All of us would hope that the NHS delivers effective, high-quality and efficient care to all. But sadly, there are hospitals in the NHS which do not. Even some that are delivering good care run up debts year-on-year – which then have to be financed by taking money from other parts of the NHS. Whether hospitals have good care and bad finances, bad care and good finances, or bad care and bad finances, patients suffer.
This week, the papers have covered my decision to consult with South London Healthcare NHS Trust on the proposal that they may be put into special measures, or 'trust special administration' in the jargon.
Although the action is specific to a particular hospital trust, the reason for it is part of a comprehensive, national programme of action to tackle the pockets of poor performance that still exist in our NHS.
Rather than continue to sweep problems under the carpet, or hide the deficits with bungs and bailouts as Labour did, I have taken action. In 2010, I launched a programme of work to root out and tackle poor performance in the NHS, wherever it exists. I published information about hospitals on the things which really matter to patients – like mixed-sex accommodation, hospital infections, and the quality of care. I did this not only because it would help patients choose where to be treated but also to hold up a mirror to those hospitals giving poor care.
I also asked the hospitals what problems they themselves faced. They told me some have too much capacity, and some have too little. They told me about poor leadership which has – for years – not been good enough. They told me that some hospitals have simply never sought to do the things any well-run business has done for decades – understand where they spend their money. They told me of debts of hundreds of millions of pounds which have to be paid back.
Labour could have sorted this out when times were good, but they never did.
Worst of all, Labour themselves contributed to the mess through badly-planned, badly negotiated PFI deals. Shamelessly, they now shrug and admit that the PFIs are not defensible. While they claim credit for building hospitals, what they don’t say is that they left us with a £73 billion bill to pay for them.
This Government isn’t opposed to private finance, but when we sign contracts with the private sector we make sure they are value for money. And unlike Labour, we will not wash our hands of those hospitals struggling with PFI deals even though it was Labour which put them in that position. That is why I have already announced a £1.5 billion fund to help the seven NHS trusts whose PFI repayments are so large it puts their finances at risk, provided they prove that they have turned their other problems around – including Peterborough Hospital, whose fate was sealed when Labour’s Andy Burnham put pen to paper on a deal he knew was unaffordable.
South London Healthcare NHS Trust is another one of the trusts we are helping with their PFI – a hospital which pays £60 million every year for the privilege.
But the problem is more widespread than South London and Peterborough. Across the country, 21 NHS Trusts have told us that their clinical and financial sustainability is at risk. And we are helping all of them – with support for their PFIs, training for their boards, or by partnering them with their more successful neighbours – in an open and transparent way. Our help has been praised by the National Audit Office, which has noted that many of the problems we are now tackling were left unresolved for years under Labour.
However, for South London Healthcare NHS Trust, even all this support may not be enough. Patients treated there have faced some of the longest waits in the country, although this has recently improved. But the organisation is still forecasting deficits of up to £50 million a year for the next five years, even after our support – on top of deficits it has run up over the last three years of £150 million. This shortfall cannot be made up by money conjured out of the air – we owe it to the rest of the NHS who would otherwise be paying for it to tackle the problems faced in South London head-on. That is why, with some reluctance, I am considering putting the Trust into special measures (using powers, incidentally, which were passed into law – but unused – by Labour).
Labour brought many parts of the NHS to the brink of bankruptcy with unsustainable PFI deals. They turned a blind eye to the problems in quality of care that many parts of the NHS face, and they ducked difficult decisions even when they had the power to take them. And once again, it falls to us to clear up the mess they left us with.
We have made clear that we will help the NHS overcome the problems they face, but we are also resolute in our determination to ensure that the parts of the NHS which are sustainable do not have to pay for the problems in the parts which face challenges. And that is why, when it is absolutely necessary, I will take the firm and decisive action to safeguard the interest of patients throughout the whole country, however hard that may be. We will not let the sick pay for Labour’s debt crisis.