Newham Save Our NHS again challenged Barts Trust Board at its bi-monthly meeting on 1stMay over migrant charging. Despite calls for the suspension of overseas visitor charges by the Royal College of Paediatrics and Child Health, The Royal College of Obstetricians and Gynaecologists and the Faculty of Health , Barts continues its hostile environment policy by investigating suspected migrants and passing information to the Home Office with regard to charging and migrant status. This despite the declaration by the House of Commons Committee of Public accounts on Windrush and recommendations following its own investigations that the Home Office is making decisions on people’s rights based on “ incorrect data from systems that are not fit for purpose”. This is not unconnected to many instances of ridiculously high charges being levied on vulnerable and often destitute people based on their assumed status as not being ‘ordinarily resident’ in the UK. The response to our questions on this from the Trust was to reiterate that they had met with us privately and would continue to consult with commissioners and others about the effects of the charges but that it was not in their remit to challenge the Government on its statutory policies. This is a bureaucratic response which does not fit well with its duty of care to all its patients, irrespective of their status or nationality. It does, however, fit the pattern of their past refusal to take responsibility for this ‘hostile environment’ policy and its effect on people’s lives. The response of the DHSC dated 2ndMay to Hackney Councillor Hayhurst’s complaints about this policy was to simply repeat the Government’s determination to continue with its discriminatory revenue collection exercise and experiment with charging for services in the NHS.
Conflict with NHSE over funding strings attached
We then asked if the Trust was unable to invest adequately in medical equipment, as indicated in their minutes of the last meeting which stated that due to “capital funding constraints” they were unable to provide such equipment “to support safe, effective and timely care”. They have admitted that it was lack of Government funding which is preventing adequate investment in IT, buildings and medical equipment. Waltham Forest Save Our NHS had also asked why they had not been awarded sustainability funds and why they had not agreed a control total. Such control totals are a way of restricting the expenditure of a Trust by agreeing to spend in different areas according to limits set out by NHSE budget constraints. It transpires that they had been offered £54.9m from the sustainability fund but had refused to accept it because the control total they had to agree would have put patients care at risk. So this is the scenario. Basically you are awarded funds if you agree to make cuts. Catch 22. Take the money and lose or leave the money and struggle with your existing budget. Currently the Trust is £84.2m in deficit and much of this is due to PFI. It puts all of the Trusts long term plans in jeopardy, as they themselves declared.
Staffing Crisis continues
Pressures on staff have continued unabated as conditions of work deteriorate and as the effects of austerity and accommodation pressures in London affect nursing and ancillary staff. The Trust says that it is dealing with 450 more patients per day than it did after its inception. Further, 500 000 patients were treated in A and E over the past year. Some staff have complained that they are being asked to do work which those on higher bands in other hospitals would not ordinarily be asked to do. Management have set a 4% target for incorrect medication and agree that initiatives introduced in the US where incorrect medication is the 3rdhighest killer, should be introduced here. This means primarily that nurses on their rounds should be allowed to proceed with their routine administration of medicine unmolested and undistracted. It doesn’t help that levels of bullying, violence, harassment , health and wellbeing , remain areas of concern. With 1 in 5 staff, mainly female, needing to provide care at home , this has affected absentee rates. Inflexible rosters, lack of onsite creche facilities and rising costs of providing supervision or care for elderly relatives or children all contribute to staff having to take time off after working extensive shifts. Most shocking of all is that in a recent survey 30% of staff interviewed said they are thinking of leaving and 22% are leaving as soon as they can get a job. There are no recent figures on the effects of Brexit on applications in recent months.