Why The Lincolnshire STP Is Dangerous

March 8th 2017

The NHS in Lincolnshire have come up with a sustainability and transformation plan that will radically alter the way our local NHS is run. I wanted to outline a few of the things that are wrong with this plan and why I believe it is dangerous for people in Louth and the surrounding area. This is by no means an exhaustive list, but it does include some of the key objections to what is planned.

Privatisation

Privatisation can still mean the NHS is free at the point of use. But its disadvantages include loss of economies of scale which mean the NHS can pay less for expensive drugs due to its bargaining power.

The NHS can engage in data sharing on new drugs on a scale that doesn't happen in countries where private healthcare dominates. This means that when you take a medicine and it interacts with another one, or with another condition that you have, this can be recorded in a massive database. Because of the vast number of drugs on the market and also of lesser-known conditions, this information is impossible to gather before a new drug is launched, even with years of careful testing. The information can save lives. With privatisation, there is always the incentive for private profit to come before patient safety.

The Lincolnshire STP is a blueprint privatisation because it consolidates services in fewer hospitals, concentrating excellence geographically. This makes it easier to sell off old hospital land for development, and to offer a smaller number of shiny new hospitals for privatisation.

At the town council on Tuesday, 21st February, health bosses actually referred to the land value of the site of Louth Hospital.

Although the STP isn't fixed, it does suggest merging unspecified "community services" from Louth and Skegness hospitals at a single site.

Structure

The idea presented in the STP is to move away from hospital care except for the most severely ill, towards care in the community. This smacks of a downgrade, with outcomes such as waiting times harder to measure.

In Lincolnshire, distance to the hospital is already a barrier to accessing services, and people's lives have already been saved as a result of being being able to get to Louth Hospital. Distance is very important in this rural area. But Louth hospital has already lost is A&E (downgraded to Urgent Care), and its Lindsey suite for coronary care.

Ambulances in Lincolnshire can be slow, and I have heard reports of people sometimes waiting an hour or more for one. If people have to travel further it won't be safe. Long waiting times can kill, whether that means waiting for an ambulance or havng to drive to Scunthorpe for stroke care or to Lincoln or Boston for other services.

Louth may grow as much as a quarter in population over the next 15 years according to the local plan set out by the district council. Plans for developments of hundreds of houses are already proposed or approved for Grimsby Road, Chestnut Drive, Kenwick Road, and Park Avenue, with a further 500 homes proposed for the area near Brackenborough Road and Keddington Road. We're going to need a bigger hospital.

Cuts

The NHS locally is facing a deficit. One reason for this is because it isn't being funded at the same percentage of GDP as some other European countries' health services. So our local trust is £73 million in deficit, and is looking to make £130 million of savings over the next five years.

The NHS isn't a drain on our economy. Healthy people are more likely to be able to work, and less likely to need to apply for disability benefits, so it's a net benefit. Lincolnshire is looking at cutting bed stock and cutting the equivalent of 750 full-time staff by 2021. It a vast under investment.

The NHS budget for Lincolnshire is around £1.2 billion a year.

Locally we lack GPs, and people are finding it harder to get an appointment with a doctor. Recruitment of doctors to this area is already difficult. The uncertainty brought about by the STP will only make this more difficult.

Will the consultation be meaningful?

The main STP document runs to 121 pages, which seems like a very long and detailed piece of work for something that has yet to go out to consultation. It is written as though the direction of travel has already been decided. At least 250,000 people attended a march in Tavistock Square on March 4th to demonstrate against cuts to the NHS and against the STPs, including buses from Lincolnshire, and there have already been two demonstrations in Louth in 2017. The government should listen to the opposition to these plans and fund the NHS properly.