Protest March and Follow Up

Index:

08 Feb 2007: A Healthy Future for Cornwall and the Isles of Scilly

07 Nov 2006:  Press release from RCHT on "Service changes to improve and modernise patient care"

11 Oct 2006:  Documents received from the RCHT under the FOI Act

RCHT's own Patient and Public Involvement Forum serves it a notice under Section 11 of the Public Health Act.

PriceWaterhouseCoopers report on RCHT management

Replies to my letters

Letters

Pictures

Why are we marching?

A Healthy Future for Cornwall and the Isles of Scilly

Who would have thought, as we marched in August, that almost everything we hoped for would come to fruition?  It hasn't all happened yet, but it sounds possible.

Read the Primary Care Trust's report here - and let's hope they deliver as promised.

Press release from RCHT on "Service changes to improve and modernise patient care"

This is a three-page document.  Use the scroll bars on the right to read all of the document.

Download in pdf format.

11 Oct 2006:  Documents received from the RCHT under the FOI Act

What I asked for:

1. Pro-forma balance sheets for each of the last 12 months
2. Cash flow statements and cash flow predictions
3. Your financial risk analysis and plans for dealing with the identified risks
4. Detailed cost centre analysis for each hospital identifying how you have allocated overhead costs among the cost centres
5. Internal communications clarifying when you knew there were cost overruns and identifying the mechanisms you put in place to manage them.
6. Your quality manual: presumably ISO9001:2000 or equivalent.
7. Details of your inventory control system
8. It would also be helpful to know the computer software you use to manage the Trust’s affairs and how real-time it is.

The response:

Dear Mr Bennett,  

Many thanks for your letter (dated 29th August 2006) addressed to Professor Colin Roberts, the Chairman of the Royal Cornwall Hospitals NHS Trust.  

In response to your request for a number of documents and information, please find attached the following (in relation to your numbered requests in your letter):-  

1. Current year attached - Month 4 report with appendices.
2. Current year attached - Month 4 report with appendices.
3. Income & Expenditure Plan attached with appendices.
4. No information available in detail.
5. PriceWaterhouseCoopers Report & Public Interest Report attached.
6. We have no such system in place and use external audit standards.
7. There are many various systems in place.
8. The computer software used is called AGGRESSO and it is a monthly accounting system.    

I hope this is helpful.  Please do not hesitate to contact me should you need further information or have any questions on the information I have attached to this response.  

Best wishes.    

Ethna McCarthy Director of Finance & Information

Royal Cornwall Hospitals NHS Trust 01872 252705

My comments:

I am still reviewing the documents but note that there is no response to item 4.  This is an important issue because, by varying the way overhead costs are allocated, you can use it to 'prove' that a hospital is uneconomic.

There is no quality system in place (item 6.) and while this is no surprise quality systems are vital for complex businesses, in part because it requires processes to be properly thought through and then documented. The associated audit process also catches a lot of waste and inefficiency.

Item 7 is worrying mostly because of the implied fragmentary approach to inventory and the absence of any detail.

Finally, monthly accounting systems tell you at the end of the month (or later) that you are in trouble.  More timely information is necessary for proper management response.

Other Files:

Report by the Audit Commission dated September 2006.

The introduction includes:

"I have been prompted to report publicly because of the recent dramatic deterioration in the Trust's financial position, as a result of a failure to deliver its 2005/06 budget. The purpose of this report is to state publicly my views on:

• the seriousness of the Trust's financial position and the risk that it will breach its statutory financial responsibilities;
• the reasons for the deterioration in the Trust's financial position;
• the adequacy of the Trust’s action taken to date and the further action planned to improve the Trust’s financial position; and
• the action that the Trust now needs to take to meet its statutory financial duties and to improve its financial position on a sustainable basis."

Patient and Public Involvement Forum serves RCHT a notice under Section 11 of the Public Health Act

The RCHT's own Patient and Public Involvement Forum has expressed its lack of confidence in the the Turnaround 2 plan and is seeking the Overview and Scrutiny Committee's ratification of their call for proper consultation on the wide-ranging actions of the Trust.

PriceWaterhouseCoopers report on RCHT management

Replies to my letters

Received from Professor Roberts, 2 September, 2006:

Letters

To Rt. Hon. Patricia Hewitt, MP, Secretary of State for Health:

To the Chairman of the Royal Cornwall Hospitals Trust:

(What I wanted to say)

What I actually sent!

To the Acting Chief Executive of the Royal Cornwall Hospitals Trust:

Why are we Marching?

The Health Services March being planned for Hayle on Sunday, 27 August, is evolving into a county-wide protest. Major organisations that have lobbied long and hard to improve health services throughout Cornwall are joining together to protest under-funding and poor management of health services. Specific demands include an independent review of health services in Cornwall and, until that has been completed, an end to the cuts in services at the West Cornwall Hospital plus removal of the threat of cuts at, or even complete closure of, St. Michael’s Hospital.

In calling for the march, Hayle Town Councillor Brian Capper produced some facts and figures on St. Michael’s Hospital:

• It has been providing health care on that site since 1914;
• It has four modern, well-equipped operating theatres;
• It has 70 beds in high-quality wards with seven patient toilets per ward;
• Patient satisfaction is an astonishing 99 percent;
• St Michael’s has never had a case of MRSA;
• Cancellation of admissions is extremely rare and is less than 1 per year on average.

Hayle Town Council, in voting unanimously to support the march, stated that it was “appalled that RCHT should even consider the closure of a hospital that is very well run, provides the highest standard of treatment and care and is clearly an important element in the strategic provision of health services in Cornwall.”  The Council was also keen to express its strongest possible support for the independent review and for maintaining and enhancing the services at West Cornwall Hospital.

Hayle mayor Paul Birch said: “It is rare to find a topic on which all councillors agree and which is supported by virtually everyone in the community. I will be at the front of this march and, as a member of the Mayors Parlour Campaign, fight to ensure its objectives are realised.”

According to Hayle Town and District Councillor John Bennett, who has been appointed as march coordinator: “We are expecting thousands of marchers and are planning accordingly. Please come to ensure we get a fair allocation of medical resources to Cornwall – ‘or 20,000 Cornish folks will know the reason why!’  Stand up and be counted and make Trelawny proud.”

The march will take place in good weather or in ‘Cornish sunshine.’ Protesters will be accompanied by bands from throughout Cornwall and led by those who have been fighting this fight for many years.