision making was finance driven, with too little attention given to clinical considerations.” The Care Quality Commission lists factors leading to the Kings Mill test failures:

  • “Short term decision-making by managers” meant the laboratory did not keep up to date with technological advances.
  • “There is no air conditioning in the laboratory and therefore no adequate temperature control… This will introduce variations in… quality, particularly during the summer.”
  • There was a “Trust culture of short-term cost-cutting without the necessary strategic planning to ensure continuity of service.” Examples include “considerable delays to procurement of the semi-automated [equipment] on grounds of cost.” Four specialist laboratory scientists were made voluntarily redundant, only for their work to be covered by agency staff at increased costs. (This occurred more recently, showing “short-term cost-cutting culture” continues.)
  • Staff were not released for courses or to visit centres of excellence by management “as routine work took precedence. [This is] short-sighted decision-making.”
  • There was “a management decision to change one of the [test materials] to another … which was found not to work. This decision was based on price alone, saving a paltry sum. The consultants were not informed of this substitution and only realised when the new [material] repeatedly failed to perform.”

The report concludes that “a patient-safety, risk-management approach to clinical services issues should replace the cost-based approach.”

But exactly the opposite is happening across the NHS. The massive £20 billion ‘efficiency improvements’ – started under the last Labour government – is the background to the Kings Mill managers “cost-cutting culture”. This government is allocating 20% less funding for pathology services by 2015.

Big business

Hospital pathology services have seen big changes since Lord Carter’s 2006 report (under Labour). This private health company boss recommended moving from hospital-based to regional laboratories, which private companies could bid to run.

Tenders are now being examined for community pathology services right across the Midlands – a contract worth £300 million.

These blood tests are mostly automated and profitable, so hospitals use them to subsidise complex tests, like cancer diagnosis.

Without routine high volume work, hospital laboratories become ‘uneconomic’ but big business just wants to cream off easy profits.

Kings Mill was an early adopter of the Modernising Scientific Careers project, changing how medical laboratory scientists work.

There is also enormous financial pressure from unsustainable PFI payments, such as Kings Mill’s.

Mansfield Socialist Party members call for an inquiry by health workers’ trade unions, patients and community representatives.

The financial books should be opened so we can see where our money is spent and where private profit is putting more patient’s health at risk.

New, sweeping NHS changes will result in more tragic and avoidable cases where cuts, ‘business culture’ and privatisation cost lives.

New evidence has emerged using the Freedom of Information act which shows that the government’s drive to make all NHS hospitals achieve self-governing Foundation Trust (FT) status by 2014 will benefit private medical practice at the expense of NHS patients.

Under the Health and Social Care Act, which became law on 1 April, the 2% cap on doing private medicine in NHS hospitals has been raised to 49%.

As FT hospitals have to compete with one another for income, a higher rate tariff on private patients could result in NHS patients going to the back of the queue.

So far 40 FT hospitals plan to open private patient units.

Initiated by the last Labour government, FTs – which aren’t accountable to the health secretary – represent another nail in the coffin of the National Health Service.