Sustainability and Transformation Plans (STPs) for England, which were announced in NHS planning guidance published in December 2015 and have since been prepared in secret in 44 “footprint” areas, are now being revealed. According to reports [i] 41 of the 44 STPs have so far been published – some of them only in response to people’s campaigns, and some of these still incomplete, lacking appendices outlining finances and details. So, why all the secrecy over STPs and what is their significance?
What is clear is that the whole direction of these plans for the NHS is being driven by the present government in the face of the opposition of people and those that work in the NHS to safeguard the future of the NHS. The Prime Minister, Teresa May tried to claim in Parliamentary Question Time [ii] on November 23 that “Sustainability and Transformation Plans are being developed at local level in the interests of local people by local clinicians”. Yet what has been seen is that these are secret “top down” plans prepared in the corridors of power of government, of NHS England and boardrooms of management consultant companies. In fact, it shows that the people and those that work in the NHS are being treated with the utmost contempt. Indeed, the reason for the secrecy was further confirmed when it was revealed in Parliament that the Prime Minister had called in NHS leaders to order them to stop any hospital mergers, or closures, that risk causing local protests [iii].
What are the STPs? Everyone should find out what is to be known about them. In December 2015, NHS England issued guidance to change how the NHS in England is organised, with a ridiculously short time-scale for its implementation. All CCGs (Clinical Commissioning Groups) and NHS Trusts in England, and the local authorities in their area, were arbitrarily organised into one of 44 area-based “Footprints” covering all of England. By implementing the so-called “new models of care” that are set out in NHS England’s “5-Year Forward View” of 2014, each “Footprint” was required to produce a joint 5-year Sustainability and Transformation Plan for their area. This STP was directed to wipe out the NHS financial deficit in their area within a year, and for the next five years.
The STPs refer to “efficiency”, but by this is meant to make cuts to services to make good a “deficit” caused by fraudulent budget constraints. The double-speak of successive governments past and present to impose the the neo-liberal agenda in health whilst claiming that the NHS is “safe in their hands” is beyond belief. What is so noticeable about the STPs is that whilst government tries to claim that these “local plans are being developed at local level in the interests of local people by local clinicians” the real direction is that they have been developed “top down” in secret towards a model of care that is almost a direct copy of the neo-liberal health care system in the US. A system where insurance companies and not clinicians decide who gets health care. A system where the big health corporations and insurance companies are directly in control of the health care system and make vast profits at the expense of the well-being of the people. The director of STPs for NHS England, Michael McDonnell, himself said that the STPs “offer private sector and third sector organisations an enormous amount of opportunity”.
No serious plan can be put forward and taken seriously if it starts from this direction of the government to destroy the NHS, further open it up to privatisation and further create the conditions to make people pay for health and social services. These plans must be opposed because how can we have a proper discussion on these issues when this is the aim of it. Without establishing a proper public authority and public services accountable to the people and those that work in the NHS, nothing can be properly sorted out. Access to health care is a right of everyone in a modern society, and this right must be guaranteed for all. Resources must be ensured for the training of doctors and consultants required for all acute and community services. Locally accessible district hospitals with a wide range of properly funded acute and emergency services must be retained. Public right should prevail and the duty of government to provide a comprehensive acute and community, physical and mental health service across England to all communities must be restored.
The significance for the people and those that work in the NHS is to build the campaigns and organised opposition of the working class and trade unions movement, uniting the people in many areas of the country to oppose the direction that these STPs represent. The people must organise regardless of political views and keep the initiative in their own hands to safeguard the future of the NHS and chart a new path and direction for society.
[i] Health Campaigns Together http://www.healthcampaignstogether.com/
[iii] “Last week, the Prime Minister called in NHS leaders to order them to stop any hospital mergers or closures that risk causing local protests. There is already a protest in my constituency.” Emma Lewell-Buck MP for South Shields