Adjectival Single Issue Independents

At some point someone will make the above comment. People ain't keen on single issues, or what they perceive as single issues. But PFI isn't a single issue. It affects all major government and local authority briefs as I will demonstrate below. (For your information, there is a claim that you can get from one person or subject to another in six links, no matter what they are.)

PFI Six Links

Health

For good health, you need hospitals. Hospitals are built using PFI. 2 links

Education

New schools are being built to replace old stock. The funding method? PFI. 2 links

Law and Order
New prisons are being built using PFI. 1 link

Foreign Policy
Multinational health companies are moving in to take over GP practices, day hospitals, specialist clinics and ACADs (ambulatory care and diagnostics centre, a kind of minor injuries and operations unit). This has been made much easier for them to do, because the health centres and hospitals they move into are leased, not owned by the NHS. This situation exists because of PFI. 3 links



Housing

Local authorities are providing housing for people in currently in continuing care, those with learning difficulties and elderly. They are having to shoulder this burden because the day hospitals that used to look after them are shutting. The day hospitals are shutting because health authorities are in debt. The health authorities are in debt because of PFI. 4 links.

Rent, rates etc

Local authorities will have to raise their rates and rent because they will be paying off debt. (Either that or cut services.)The debt that they will be paying off, is for new schools. The new schools have been built using PFI. 3 links

Transport

Most people are going to have to use their cars in future to travel to hospital. Their local hospitals are shutting because their health board cannot afford to run them. They cannot afford to run them, because they are in debt. They are in debt because of PFI. 4 links

Environment

More and more people will have to resort to cars to travel to schools or hospitals, which damages the environment. They have to do this because their local schools and hospitals have shut. They have shut, because they need replaced and the Treasury will not give them public funding. Therefore they have to resort to PFI, which is far more expensive and means they can't build as many schools and hospitals. 4 links

National debt

A new national debt through PFI is being created, although at the moment it only exists on local authority and health board accounting sheets. It is running at £4 billion per year and that will continue for the next generation at least, because many of these contracts last for 20-30 years. At the end of that, we will not own the buildings we paid for; under PFI, ownership of the building usually remains with the creditors. So we'll have spent all that money for nothing. 1 link

Still think PFI is a single issue?

Allyson Pollock Lectures

Now I'm sure quite a few of you political types are looking at my blog, so I thought I would put this here for your benefit. Allyson Pollock is holding a series of lectures at Edinburgh University;

PFI and Value for Money in Scotland Mon 5th March 10-12 noon
The Future of Scotland's Health Services Mon 12th March 10- 12noon
Not For Profit Providers Mon 19th March 10-12noon.

There may be a possibility that some of you out there have not heard of Allyson Pollock. If you haven't and you have an interest in the NHS's future, you should be ashamed of yourself. Professor Allyson Pollock is the sharp shootin' tabacca chewin' champion of anti PFI. She has more degrees than a thermometer and worked in London until recently, when she came up to Scotland (hurray!) to head the Centre for International Health Policy at Edinburgh University.She wrote the classic NHS Plc which is a searing account of what has happened to the NHS, and more recently The NHS- a Guide. Read them.
More to the point she has answers on how we can get ourselves out the PFI mess. So if you're a politico and you're writing your manifesto, get your bahookie down to one (preferably all) of these lectures. If you're a medic, go along. If you have any interest in saving the NHS go along.And before you ask, I'm not being paid a fee to say this..

(Edit: The person to contact for tickets is Suzy Currie; either phone 0131 651 3957 or email Suzy.Currie@ed.ac.uk)

How to Run a Conference on Hospital Closures

Your cordial editor came across a document left on the podium at an NHS conference and thought she would print it here for your instruction;

How to Run a Conference on Hospital Closures

1. Call the participants 'stakeholders'. Do not, however, provide them with stakes; this could lead to misunderstandings.
   
   
   
2. Provide plenty of 'fiddling' material. Folders are good, post it notes are better and pens are mandatory. Even better if you provide a pen with a 'clicky' end; this provides endless entertainment and takes the minds of the participants off the subject of closures.
   
   
   
3. Turn up the heating; this makes the audience lethargic.
   
   
   
4. Put on a power point presentation. Take ages to change the slides. Mix up the x and y axes so that the information doesn't make any sense.
   
   
   
5. Present everyone with an eighty page document; good 'fiddling material' and make sure it has a clear page on the back free for doodling.
   
   
   
6. At lunchtime, load on the carbs and fat. Chicken Supreme is good; so is steak pie. Vegetarians are problematic, but the addition of a pudding esp Black Forest Gateau can provide the 2 o clock 'slump ' you are looking for.
   
   
   
7. Spilt everyone into discussion groups, but don't mix them; trade unionists in one group, doctors in another and the public in yet another. Otherwise they might share information and work out what's going on.
   
   
   
8. At 2 o'clock,when everyone is recovering from lunch, announce that you are 'modernising' the hospital, fit for the 21st century, with the very best in equipment and specialisms. NEVER use the word 'closure'.
   
   
   
9. Have your car , with its engine running, ready to leave at 2.03pm.
   
   
   
10. Destroy this document once you have read it, in case it falls into the wrong hands.

PFI for Dummies

Over the past few months, much has been said about PFI, and its influence on the Monklands closure. It has been said that the reason that Monklands has been picked for a downgrade, is because it is state run, whereas Hairmyres and Wishaw are PFI hospitals. But what is PFI and why might it lead to the closure of hospitals?

PFI – Private Finance Initiative

PFI stands for ‘Private Finance Initiative’. It is money borrowed from the private sector for capital builds and refurbishments in the public sector, usually for hospitals and schools. It is a fixed loan, paid back over a period of 20-30 years.

Why was PFI used?

It was seen as a way of controlling expenditure on public projects.
Central government was concerned that when building companies were doing public projects, they tended to be careless about running over budget and over the deadline for the project, because it was getting paid from the public purse. PFI meant that the building company had to be more careful, because the money was coming from banks and business men who would object more, if they were not getting value for money.

It was a way of removing large scale spends from the public balance sheet.
Because this money was being borrowed from the private sector, and being paid from local authority budgets, it meant that these costs did not appear as expenditure on central government accounts. This enabled whatever government was in, to look as though they were keeping a strict control on public spending.

Is PFI value for money? - Absolutely not!

It is far more expensive to borrow money from the private sector. These loans have to be paid back over 20-30 years at a prohibitive rate of interest. Hairmyres and Wishaw were built for £200million; we are having to pay back £1 billion over the next 25 years. That’s five times the original amount. If NHS Lanarkshire had been allowed to borrow public money and pay it back at the rate it is doing for the private loan (£40million per year), the debt would have been paid off by now.

The money has to be found from existing local budgets.
These loans are being paid from the existing budgets of local authorities and health boards. Because they are not being given extra money from central government to cope with these loans, they are having to find money either from cutting services or selling assets such as land. Recently, NHS Lanarkshire managed to reduce its £20 million deficit by selling the land that Law hospital used to stand on. And although NHS Lanarkshire deny it, the closure of Monklands A&E will mean that the board is paying for two A&Es, instead of three.

PFI is inflexible – you have to pay whether you are using a building or not.
Sometimes in a hospital, operating theatres or certain wards might not be in use. In a state run hospital that is not a problem; it just means the facilities are mothballed and they cost less money while they are idle. That is not the case with a PFI hospital. The hospital has to pay for the building and the facilities, whether they are being used to full capacity or not. Even if the building is knocked down, the loan still has to be paid to the end of its fixed period. That means that if a health board has to make savings, the only way it can do this, is by cutting back services in state owned hospitals; it is virtually impossible to do this in a PFI hospital.

PFI will eventually have to be paid for by central government, and it will cost far more than if they had used public money to begin with.
It is estimated by some sources that Britain as a country is paying out £4billion a year on PFI projects. Bearing in mind that the loans are for 20-30 years, we will end up paying £100 billion by the time the present loans are up. There is no way that local authorities can sustain this through their budgets; sooner or later this will have to be paid for by central government.

What can be done?

Several things could be done about this.

1. Don’t enter into any more PFI contracts. Use public money and cut out the middle man. Spending on hospitals and schools is not cheap, but it never has been. Sometimes you have to accept that to provide a good service, you have to spend money.
2. Re-negotiate the present contracts. Many local authorities ended up with prohibitive loans because they were not experienced in dealing with complex areas of contract law. The government has the power to re-negotiate, because the financing companies know that the local authorities will run out of money and the only chance of getting the loan redeemed will be if central government steps in. That means central government can negotiate on its terms.
3. Do it now. To service these debts, day hospitals, nursing homes and a whole host of services are being cut to make savings. We must pressure the government to act now, not after these services are closed.

A&E Closures

Since the announcement of the closure of Monklands A&E, many people have given up hope.They feel that it was a ‘done deal’; that the decision was taken long before the public consultation started. ‘Why should we bother campaigning; it’ll turn out the same anyway,’
some say. But it needn’t be like that.

The A&E decision can be reversed by central government

Forget about the health board; the people with the money and power to reverse this decision are the politicians at Holyrood. As long as Monklands is still operating as a full A&E general hospital,(which it will until 2009) the closure can be reversed. But we must make sure that we the voters, pressure our politicians until they do this.

The battle for Monklands is a battle for all hospitals in Scotland.

We are not the only area suffering from hospital closures. Across Scotland, centralisation of services is leading to the closure of many A&Es. Ayr, Livingston and Dunfermline are having their A&Es shut; in Glasgow, the Victoria, the Western and Stobhill A&Es are being removed. Yorkhill Hospital and the Queen Mother’s hospital are to be shut, and the facilities built beside the Southern General. The lucrative west end sites that they stood on are being sold off to private developers.

The reason that there has not been more reporting on this is because the process of consultation on the closures has been staggered. Ayrshire and Arran Health Board went through the consultation process last year; Lanarkshire Health Board went through it this year and the process is just starting in Glasgow. The hospitals are being picked off health board by health board to minimise public protest and we cannot sit back and allow it to happen or we will be left without a health service.

The NHS is part of our ethos as a civilised country

In every generation, there are moments of conflict, where people of a nation have to ask themselves what they stand for and what they believe in. The generation that gave us the NHS were the war generation, who endured hardship and horrors that we can only imagine now. They decided for us, that they did not want a future where only the fittest survived and the rest were discarded. They did not want people dying of preventable diseases, because they were too poor to afford a doctor. They wanted a future where everyone would have access to education and health, regardless of status and that health would be a public service, not a private business.

We are at such a moment now and we have to ask ourselves the same question; do we want a country where the poor, the sick and the old are ignored? Do we want a country where only the rich have access to good health care, or do we want a universal health service, the NHS which was so hard won and handed on to us by the last generation? If we believe in free access to health care, then we must act NOW. The NHS is being quietly dismembered and sold off to the private sector, piece by piece; if we do not protest now, there will be nothing left for our children.

Caption Competition

'...and we will strive to produce a modern ambulance service, fit for the 21st century to work in synergy with the NHS, and the environment...'

Is this the future of the ambulance service? You can comment with an alternative caption. Best ones get printed here..

Btw, with a total lack of irony, the management at the Victora infirmary came up with the bright idea of providing loans for the staff to buy bicycles for the staff to ride into work. This would then free up the parking spaces in the car park. (Yes loans, they wouldn't even buy them the bike.)
Could this picture be the first example? Might we have bike sharing on tandems? Will you have to BYOS (bring your own stretcher?) Let us know.

Update: For sheer bad poetry, (and bringing back memories of a happy childhood watching Camberwick Green) Deacon Barry is ahead for his 'Riding Along on an Ambulance Bike'. McGonagall ,look to your laurels..

Welcome to my blog

Hi there and welcome to my blog. I'm one of many people fighting the A&E closures that are happening across Scotland just now, and I'm standing as an independent health candidate in Coatbridge, where our erstwhile government is trying to convince us that it's good for our health to shut Monklands Hospital in the area that has the highest rate of heart disease in Europe. (Doh, wake up and smell the coffee, dude!)

So how did I get here? Well, one day my mum started to show signs of Alzheimers. I became her carer and came in direct contact with the care system. What an eye opener that was.

About four years ago our council started shutting nursing homes in our area. I went along to a carers conference organised by a local carers group and asked, 'Why are you shutting nursing homes when we have a growing elderly population, and where are all those people going to go?' I got no answer. The closures continued and I waited for the local politicians to protest. It didn't happen. I joined a carers lobbying group, (North Lanarkshire Carers Together) to try and do something about this.

In October 2005 our group was invited as 'stakeholders' to one of the consultations regarding Monklands hospital. I became suspicious when I spotted Black Forest Gateau on the menu. (For those of you who haven't attended conferences before, this is what they give you before they announce cuts and closures; it produces a soporific effect on the eater, and reduces resistance to unpopular decisions). Sure enough, after the Black Forest Gateau we were invited to play a game of 'Which Hospital Shall We Downgrade?' or as they called it, preference scoring. I went home in a daze and after the gateau had worn off, I was raging. When the announcement came in February, that they were going to downgrade Monklands, I joined the campaign to save Monklands and the other hospitals in our area as well.

At this point I came into contact with the Scottish Health Campaign Network, whose members opposed the closure of Stobhill. Dr Jean Turner is on the group(she's a health independent and defeated Labour at the last elections in Strathkelvin and Bearsden and she is standing again. Vote for Jean, because she's lovely). I worked with them for the next few months and was involved in discussions regarding the future of Monklands and the other hospitals facing closure. It very quickly became obvious that there was no future for Monklands; not unless something drastic was done. So I declared as an independent candidate in September. From mild mannered carer to fully fledged rebel. Warning; it could happen to you.

To those of you who have not rebelled yet, two words ; why not? This is the health service for pete's sake. It is being taken over by American health companies and PFI. If you don't stand up and be counted now, it will be too late later. We have got to kick this into touch now. (Duh, what's PFI). It's not a rude word, but it should be, and it usually has several expletives attached to it by those who know what it is. It stands for Private Finance Initiative and is basically bankrupting the NHS who are using it to build hospitals, and is going to bankrupt our local authorities, because they're using it to borrow money to build schools. Read all about it in my guide PFI for Dummies.