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Why This Proposed NHS Merger Matters To Bristol People

22/08/2017 15:59
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Did sparks fly in households across south Bristol when it emerged that three NHS Clinical Commissioning Groups (CCGs) - NHS Bristol, South Gloucestershire and North Somerset - are to be merged?

No. But scratch the surface of what this proposed merger means, and it becomes clear why people I represent who care about their NHS might want to sit up and take notice.

Deflecting attention from improving services to an organisational re-structure is the last thing our city needs. Take a moment to consider this: if it goes ahead, a merger of these three CCGs will be the fifth NHS reorganisation Bristol residents have experienced in the last 15 years.

After the disastrous top down reorganisation caused by the Health and Social Care Act and the evidence that mergers within the NHS usually fail, we now head into yet another local reorganisation with all the uncertainty this causes, an expensive consultation, and then rebranding.

Alarmingly this means more precious time and money will be spent on attention to structural issues, not developing and improving services and making the changes that are needed to ensure our NHS better meets patient need.

Then there's the lack of transparency and democracy. I understand staff, GPs and Scrutiny Leads in local councils have been informed of the proposal, which suggest NHS England have given a green light to a merger. But nobody has asked Bristol taxpayers what they think.

So the people most affected by the decision have been left out so far. There is a formal legal process - including a duty to consult members of the public - for this type of change. Best practice guidance is for patients to be consulted as early as possible. Only right given the potential impact. So it would be good to see the local CCGs not only use best practice guidance, but first and foremost to abide by their legal duties. Undertaking a genuine consultation is going to be difficult as all the signs are the decision has been taken.

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If the leaders of the three unitary authorities in these areas decided to amalgamate their budgets without first asking council taxpayers, there would be an outcry. Rightly so. Somehow the NHS thinks it's acceptable to do the same thing, with barely an eyelid being bat.

This merger affects people living in three areas. But as a Bristol MP my focus is most fiercely fixed on patients living in the city. And it's clear that this proposed merger will see Bristol residents losing out.

The long standing financial problems of this cluster of CCGs are in North Somerset and South Gloucestershire - not in Bristol. There are particular issues facing the Trusts overseeing Weston-super-mare and North Bristol. What they need is support and crucially more funding, not tinkering.

Yet Bristol has maintained a financial balance while the others have not. Should that really mean Bristol taxpayers have to cover the tab?

A merger will formally amalgamate budgets, meaning no way for Bristol residents to know what's happening to our funding; to track how money previously allocated for Bristol patients is spent, since that funding will go into one pot to cover deficits that have been accrued elsewhere.

These are all good reasons to care. But if you're still sceptical, let's bring it back to on-the-ground reality.

South Bristol finally got the hospital that local people had spent over 50 years campaigning for, when it opened in 2012 with money allocated by the last Labour government. I've been working with constituents and healthcare managers to ensure the services that it provides more closely match local need. We have made some progress, but more needs to be done. Worryingly this merger threatens the funding needed to bring about those changes.

Organisations in our NHS could and should work together and cooperate but that does not require a merger. This is a bad idea, threatening funding and taking NHS professionals' eyes off the ball. It's likely to result in a bad deal for the people I am elected to represent.

If they are intent on pursuing this merger, NHS managers need to prove what benefits it will bring for people I represent, including for South Bristol Community Hospital, and tell them loud and clear.

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