- A WORLD-RENOWNED scientist who discovered the link between smoking and
cancer has officially opened a new flagship building at the site of Walsgrave
Hospital. Professor Sir Richard Doll opened the Clinical Sciences Centre on
Friday, which is part of the new £400 million super hospital currently being
developed.
Rugby Advertiser 18 March 2004. [See Freedom to Care
Commercial influence
on academic research for information that came to light later about
Professor Sir Richard Doll.]
- This great free-market experiment is more like a corporate welfare
scheme. A hospital in
Coventry lays bare the deceit of neoliberal logic: staff cuts, ward
closures and millions to the financiers. After
my
column last week, several people wrote to point out that the neoliberal
project - which demands a minimal state and maximum corporate freedom -
actually relies on constant government support. They are, of course, quite
right. The current financial crisis, caused by a failure to regulate financial
services properly, is being postponed by government bail-outs. .... But over
the past week an even starker example has emerged. In Britain the split
loyalties of the major political parties have created a hybrid system of
public provision. If it left public services intact, the party in power would
be roasted by the corporate media, but if it attempted full-scale
privatisation, it would be booted out of office. So the last Conservative
government devised a plan that would keep both sides if not exactly happy,
then at least totally bewildered. They called it the private finance
initiative, or PFI. Corporations would build and run our schools, hospitals,
roads and prisons, and rent them to the state. This, the Tories maintained,
would enable costs to be cut, while ensuring that public services remained
free of charge. At first Labour opposed this scheme. Alistair Darling warned
in opposition that "apparent savings now could be countered by the formidable
commitment on revenue expenditure in years to come". But as the 1997 election
approached, Labour sought to prove that it was more sympathetic to business
than the Tories were. Two months after the party took office, the health
secretary, Alan Milburn, announced that "when there is a limited amount of
public-sector capital available, as there is, it's PFI or bust". From then on,
the only money the NHS could rely on for capital projects belonged to the
private sector. The problem was that much of what the NHS wanted to do was not
attractive to private financiers. In Coventry, for example, it had been
planning to refurbish its two hospitals at a cost of £30m. But its analysts
realised that business would not be interested. The scheme was too small, and
there was no scope for the financial innovation that could produce serious
profits. As a confidential report by the local health authority showed in
1998, the health service redesigned its scheme to make it more attractive to
private capital. Instead of refurbishing the two existing hospitals, it would
ask private business to knock them down and build a new one - the University
hospital. This would cost not £30m but £174m. The health experts who wrote the
confidential report predicted that in order to find this money, the hospital
trust would have to cut both beds and services. They have just been proved
right. Did I say £174m? I beg your pardon. By January 2002 the price had risen
to £290m. A month later it reached £311m. By the end of that year it had grown
to £330m. In 2003 it was estimated at £370m. In March 2007, the Birmingham
Post reported that the final cost was £410m. This year the hospital trust must
find £56m, covering repayments and service fees, to hand to the private
consortium. The annual cost will rise in line with the retail price index for
30 years. It is now pretty obvious that this fee is unpayable, if the hospital
is to maintain a proper standard of care. Over the past few days the hospital
trust has announced a £30m hole in its budget. Around £10m of the necessary
cuts could be found by making staff redundant: it will lose perhaps 200
people, possibly 375. It will also rely on "revenue generating activities".
These include charging people £3 for dropping their sick relatives outside the
hospital, and £10 for parking there, while cancelling the free parking scheme
for disabled people. As the new hospital is on the edge of the city (against
the wishes of 160,000 people who signed the Socialist party's petition to have
it built in the centre), which means that it is hard to reach without a car,
this is an effective way of raising money. But it casts doubt on the
government's claim that the NHS remains free at the point of use. The hospital
trust's press officer told me that this cost-cutting is a unique event: "We
have always balanced our books up to this year." But in 2005 - the year in
which the PFI payments began - a leaked memo revealed that the trust was
anticipating a deficit of £13m by the end of the financial year, and "drastic
measures" were required to plug the gap. These included the closure of one
ward, the removal of eight beds from another, limiting the opening hours of
the surgical assessment unit and the "rationalisation of certain posts": which
meant, eventually, cutting 116 jobs. In 2006 the local newspaper reported a
shortfall of £29m. This was met partly by freezing the recruitment of district
nurses. In January this year, the hospital announced that it was closing
another ward.... Yet another ward - where people with acute conditions such as
pneumonia and strokes were treated - was closed in June. The impact of these
cuts is already being felt: three months ago the new hospital found itself in
the bottom 10 in the national league table for waiting times. Where will the
money come from over the rest of the 30-year PFI contract? There is one set of
costs the hospital cannot cut: the money it must pay every year to the private
financiers. In September 1997 the government declared that these payments
would be legally guaranteed: beds, doctors, nurses and managers could be
sacrificed, but not the annual donation to the Fat Cats Protection League. The
great free market experiment looks more like a corporate welfare scheme. The
government justifies all this by claiming that privately financed schemes are
cheaper than comparable public schemes.
Allyson Pollock showed on these pages in April that the data required to
support this claim does not exist, or if it does the government refuses to
release it. But as the Coventry scheme shows, there's an even bigger deception
at work. The government compares the cost of building the hospital under PFI
with the imagined cost of building it with public money. But it would not have
been built with public money. If public funds had been available, the two
existing hospitals would have been refurbished, at around one 13th of the
cost. George Monbiot
Tuesday September 4, 2007 The Guardian
[The hospital is not only on the edge of the city. It also is a centre
of excellence serving patients from the whole of Warwickshire and beyond, many
of whom have no direct public transport even to Coventry city centre, so that
a car is the only practicable means of transport and the parking charges are
virtually unavoidable.
We can confirm that the public financial reports to the hospital trust can be
unintelligible. My husband, who is a retired local authority
finance director, attended a board meeting for the Patient & Public
Involvement Forum in 2006 and saw a report with an apparent excess of
income of more than £20m described as "Balances and other", which
did not demonstrate the financial problem of which the board members were
clearly aware.]
- Superhospital:
£40million cash crisis. Coventry University Hospital is facing a
staggering £40m cut in 2008. Built under PFI, the hospital is already trying
to shed 200 posts and has resorted to asking all staff if they will volunteer
for redundancy, early retirement, a cut in hours or two weeks unpaid holiday a
year. They have also massively increased parking charges. Trust finance
director Andy Hardy admitted yesterday: "We can't rule anything in or out at
the moment." But he said that the trust had already identified most of the
savings required and added that such an advanced hospital "comes at a price". Summary by
Keep our NHS Public of Coventry
Evening Telegraph 15 October 2007
-
Unions fear
hospital job cuts. Unions representing University Hospital staff fear
scores of compulsory redundancies are to come as too few have signed up for
voluntary redundancy as part of the crisis-hit hospital's struggle to save an
additional £10m on top of £20m in savings already identified. Unison says 284
staff have signed up to go voluntarily, half of which are frontline staff who
will not be allowed to do so. The hospital disputed the figure saying that 400
staff had expressed an interest in voluntary redundancy, half of whom were in
managerial and administrative posts. But a hospital spokeswoman said: "At this
stage it is only an expression of interest. We need to go through them and
look at what impact leaving their posts would have on delivering a clinical
service." But Charlie Sarell, regional officer for Unison, who is in on-going
discussions with hospital bosses, said: "There is a shortfall in applications
for voluntary redundancy among administration and managerial staff. Unison
doesn't believe that in any way these areas are overstaffed at present.
Therefore, losing administration support for nurses, doctors and other
healthcare professionals could have a direct impact on performance and health
care." He added that other measures to reduce staff costs, such as unpaid
holidays and reductions in hours, would not be enough. It was recently
revealed that the hospital will be required to find and additional £10m in
savings next year. The hospital trust has also borrowed £76m from the NHS
which will have to be paid back. In addition, the trust owes £54m-a-year in
payments to the private consortium which built and owns the hospital under the
Private Finance Initiative. Summary by
Keep our NHS Public of Coventry
Times 19 October 2007
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