Council bids to limit health cutbacks
Kensington and Chelsea Primary Care Trust’s (PCT) financial situation has been a matter of serious concern since the Government imposed requirements to reduce spending by £10 million in 2006/07. An RBKC Direct article in May 2005 expressed the Council’s initial unease but things have since developed.
The Council’s Overview and Scrutiny Committee (OSC) on Health held a public hearing in June 2006 and expressed fears that the proposed reductions could jeopardise key local services. This could have potentially serious consequences for some service users and providers. So why are local residents facing this situation? What is the OSC suggesting?
Kensington and Chelsea Primary Care Trust
Kensington and Chelsea PCT is the NHS body responsible for local health services in Kensington and Chelsea. It works with GP practices, the Council and hospitals to fund local health care, enhance the effectiveness and efficiency of local health services and to make them more accountable to the communities they serve.
Why the deficit?
Despite the recent growth in local healthcare spending, the PCT is facing cutbacks because of overspends in previous years and an accumulated deficit of £26 million in 2006/07 which has to be fully repaid over a very short period.
The PCT had already made plans to address this overspend and was successfully reducing its monthly spend. But the overspend issue was exacerbated by the Government’s insistence, via the London Strategic Health Authority (SHA), that the PCT should also make £7.6 million of savings in the current financial year (2006/07). This is equivalent to three per cent being ‘top sliced’ from the PCT’s budget for that year. This three per cent is held in reserve by the NHS.
The projected deficit for 2006/07 is £10.1 million and widespread reductions will have to be made to meet these tight financial objectives.
The Overview and Scrutiny Committee
The Council’s Overview and Scrutiny Committee (OSC) on Health has powers to scrutinise local health services and to make recommendations accordingly, although it does not have direct control. It acts to ensure residents’ views are represented and, in this case, is seeking guarantees that cutbacks will be responsibly planned and implemented.
The PCT’s turnaround plan
An ‘Outline Turnaround Plan 2006–09’ was approved by the PCT on 20 June 2006 and was then examined at a well-attended OSC public hearing the day after. The meeting revealed deep concerns not just from Committee Members but also from members of the public, service users and providers, and another NHS Trust.
Some of the published conclusions of the OSC are detailed below together with quotes from a letter written to Secretary of State for Health, Right Hon Patricia Hewitt MP, by the Chairman of the OSC, Cllr Christopher Buckmaster.
Key recommendations from the OSC
- The OSC would like to know the rationale for specific savings. How do the proposed savings relate to the needs of service users? Where is the impact assessment of making these savings?
- The OSC urgently invites the PCT to place the full Turnaround Plan in the public domain.
- There should in future always be a clear and open process for consulting with the public and stakeholders on proposals of this importance.
- The OSC urges the London SHA to grant the PCT three years to ‘get its house in order’ so that there is more time to consider the consequences that cuts will have on some of the most vulnerable members of the community.
- The OSC urges the London SHA to release funds, at least equivalent to the £7.6 million of savings insisted on, to alleviate the need for the PCT to make sudden cuts on this scale. Such a release would not require additional funds from the Treasury as the money is already within the NHS but not being utilised. (See letter.)
Extracts from the Chairman of the OSC’s letter to Patricia Hewitt MP
“These PCT cuts bear all the signs of a knee-jerk financial reaction to a dictat from elsewhere, rather than a considered response to real problems. It was clear in answer to questions at our OSC that the PCT had not thought through the consequences of its proposals, some of which by reducing preventative care will lead to greater NHS costs in the future.”
“We argue, forcefully, that to introduce the three per cent top slicing this year, when the PCT is already in deficit and had set its budget, is wrong. The effect is to increase the very deficit which the top slicing is designed to alleviate. This compels the imposition of ill thought through cuts, some of the consequences of which I have outlined. I therefore formally request that you authorise the London SHA to release this year the three per cent top slicing imposed on the PCT for the year 2006/07.”
The Council awaits a response from Patricia Hewitt MP with interest and hopes that she will act so the PCT does not have to cut services quickly. The OSC was unable to endorse the Turnaround Plan in its current form.
As always, we would be interested to hear your views about these NHS problems in the borough. Please email any comments you have to rbkcdirect@rbkc.gov.uk.
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