Save Our Health Services Devon (SOHS Devon) was formed in April 2016 to campaign against the threatened closure of the acute services at the North Devon District Hospital, following the leaked publication of a document entitled The Case For Change. SOHS has since spread to embrace the rest of Devon with action taking place most recently with the proposed closure of Teignmouth Hospital and a countywide response to the Government White Paper on Integrated Care Systems. Many documents relating to the campaigns of 2016-18 can be seen at the ARCHIVE site.
In a letter to the North Devon Gazette written in October 2019 campaigner Dave Clinch, outlined the straws that broke the camels’ backs. It is part quoted below, interspersed with information from other sources, to give a brief history
“…..It was made clear by the [Clinical Commissioning Group] and the North Devon Healthcare Trust (NDHT) that ‘nothing was off the table’ when considering where cuts could be made in the second remotest district hospital in Britain. There were to be ‘no red lines.’
“ The SOHS Devon campaign North Devon Sees Red was launched by leafleting towns and villages across the area, organising many packed public meetings, a large march to the NDDH, a massive demonstration with over 5,000 people in Barnstaple on 22 October 2016 and a ‘we are the red line’ day of action at several community hospitals in April 2017.”
Dame Ruth Carnall’s company was paid £658,514 in 13 payments from April 2016 to March 2017, the last payment being for £237,056. Dame Ruth Carnall was not seen at any further meetings.
This was for advice on how financial cuts were to be made across the Devon Health service. “Ruth Carnall, was appointed chair of the risibly named Success Regime which was created to oversee Devon’s Sustainability and Transformation Plan.” STPs were the plans to integrate the provision of healthcare, including purchasing and commissioning, within each geographical area of the NHS across the country. Introduced in 2016, in Devon proposed efficiencies looked likely to lose vital services at NDDH. “The SOHS Devon campaign, nevertheless, was successful in preventing the acute services at NDDH being cut, albeit [campaigners] agreed that [the bureaucrats] would be back again.”
By 2018 STPs were already well on their way toward Integrated Care Systems- see below- even if that name for them had not yet been decided.
Dave Clinch continued in his letter “Now the bureaucrats at the clinical commissioning group and the North Devon Healthcare Trust are back with their eye on key areas of ‘challenge’ at NDDH, i.e. maternity, paediatrics, stroke, obstetrics, oncology, acute medicine, trauma and orthopaedic and care for the elderly.”
“When asked by an observer at the September  board meeting of the NDHT whether or not the above services would not be cut, CEO Suzanne Tracey was unwilling or unable to give a guarantee.”
“Suddenly, however, there are now millions of pounds available, according to Mr Heaton-Jones MP for North Devon as he announced funding for a new hospital last weekend.[October 2019] That the current hospital is in danger of further cuts, on the grounds that it has a staffing problem, is completely ignored. ‘Perverse’ hardly explains it. [Meanwhile] Community hospitals closed, patients families having to travel long distances to see loved ones, for example. More isolation, the increasing likelihood of avoidable death.”
SOHS could see the need to bring the NHS “back into full public ownership ridding it of all the private companies that are sucking it dry, along with the exorbitantly paid senior managers and their expensive advisers who have spent years carrying out government cuts.”
Over the last 3-4 years plans have been developed to impose a new structure on the NHS across the whole of England. They are now coming to fruition. The Country is to be divided into 42 ‘footprints’ each of which will have its own Integrated Care System or ICS, the rationale of which is derived from the USA system of healthcare. This is essentially supplied via market forces, enabling insurance companies, big pharma, and healthcare professionals to all run hugely profitable businesses on the back of people’s ill health. The kind of business, you might say, that encourages people to take drugs they don’t need, while rationing their access to vital operations.
Ever since the introduction of the new Health and Social Care Act in 2012 the creeping privatisation, which had continued through all political administrations since Margaret Thatcher, became more openly licenced with vastly broadening access of private providers of health and care services, to the NHS (like Virgin’s contract for children’s services in Devon). However, from 2012 until now (early 2021), the administration of health services has been carried out by Clinical Commissioning Groups, who, in theory at least, have been subject to public scrutiny ( via bodies such as scrutiny committees on county councils).
So since before the Coalition government created the 2012 law, there has been a move toward shedding responsibility for health from central government to the market but from 2016-17 it became clearer. We have witnessed this in the gradual removal of beds, centralisation of services (making them often more difficult to access), and failure to recruit more students into the nursing and medical professions (in fact making it more difficult for student nurses by giving them university student status in 2018 and dropping their bursaries. After much public protest, including petitions organised by SOHS, these were re-instated in December 2019 but only to the tune of £5,000 pa [- see more about this on our ISSUES page.(1)*] Others training for public services, like police and firefighters are still paid while training – why can’t the same be done for nurses?).
This has all been done under the name of Austerity, which thanks to the pandemic has now been totally undermined as a valid rationale for running our public services. There has been a sudden volte-face so it seems. The Chancellor released £££Billions to save the economy –a life-saver for many for which we can be grateful but it has also opened our eyes to the fact that as a sovereign state we have the freedom to produce currency just like that. But this has also meant that Government has had no compunction about spending £££billions on contracts to friends and relations. Mr Hancock and Mr Johnson used the excuse there was a war on and scrutiny was an irrelevance. There have been countless articles in the press and media about this blatant culture of cronyism and the fact that the real NHS – paid with public money without the middle man of private provider – has given a hugely better value for money service than those that went for example, to the providers of PPE. [ see NEWS page – among which Ayanda Capital Ltd,(Private Equity) £252m, Pest Fix (pest control services) (£108m), Clandeboye AgenciesLtd (£108m), andAventisSolutions ( an employment agency with net assets of £322 (£18.5m)
The legal campaigning group The Good Law Project bravely took the government to court earlier this year (2021) over the awarding of such contracts, and won. But this and similar challenges to its behaviour has led to government’s determination to weaken the power of judicial review.[see NEWS page]
It seems that the government saw their achievement of awarding unscrutinised contracts without due tendering processes as a kind of bellwether for the move to even greater privatisation. It seemed that if they could use the rationale of ‘collaboration rather than competition’ (notwithstanding that when introduced in 2012 ‘competition’ was itself seen as the beginning of the end for the NHS) and do away with ‘unnecessary, costly and time-consuming’ competition, they were well on the way to what they had been working toward for almost twenty years. In that respect the pandemic had been a godsend to them.
It is relevant to mention here that NHS England is the revisionary body established under the 2012 Act which saw the devolution of administrative power and responsibility away from national accountability by the Secretary of State to a fragmented service administered by local clinical commissioning groups across the country. In its powers and ambitions it differs from the old NHS which although considerably amended since it’s birth in 1948 was an essentially different organisation.
The Integrated Care Service
In late November 2020 NHS England held an online public consultation on the introduction of the system they had been working on for several years. The Integrated Care System. The consultation period was totally inadequate and NHS England appeared to be taking advantage of the pandemic to whisk it through under most people’s radar.
This would be similar to but not the same as the Clinical Commissioning Group. The crucial thing about ICSs, which has not been spelled out in the White Paper seeking their legislation and published in February, is that the structure of their governing bodies is such that private company representatives will be able to sit on their boards, recommending and hiring their own companies to provide services. Such services will not be subject to a tendering process of scrutiny and competition, they can and no doubt will be offered an open door. Given this government’s track record it is by no means far fetched to say they can and possibly will be similar to the kinds of contracts which we saw going ahead during the pandemic, only this time they will be perfectly legal and judicial reviews will be an irrelevance. See CAMPAIGNS AND ISSUES, NEWS and TAKE ACTION pages for more information on this life-shattering plan.
This can be stopped. In 2018 MP Eleanor Smith presented the National Health Reinstatement Bill. If our government really want to improve services to the public they need to act on that Bill not the 2021 White Paper.
Privatisation matters: these website give you all the reasons and some interesting examples of how things can go wrong https://lowdownnhs.info/analysis/why-does-nhs-privatisation-matter/
SOHS have attended, and continue to attend, hospital and CCG board meetings, and Devon County Council Scrutiny Committee. They have joined Patient Participation Groups (some of them were already members) and attend public stakeholder meetings and patient information groups. They have written, and continue to write, letters to secretaries of state, ministers, MPs, councillors, boards of directors, scrutiny committees and the local press. They have a face book page and as well as organising local rallies and demonstrations attend national ones. They take part in and contribute to nationwide campaigns, like Keep Our NHS Public and Health Campaigns Together. They have created petitions. They have carried out campaigns across the county including for Teignmouth and for Minor Injury Units (see the CAMPAIGNS AND ISSUES page) The North Devon group have a respectful relationship with the Board at North Devon District Hospital, which has recently merged with the Royal Devon & Exeter Hospital, and believe that their aspirations are not so very different from those of SOHS. But like many other hospital boards across the country they need help if they are not to be completely swallowed up by the government’s overhaul of health services in the name of efficiency and improvement.
With your help we can fight this and get back to a health service which is fair and equal for all with money going to the right places, not to overpaid management consultants and service providers, and the right pay for nurses, doctors and all the other staff of our hospitals and doctors surgeries. Contact us now.
(1)* See NURSES PAY on CAMPAIGNS AND ISSUES page