As Jeremy Hunt stays as Health Secretary, the NHS gets a dose of reality
After they had reported rumours he was being sacked, the television headlines said simply ‘Jeremy Hunt remains as Health Secretary'. They did not mention that the NHS remains in dire circumstances. Nor did they warn that the sacks of gold promised by Brexit campaigners for the NHS are most unlikely - repeat most unlikely - ever to be delivered.
In fact the situation in the NHS is getting steadily more alarming. Should anyone think that is 'doom-mongering', listen to Jim Mackey, head of NHS Improvement and probably the second most important person in the NHS. On the day (July 14) Mr Hunt kept his job, he told a conference that the NHS is "in a mess."
Finances are tightening still further, hospitals have posted record deficits, recruitment of staff from overseas is under Brexit threats, the latest way forward - through Sustainability and Transformation Plans (STP) - are taking longer than expected to draft and now the safety of patients is being set against cost.
Members of this government have poured scorn on the Labour government on whose watch the Mid-Staffordshire scandal occurred. Now this government is telling hospitals which are running deficits that they should not automatically employ staff or improve facilities to meet levels advised by the regulator or standards set by royal colleges.
This latter move has shocked those colleges. The Health Service Journal quoted Royal College of Nursing chief executive Janet Davies: “This gives completely the wrong message to trusts, whose boards are responsible for the care, treatment and safety of their patients, by suggesting that finances are more important than patient care."
The move will create a new splash of red on hospital risk registers which are already facing a blizzard of new rules - such as caps on agency pay and on management pay - and are still struggling to reduce their deficits.
There are warnings in there air of cuts to services and loosening of targets - the four hour target for A&E waiting times is thought likely to be changed to ease hospitals’ woes.
The CCG warns of "Future cuts - Annual funding is less than needed to meet demand" and talks about the 'impact of the cuts to social care services' and points to the "£500million funding gap across Wiltshire, BANES and Swindon for 2017."
The first advertisement quotes Dr Richard Sandford-Hill a GP at Market Lavington Surgery and member of the CCG's board: “Providing health care for an increasingly ageing population is difficult. In my own practice a majority of my routine appointments are attended by people aged over 65, and those people often have complex long term needs."
The CCG's text continues: "The NHS is used to doing as much as it can with ever-stretched budgets. The shortage of people working in social care means that together with Wiltshire Council, we're doing our very best to make sure we can support people. And it's not all doom and gloom - we're making some great strides forward to make sure we can properly deal with some of the issues we are facing."
The second advertisement in the series concentrates on explaining 'How we support you to live well' and has a careful guide to choosing the right healthcare when someone is feeling unwell.
On the day Mr Hunt was confirmed in his cabinet post, the much revered King's Fund produced a report on Deficits in the NHS 2016: "There needs to be realism about what the NHS can achieve with the funding allocated for the rest of this parliament."
The King's Fund calls on the government to review the promise of a full seven-day service and believes the government "...has a responsibility to be honest with the public about the consequences of the NHS 'offer', particularly in view of its manifesto commitment to 'protect and improve' the NHS."
The Wiltshire CCG is certainly being honest with the public in its series of advertisements.
Wider planning for Wiltshire's health services:
Amidst all this turmoil, senior NHS leaders in the county are working hard and to very tight deadlines on the STP across Wiltshire, Bath and North-east Somerset and Swindon.
Not everyone is happy with how the STP is being drawn up. One the most vocal critics is Wiltshire Council's leader, Baroness Scott. Her unhappiness about the process and the role given to the Council and its staff (first reported by Marlborough.News in April) has now been repeated - even more forcefully.
At the full council meeting on Tuesday (July 12) Independent Councillor Chris Caswill, asked when the plan would be made public so it can be scrutinised by the public. Baroness Scott: "I would love to know. This is not being led by this Council."
"I was very disappointed when NHS England changed the rules...to the Health and Wellbeing Board (HWB) and the Council being just consultees on it."
"That is not what I think should be happening if we are going to integrate health and social care." She did say the HWB was getting updates on the planning talks. But ended her reply: "I haven't seen it yet."