While Theresa May toured the TV studios during the General Election campaigning promising to deliver a fairer society, her Health Ministers were hard at work drawing up a new hit list of fourteen areas across the country which will face a fresh round of NHS cuts.
You may not have heard of the Capped Expenditure Process (CEP), because Jeremy Hunt doesn't think that you need to know. But if you live in one of the fourteen areas that are being targeted, you could soon notice devastating impacts on local health services.
The CEP aims to cap spending in particular areas of the country that NHS England claim have been overspending their 'fair share' of funding; a statement which assumes that current financial allocations are fair and achievable, something which hospital leaders, clinicians and patients across the country would dispute. Against a backdrop of seven years of underfunding of the NHS it is well known all sections of the Health service face huge cost pressures with many Trusts reporting deficits each year. However, there has so far been a complete lack of transparency about how significant the 'unfairness' has to be for an area to be selected and the Kings Fund has questioned whether one-off actions such as property sales or large charitable donations, which had an impact on the historical financial position of NHS Providers had been considered.
The secrecy does not just extend to patients. Even as the Shadow Health Minister, I have not been provided with any information about the process by the Government. An example of this is that just before Parliament broke up for the summer recess, the Health Minister, Philip Dunne MP refused to provide me with a list of areas affected, despite this information being in the public domain following leaks to the media by NHS whistle-blowers several weeks ago.
We now know that the areas to be impacted are: Bristol; South Gloucestershire and North Somerset; Cambridgeshire and Peterborough; Cheshire (Eastern, Vale Royal and South); Cornwall; Devon; Morecambe Bay; Northumberland; North Central London; North Lincolnshire; North West London; South East London; Staffordshire; Surrey and Sussex; Vale of York and Scarborough and Ryedale.
From CEP's to STP's to ACS's, the number of acronyms proliferating in the NHS seems to grow. The common denominator amongst them though is a lack of accountability; we are all familiar with STP's now and the huge cuts they are meant to be delivering. But where is the meaningful engagement with the public, staff and patients about these proposals? The CEP process has the same agenda in terms of cutting services but also has a complete lack of transparency. For information on changes to to what services are delivered in the NHS to only reach the public through whistle-blowers is a damning indictment of the culture of secrecy currently prevailing.
Analysis by the British Medical Association paints a worrying picture of what could be in store if you are unfortunate enough to live in one of these areas. Potential implications include the closure or downgrading of hospitals, wards and services - including maternity and emergency departments. Patients with heart problems could be denied angiograms, knee operations could be rationed, access to hearing aids and IVF treatment could be restricted as could diagnostic procedures such as endoscopies which may affect patients who are suspected of having cancer.
Whether the supposed financial disparities that these areas have apparently benefited from are recent or historic; one thing is certain, they are not the fault of local people. But it is local people who will pay the price, with changes to their health services which could leave them inconvenienced at best and unsafe at worst. These proposals represent an existential threat to one of the founding principles of the NHS, that of care being freely available at the point of need. Yet again the Government are hiding these radical changes from public view.