Wycombe Labour's response to Steve Baker's report on Wycombe hospital. Open letter from David Williams,QC, Wycombe Labour's Parliamentary candidate.
Dear Mr Baker,
I am writing to you about the report you commissioned from Durrow Consulting on the future of Wycombe Hospital and which you published on 2nd October 2014. We have previously expressed concerns about the background of the directors of Durrow and the circumstances of the commissioning of the report.
I and my colleagues in the Wycombe Labour Party will be carefully considering the proposals in that report with doctors, nurses and other experts in order to consider whether, as you told the BFP, only Durrow have a serious proposal for how local acute hospital services can be provided in the future. The idea of integrating services to provide a one-stop service is not new – it was the original concept of the NHS and is central to Labour’s plan for a National Health and care service.
In the meantime, and in order to help us consider the proposal we would welcome some clarification on particular issues.
The report envisages that all the services at the hospital would be provided and managed by a single organisation, encompassing GP services, emergency medicine, maternity, elective surgery and care of the elderly. As a result of reforms to the organisation of the NHS, in particular the recent reforms under the Conservative government (implemented contrary to the 2010 Coalition Agreement and at a cost of £3billion) we are unsure how this could operate in practice.
The local ‘NHS’ providers such as Bucks Healthcare Trust (which is currently ‘broke’ showing a £5m loss in the year to August) are probably not in a position either administratively or financially to undertake that sort of unification of services. It is notable that Durrow have not made a suggestion as to who might be best placed to operate this unified service. One answer is of course a private provider such as Care UK, which part owns BUC which currently operates the MIIU and GP out –of hours service from Wycombe hospital. With the £13 billion backing of their owners Bridgepoint Capital, Care UK could well take over the operation of all services at Wycombe Hospital – and be paid to do so by the NHS. The funds paid by the taxpayers of Wycombe would then find their way into the coffers of a private equity firm. Bridgepoint and Care UK’s financial arrangements - whilst perfectly legal and similar to the Glaser brothers in respect of their purchase of Manchester United FC- are designed to maximise returns and minimise tax liability through the use of complex financial tools such as Jersey loan notes and preference shares. We note that Bridgepoint Capital say further investments in the healthcare sector are likely,
‘We believe that there will be excellent growth prospects and consolidation opportunities for those private sector players that can offer flexible, efficient and innovative business models in this evolving environment.’
I wonder whether this Durrow proposal is just what Bridgepoint Capital and Care UK have in mind? On their website Durrow said in relation to a similar report,
In this example the entire project is managed and funded from private capital but the NHS has occupancy and buy-out rights. We see it as a successor to PFI/LIFT and similar public/private finance mechanisms.
Having regard to all of this could you answer the following questions
- You said in May 2014 that you had discussed the study carried out by Durrow with Jeremy Hunt, the Secretary of State for Health, and had clearance from the Independent Parliamentary Standards Authority (IPSA) to use your parliamentary allowance to pay for the report. IPSA have said that they do not provide advance clearance and the Department of Health have also said they do not hold information about the meeting you say you had with Jeremy Hunt. Can you provide an explanation for these anomalies?
- Were you aware of Ruth Harrison’s background and the criticism made of her in relation to her management of Stoke Mandeville Hospital during the outbreak of c.difficile which killed 33 patients there? Equally were you aware that Derek Smith had charged the NHS £3,000 per day for his services? If you were, can you explain why you thought Durrow were an appropriate organisation to carry out the study?
- Can you tell us how much the report cost? And who has paid for it, both directly in who paid the invoice and indirectly if the money is then claimed from elsewhere?
- You received a draft report from Durrow in early September. The report was eventually published on 2nd October 2014 and is identified as ‘Wycombe_11thSep-cropped-FINAL.pdf’. Can you place in the public domain all copies of the draft report please?
- What is your understanding of who would manage and operate the combined services at Wycombe Hospital? Would it be Bucks Healthcare Trust or a private entity? Have you had discussions with Durrow on this issue and if so please can you put them in the public domain?
- Are you in favour of all NHS services at Wycombe being run by NHS providers on a not for profit basis or are you prepared to see the Hospital and all its services being operated by a private company?
- What role do you envisage the CCGs will play in your plans as they are the commissioners for the local health economy? How do you envisage managing any conflict of interest between the CCG/Commissioners and any bidders given that CCG Commissioners are permitted to (and do) have a financial interest in companies which provide the services their CCG commissions?
I look forward to receiving your replies.
David Williams QC
Labour Party Parliamentary Candidate for Wycombe.