Counting the cost of health
IT SEEMS HSSD is heading for an overspend somewhere north of £2.5m.
IT SEEMS HSSD is heading for an overspend somewhere north of £2.5m.
Even that may be optimistic because they admit some of the savings they're proposing could prove 'politically unacceptable'.
This from a board which came to office just six months ago following a stinging vote of no confidence sparked by the old HSSD's failure to balance the books and by their drastic cost-saving measures.
Add to that the fact that HSSD has failed to re-open the wards which the new members had roundly slammed the old board for closing. Then throw into the mix the news that their chief officer, hailed by some (rather naively) as a sort of messiah, is on his way out. Taken altogether, I think it is fair to say that the political board of HSSD is in a bit of a pickle.
Should we be surprised?
I don't think so. While I usually try to minimise my comments on HSSD issues, for fear of acting like a retired general offering an armchair critique of his successors' tactics, sometimes it can't be avoided, so let's go through the issues one at a time.
Firstly, the overspend.
I have huge sympathy for the department in its efforts to cut spending. Even in my time on the board, staying within budget was incredibly difficult. There are just too many legitimate demands on a limited budget and the choices that have to be made go way beyond 'hard'. While my board managed - with difficulty - to come in under budget for seven years out of eight, I suspect these days it is even harder.
The FTP is almost unique as an austerity programme in seeking roughly proportionate spending cuts across all areas of political activity. Even the latest round of public spending cuts, just announced in the UK, single out health as an exception because of the unique pressures on its budget. Isn't there also a case for special pleading in relation to the HSSD's budget? By that I'm not suggesting the department shouldn't have to make efficiency savings like everybody else. Rather that all of that cash needs to be reinvested in their services simply to cope with medical inflation, new treatments and an ageing demographic.
How many sets of politicians must fail to achieve the near impossible before the States realise that it is just that?
Then we have the ongoing ward closures. In the case of Divette Ward I think there is a strong case for saying the closure was justified on efficiency grounds. It was set up when the long-term psychiatric wards were at Castel Hospital. Now they are on the PEH campus in modern facilities the whole picture is very different and I imagine the rationalisation will have saved a lot of agency costs.
The loss of a surgical ward is very different. It delays operations which, while they may not be clinically urgent, are still a huge issue for those on the waiting list. The wards issue was also emblematic of the pledge by the three new board members - Dorey, Storey and James - to create a new regime. They were appalled at the ward closures and vowed to reverse them. Six months on there is no sign of any real change and the predicted budget overspend makes it impossible for the HSSD to 'buy' a solution. It comes perilously close to broken election promises.
It all gives former board members a reason to be more than a little sore, but it doesn't end there. They were hoofed out because the ward closures were deemed politically unacceptable. Now we know that the new board is proposing further savings they believe come into the same category. Isn't that double standards? And what will those controversial measures be?
As for Mark Cooke's departure it would be interesting to know who came to the conclusion that he should go. Was it him, the political board of HSSD, the political centre or some combination of the three? Is there a pay-off involved and, if so, how much and from what budget?
How will HSSD tackle the huge issues it faces without an experienced CEO?
For what it's worth, I think that while the initial hype about him was hugely overdone, the top man at HSSD has done pretty well. If it's his choice to move on from what amounts to mission impossible, I don't blame him.
