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The Friday Surgery

Sustainability and Transformation Plan (STP) induced hospital closures- welcome to the new generation of NHS estate agents

Encounters with estate agents are not necessarily known for their entertainment value. However years ago I had one such encounter that I still remember fondly to this day. I went to see a flat in Leytonstone, London. Things started badly when I realised on arrival that the flat didn't appear to have any windows. At all. My chipper estate agent, called Seb, replied 'yes, but it has bags of character'. However he was unable to show me this character because the front door had been sealed shut. That's right, sealed shut. Not just a bit stuck but sealed shut using some form of welding equipment. So we just stood outside for a bit, wondering what to do now. We talked about the weather for a bit and then Seb suddenly remembered he was an estate agent and started talking about how desirable the area was. He said it was the up and coming neighbourhood in the whole of London. I told him that I could just cycle to the area and have the same experience.

'Yes, but what about the spacious garden? You can't get that from just cycling into the area'.

'Yes I could sit in the spacious garden and think about how nice it would be to get in the welded door to my flat with no windows.' I replied, with more than a little sarcasm.

He then tried to barge the door three times, partly breaking the handle. 'It's a period door', he grunted through barely concealed expletives. My favourite part came at the end when we both stood there, unable to get into the flat with no obvious windows. He asked,

'So are you interested?'

Why mention this story in a weekly NHS blog? Well it was because I was reminded of this story when reading about Michael Wilson, the Sussex and East Surrey Sustainability and Transformation footprint lead, last week. His initial plan outlined £580m of savings in Sussex and East Surrey alone over the next few years. This would be delivered, wait for it austerity-watchers, through estate savings, efficiency savings and community models of care that would undertake acute activity.

Now I'm not going to insult the readers' intelligence by even engaging with the real estate sales or the idea of efficiency savings when in the world's sixth richest country we still spend below the OECD average (less than Greece) on health.

But maybe there is some slack in the community?

Well, the problem with the community providing the savings is the fact that the government has decimated adult social care provision through average cuts of around 35% in recent years. This programme of community care annihilation is unprecedented and has left most organisations in the community and voluntary sector fighting for survival.

So I was forced to think outside the box. Where else in the community might we locate these services? I popped along to my newsagent. My plan was to explain about STP and the need for creative solutions and ask whether Joyce might be able to house, for instance, a new combined post office/laminar flow operating theatre in her shop. I mean, far be it from me to presume a workable command of newsagent feng shui, but straight away I could spot wasted space where the grab bag crisps rack was. Problem was, I couldn't get to speak to her as the shop and it's post office were packed with people trying to post parcels in the 5 minutes they had between dropping the kids at school and going to work. I did however hear a conversation about the waste of money that was our recently opened swimming pool. This was my next destination.

When I arrived I steadied myself, ready to push my new swimming pool/complex musculoskeletal elective surgery facility idea on them. Don't worry Michael, I thought, I've got your back covered. I was sure they were going to like it. Problem was that once again they seemed really busy just being a swimming pool. One of the desk staff had left the desk to referee a potential stolen slush puppy incident (the ice drink, nobody had stolen a dog), which left a backlog at the till and a long queue.

The local school was my next stop. If all of the adults are busy then maybe the kids can help? I was taking my kids and two of their friends home from school because their parents couldn't get out of work in time. I asked Anna, Andrew, Madison and Lauren whether there was any Sustainability and Transformation five year forward plan footprint slack that they could pick up. Perhaps cardio thoracic medicine, for instance? But they just scooted off, calling me a weirdo. Even when I shouted after them that Michael Wilson was serious about ‘improving both care and quality of services through the smarter use of resources’, they kept scooting.

Which brings me back to Seb, my estate agent in Leytonstone. Michael Wilson and the many other STP leaders around the country are in the exact same position as Seb. They are putting together plans to sell us a metaphorical windowless flats with no door. And he is no more likely to sell the local public nearly £600m of savings through transfers to community care than Seb was to selling me the windowless flat with sealed doors.

With £580m of NHS cuts coming, we can assume that Mr Wilson's model of community care won't involve any great infrastructure funding. It will instead be the unholy offspring of a resuscitation of big society volunteerism combined with the privatisation of pain and misery into the few hours that families with stagnating wages and increasing debts can squeeze together between them. There is no slack left in the community, either through our beleaguered community and voluntary sector or through families, carers and neighbours. I know this, you know this and Michael Wilson knows this.

So in conclusion folks, watch out. There is an STP estate agent coming your way soon.

Please sign and share the following petition to stop the Michael Wilsons of this world gutting the NHS. https://you.38degrees.org.uk/petitions/stop-the-plans-to-dismantle-our-nhs

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