Public Meeting at Hedworthfield Community Centre

Meeting #2 in response to phase-1 of the 'Path to Excellence' consultation

• Overview
• Video of entire meeting including Q&A
• Abridged transcript of presentation by
  Stephen Hepburn

  MP for Jarrow
• Abridged transcript of presentation by
  Gemma Taylor

  Coordinator : Save South Tyneside Hospital Campaign
• Abridged transcript of presentation by
  Roger Nettleship

  Chairperson : Save South Tyneside Hospital Campaign
• Abridged transcript of presentation by
  Professor Allyson Pollock

  Director of the Institute of Health and Society : University of Newcastle upon Tyne
• Abridged transcript of presentation by
  Marion Langley

  Staff Side Chair and Unison Branch Secretary : South Tyneside District Hospital
• Abridged transcript of presentation by
  Emma Lewell-Buck

  MP for South Shields
• Selected comments from people at the meeting

Friday 15th September 2017

Thank you to the more than one-hundred people who attended our public meeting at Hedworthfield Community Centre on September 15th. Thank you to our local MPs and those who continue to fight to save our services. Thank you also to our guest speaker Professor Allyson Pollock (Director of the Institute for Health and Society - Newcastle University), who gave us a clear summary of the broader context in which we are fighting. See below for abridged transcripts of each presentation.

What is brilliant about our public meetings is that they involve everyone in the fight to safeguard the future of health services in South Tyneside and Sunderland. It is only by enabling people to come together as a campaign, that we can win our battle here as others have done in other parts of the country.

The meeting called on everyone to tell their friends and colleagues what is happening, to join our campaign, and to march with us in South Shields on Saturday October 14th.

Stephen Hepburn

MP for Jarrow

T

his [campaign] came about because there was an alliance between Sunderland and South Tyneside health trusts. Following ...that there was a review of services, and a consultation started in July of this year ...to look at possible closure or downgrading of a number of services at South Tyneside and to transfer [them] to Sunderland.

...If this proposal was to go ahead, we believe it will be severely to the detriment of the people of South Tyneside [and] to the detriment of the people in Sunderland, who's already over-flooded services are going to have even more demand on them.

We have been involved in a number of activities, ...meetings like this, ...demonstrations, and a petition where the figure has now gone through twenty-five-thousand, and we've had another six-hundred added tonight.

---

Gemma Taylor

Coordinator
Save South Tyneside Hospital Campaign

F

irstly I would like to thank all of those in the South Tyneside Hospital Campaign, including the MPs who have made such an important public meeting possible, where we can meet to discuss the public consultation so far, which could see the downgrading of acute children's A&E from 24 hours to 12, and moving consultant-led maternity, special care baby unit (SCBU), acute stoke and inpatient obstetrics to Sunderland Royal Hospital.

During the [consultation] period, SSTHC has encouraged people to raise their concerns about the downgrading of their health services at the consultation meetings. ...Our concerns include the following:

...Hundreds attended our meeting at Brinkburn CA. ...Following this meeting we are calling on all of you to support a march and rally in South Shields.

...[The government, wishing to impose STPs], continue to press forward with massive cuts to NHS budgets, and encourage NHS England to close hospitals and acute services. This is one of the main excuses for the implementation of these plans in our area. Even though the NTWND STP has not been agreed, and not been signed off.

...SSTHC has attended every meeting of the 'Health and Well-being Board' and CCG. We have challenged were we could and sometimes where we could not. We have attended the Scrutiny Committee and provided our support and briefings to councillors who sit on that committee, about the concerns of clinicians and local people. In other words, we are using every avenue we can to challenge the agenda to downgrade hospital services. The campaign [alongside our MPs] called for the consultation to be stopped because of the lack of clinical involvement in devising the review options.

...We have been accused of scaremongering, yet everything we have said so far has come to be true. For example, they told our midwives to tell their mothers-to-be that there would be no change to maternity services. What are we facing? - Changes to maternity services including the loss of consultant-led services and the SCBU. They told us we were scaremongering when we said there was a threat to A&E services - what do we see in the first phase [of the consultation] - a reduction in hours and possible reduction to nurse-led services for the children's A&E.

This is not a consultation that is limited to one or two specialist services. It is an all out plan to remove acute services from South Tyneside Hospital. This is what they declared in April 2016, and this is why we formed the campaign.

I'd like to give a tribute to all the activists in South Tyneside. ...Jeremy Corbyn came to South Tyneside last year where he signed our petition, he pointed out that health care is a right and not a privilege. We should have access to these services as close as possible to our community. This is what we are fighting for. ...A victory for us, will be a victory for everyone in the northern region.

It's not that we aren't in favour of a clinical alliance. That is something that has been going on for some years. If anything the campaign is saying that the clinical alliance between the two hospitals should be improved, but not from the point of view of taking away our clinical services, but from the point of view of developing both hospital's services.

The initial statements that the 'alliance' made - claiming that our services are no longer safe or sustainable - are frankly untrue and insulting. [None the less, those statements] were then backed by the local CCG and 'NHS Improvement', and then signed into the NTWND STP, and in-fact [they form the central tenant of the STP: I.e.] ...all duplicated services are unsustainable.

So right form the 'get-go', they had a plan to close down all acute services at South Tyneside Hospital, including critical care and A&E. [However], they announced [their plans] in a piecemeal way [consisting] of 3 phases. ...We opposed the STP (and not just our campaign, but all over the country) ...and put the STPs on the 'back burner', and effectively (after a so-called 'draft consultation') they were withdrawn, but [they] have now come back again. ...The closures within our hospital were set back one year. ...They intended to be closing our A&E in this period [but they only started their first consultation phase in July this year], and that is why we are here today to confront this consultation on the first [of the 3 phases].

The 'alliance' have explained what the fist phase is [about], but the one thing they don't say in the documents they [give] to the public - [although it is mentioned in their business plan - is a discussion of the services that we have right now]. There is a reason for that. If they were to [discuss] the services we have now with children's 24 hour A&E, with consultant-led maternity, with stoke services and with gynaecology services, [the public] would see that the options the [consultation is] presenting are less safe and less sustainable than the ones that actually exist now. This is not just our opinion, this is [supported by staff, who have not been consulted despite claims to the contrary]. ...We have documents from staff inside the hospital ...that show clearly that most clinicians and most staff have not been consulted.

So what we are doing now is preparing a briefing for everyone, and we will include in that briefing the views that come from the staff. ...Our briefing will show that:

• The continuation of consultant-led 24/7 children's A&E is still the safest and most sustainable option for the 17 thousand children and young people who attend that unit every year. It's built up an excellent reputation that needs to be ...supported rather than downgraded. What they are trying to propose is a 12-hour service from 8am to 8pm. But anyone who goes to the children's A&E after 8pm will see that the service is still crowded. [The other unsafe option on offer is to maintain a 24/7 service, but without any consultants].
• We shall also show that keeping consultant-led maternity services including the SCBU is the safest option, for the 1300 to 2000 mothers-to-be that attend the unit in South Tyneside [every year]. In spite of some of the [most] adverse health issues in the [region - as acknowledged in their own business plan], the South Tyneside maternity performs better than the UK average with lower perinatal deaths. It [also] scores [better] in terms of low numbers of caesarian operations... If invested in, [our maternity unit] could achieve even better results.
• With [regards to the] stroke [unit], the 'path to excellence' [consultation] recommends its complete closure. That's interesting because they said [previously] that they were not going to [explicitly state] what their preferred options [are]. ...opposing their own suggestion to keep stroke rehabilitation at South Tyneside hospital.

Closing such successful units (or downgrading them) will not save any significant sums of money, and that's an interesting point because we know it's driven by government cuts, but their own business case says that they will save at most £2-million per year for all these closures from a hospital budget of 150-million. They also claim that it is not their aim to save money, but if that is the case they should continue to invest in safe and sustainable services at both our hospitals in South Tyneside and Sunderland, and stop closing down such vital services.

The context of this is the largest ever cuts to our NHS resources by government, which is a politically driven plan of privatisation. We think this is a plan to shrink publicly provided NHS services and replace them with profit driven private sector services. Private [health] services are the most costly and inefficient.

We know the 'Path to Excellence' is not a plan to improve the NHS. Those of you involved in the fight to save the Jarrow Walk-in Centre will remember that the South Tyneside CCG told us that the closure of the Jarrow Walk-in Centre was a "Path to Excellence" - concentrating services on one sight at South Tyneside district hospital. David Hambleton (Chief [Executive] Officer - South Tyneside CCG) used to tell us that 'you need to give up your Walk-in Centre, because if you allow us to move it to South Tyneside district hospital, you'll have all the acute services there'. Now he is arguing for closure of acute services at South Tyneside hospital and saying 'don't worry, it's a "Path to Excellence", you'll have all these services at Sunderland Royal', but for how long? Where will it end? Sunderland Royal is coming under attack. Part of the problem is that Sunderland Royal is being underfunded. It was going to run out of money in March, it was pushed ...into a financial alliance.

So how can we trust these health service leaders. Especially when health service clinicians seem to have no control over such vital health services. ...This is why we have so many people involved in the campaign, ...to fight for an alternative direction for South Tyneside where access to physical and mental health acute services are accessible in our district hospital for the 150,000 people that live here.

At the moment we know our hospitals are not perfect, suffering from the massive cuts and the refusal of government to train enough doctors and nurses. In every hospital there is a shortage of clinical staff. The point is, this suits the government and their health commissioners because they are using these staff shortages as an excuse to wreck our health services even further.

So let us build for the future. Let us arm ourselves with our own understanding, and fight to save both our hospitals in South Tyneside and Sunderland, and contribute to the fight to safeguard the future of our NHS.

Your [local] battle is going on [repeated] all across the county, and it started with the 'Health and Social Care Act' of 2012. That act [of parliament] removed the duty on Jeremy Hunt (who is our Secretary of State for Health) to provide universal health care throughout England. That's a really big thing. That duty has been in place since 1948.

So now the government does not need to provide health services any more to all of you throughout England. It can quite happily close services, your GP services, your community services, your hospitals, and make you travel further and further until such time that you can't get care any more.

The other thing [the government] did in the Health and Social Care Act, [is] it made commercial contracting virtually compulsory. So these commissioners you've been hearing about are now out to tender. That means involving teams of lawyers and management consultants on both sides at enormous expense. These contracts are being given to companies like Virgin who have [for example] billions of pounds of contracts for people with learning difficulties [and] people with mental health problems. [Contracts] are [also] being given to the 'Health Corporation of America' and 'United Health Care' [amongst others].

What the government - this government - is planning, is the wholesale disposal and closure of health services, to leave a rump service behind, and for those who can afford to pay [to] go privately. And now what the government has done is set up the foundation trust hospitals and 49% structurally private. ...They can generate half their income from private patients. That has never been the case before, ever. They are being incentivised to do it because the government is turning off the funding and encouraging them to enter into what are called 'Joint Ventures' with commercial companies - health care insurance companies and private property companies.

So what the government is intent upon, is turning off the funding, forcing the closure of hospitals, and using commercial contracting to bring in private companies who will decide who gets care and [who] does not. It's not [about] 'Patient Choice', for the private sector, they want the freedom to 'choose the patient' that they want to treat.

At the same time the government has just undertaken a major review called the Naylor Review, which plans the wholesale privatisation and liquidation of all the NHS buildings, the assets, the hospitals. It's the great sell-off. [The government] says it's doing it to make social housing, but instead it's going to enter into more of these PFI deals that you've seen in Hexham, in Durham and elsewhere, which are very very expensive.

The government's plan is to Americanise our health service. Now you all know that 60-million people in the U.S. have no access to health care. It's a private-voluntary insurance system. It's the most expensive system in the world - 8% of the gross-domestic-product - that is twice what we spend, yet it denies 1 in 5 people any care. Women, children, older people must make their choices as to what care they can and they can't afford.

Remember that Simon Stephens who is the Chief Executive of NHS England has spent a lot of time in America. He worked for United Health Care. He is now driving through these plans. [These plans] are being described as 'integration', they're being described as 'care closer to home', there being described in all sorts of ways. But this is about the Americanisation of the health care system, and the only way [the government] could do it was to bring in the [2012] Health and Social Care Act.

So, it's very important to understand that this is not just your battle in the local area, it's all of our battles. So you have to fight these cuts and closures, but you also have to understand why the government is doing it. It's not just doing it to close the services, it's doing it in order to enable privatisation and the entry of health care insurance companies.

Now I'm sure very few of you - none of us - can afford private health care insurance, and all the co-payments, and everything else that goes with it. But already we're seeing some of the clinical commissioning groups stopping providing IVF, stopping providing cataract and hip operations. You name it, there are lists being drawn up of what services will be in and what services will be out.

Now I know it's really complicated because the government is deliberately not telling you the whole story, and this month they brought out a new big national contract called A.C.O. How many of you have heard of the Accountable Care Organisation? Well, listen out for that. Accountable Care Organisation is an American term. It is now the mechanism for rolling up all the contacts and all the clinical services, and giving [them] to one big private provider like Virgin or BUPA. So listen out for these Accountable Care Organisations. If you have not been consulted or don't know about them, come and see me afterword because I think we need to challenge the government in the courts about this.

So there are lots of things that you can do:

1. Carry on campaigning at a local level.
2. Understand the national picture and join forces right across the country as your doing.
3. You must get behind the bill that reinstates the NHS. The NHS Reinstatement Bill. Many of the Labour MPs have signed up to it, but we want them all to sign up to it because it's our only hope. We can't put back the NHS without an act of parliament. An act of parliament brought in our NHS in 1948, when half the country had nowt. An act of parliament has now taken it away in 2012. That's why your facing what your facing - the absolute dismantling and destruction of our health service. And it will only take an act of parliament to put it back in place. We have a bill, we need the labour party to get behind that bill - and all the parties - if were going to get our NHS back.

I feel absolute despair at what is happening. I have never seen anything like the ruin and the catastrophe that is about to take place.

...The hospital is [undergoing] a massive change. We are now in a situation where we have [transferred] our payroll staff to Sunderland, so we are not even paid by our own organisation. We are in the process of [transferring] a whole load of staff into a private arms-length company within Sunderland. That is the first set of staff to leave our organisation and go into a private company.

...It's the thin end of the wedge. ...That's the future of the hospital at the moment. Anybody who has been in the hospital over the last few weeks will have seen a massive change. It feels empty, and as I said at the last meeting, we feel as though the life blood is being drained towards Sunderland from South Tyneside.

...We made a commitment at the last meeting that we would meet with Sunderland [Unison] branches and make sure that we did a joint meeting. ...We met on the 9th of August ...[for] our first joint branch meeting. ...I met with my counterpart in Sunderland and we [agreed] to meet on a regular basis to make sure we update everyone on the process.

We made a commitment to make sure that the staff were involved. [I've met with] staff who have been very committed to this campaign, in all of [the effected] services. ...I've met with a number of staff who have their own proposals, which are an alternative to what [the Trust] is putting forward.

Some of the information that has been passed by our 'senior teams' [management] to ...the Joint Health Scrutiny Committee (JHSC) ...we don't believe is correct. That was challenged outside of the JHSC. ...We feel our staff are being told one thing, and the reality is something totally different.

...Unison has given a commitment to make sure that ...staff come forward with their clear proposals and their alternatives. ...The staff want action. They want to be involved, they want to make sure their voices are heard. I don't want to see our members - our staff - going down the road of this [service] reorganisation and then [becoming] the scapegoat to the members of the public who knock on the door and say 'can I come in because my child is not breathing', and the door is shut. Can you just imagine the mental health of our staff when those sort of issues come about.

...[The staff] want to make sure that members of the public are well aware of what is going on. It's worrying to them that they have had numerous conversations with members of the public ...who are not aware of the changes. There is something wrong when we are looking at a consultation where nobody (on one particular day) comes through the door and knows what's going on.

The public need to be ...more aware of the severity of what is about to happen. These changes do mean that there could be tragedy at the door of South Tyneside. ...We have been [informed] by our own clinicians and our own nursing teams [(who have been keeping their own records of the numbers of admissions to the children's A&E after 8pm - the time of day from which the service might be unavailable following the proposed changes)] of the risks.

If a child is taken to A&E [at South Tyneside] and they need to be transferred to Sunderland, there is not [automatically] an ambulance sitting at the door waiting. ...[Additionally] if you have that child sitting ...[in hospital], and you need an ambulance [to get the child to Sunderland], did you know that the ambulance will not come quickly because the child is classed as being in a place of care, in a place of safety. ...These are things that the public need to be very aware of.

...[South Tyneside Hospital] does give the best service with the provision that we've got. What we don't want to see is the end of that service, a second rate service, because we haven't got the door open. What we don't want is the maternity staff being farmed over to Sunderland.

[Management] keep telling us that it's not [about] money. I'm not sure that I can believe that. On numerous occasions we have heard ...councillors and politicians tell us that there is a money issue. ...When you look at the service provision for maternity, and the massive reduction in finance, it can only be done by reducing the staffing. That worries us. It worries the people of South Tyneside because the maternity service is something that has been held up in South Tyneside and in the region as a 'service of excellence'.

With regards to other services, such as paediatrics, I'm really confused as to why in 2012 it was held up as a 'service of excellence', but then [we were] told just before the announcement of this consultation that it was [in-fact] never sustainable. In 2012 there was [apparently] a financial report to say that it was not sustainable. Why did they wait from 2012 until 2017 to try and find staff and to make sure that the service was sustainable?

One of the other issues is the transport. ...We know the bus services in South Tyneside are appalling. To get to Sunderland [requires] 3-buses. ...Not everybody has a car in South Tyneside. ...What do you do in the middle of the night?

Every person in this room has family. Please tell everybody. The plea from the staff at South Tyneside is to let everyone know what is happening.

...Alongside the government's mantra of improving health and social care, [Jeremy Hunt has said that all of these areas must make £21-billion worth of cuts across England, with £5-billion falling in this area]. I have remained firm in my view form day one, despite many people denouncing me and other campaigners as scaremongering, that from the day the management teams merged, the plan was to downgrade South Tyneside Hospital and ship-off as many of our services as possible to Sunderland. And guess what, in the consultation plans now before us, South Tyneside looses out drastically to Sunderland. Not only did we loose our stroke unit some time back without any consultation whatsoever, our gynaecology, maternity and urgent children's emergency services are now all at risk.

It's worth remembering as Roger and Marion have said, this is only phase-one of a long consultation. There should be another two consultations on what is left of our hospital. The final one is to include accident and emergency.

I simply refuse to accept that any consultation that is predicated upon massive cuts, against a backdrop of massive cuts to social care and other services, will do anything at all to improve the health and social care that people in South Tyneside receive. In-fact I think we are all clever enough to realise that it is going to do exactly the opposite.

I am not alone in this view. The [Hospital] Trust and the CCG are stating that the proposals before us have been formulated with full cooperation of the clinicians in South Tyneside Hospital. But these clinicians and staff have come to me repeatedly and provided me extensive evidence (and given that evidence to the council) to say that:

• ...[Staff] have been actively blocked from formulating these proposals.
• ...The [overall] consultation outcome will be a loss of services.
• ...[The consultation outcomes] are pre-determined, and have been from the outset.

I don't see how on earth they can expect members of the public in South Tyneside to trust a consultation that raises such serious questions about transparency and due course.

I want to make it clear, the only way that this consultation can be halted, and these allegations properly investigated and addressed, is by the councillors on the Joint [Health] Scrutiny Committee (JHSC) of South Tyneside and Sunderland council referring matters to the Secretary of State for Health. I have asked now for this to be done four times. I have provided the legislative framework which makes the request totally viable, yet I am being continually refused. I made the request again recently when I was invited to come and speak to the JHSC. The South Tyneside chair tried to silence me, and refused to answer mine and my constituents' questions. In the meeting I asked a mixture of questions to the JHSC, the CCG and the Trust.

• I asked what scrutiny actually took place on the draft consultation proposals before they were ever published.
• I asked what there views were on each of the proposals, and options before them.
• I asked if they agreed or disagreed with the travel time in the proposals.
• I asked the Trust what lessons they had learned from the shambles of the Jarrow Walk-in Centre consultation.
• I asked them how many jobs would be at risk across the proposals.
• I also asked the JHSC to carry out one of the key functions of scrutiny, to scrutinise our executive. They have made no comment at all that the leader of South Tyneside Council is a paid director of the hospital, and chairs the 'Health and Well-Being Board' (that holds the CCG to account who are driving this entire process). This is a conflict of interest and it is raised with myself and others time and time again. We need this point addressing.