Concerns over Health and Welfare Bill

Sir--I have been following the machinations of the Coalition Government over the Health and Welfare bill with the twists and turns by a government determined to have its own way over policies that have no mandate and are generally disliked by a large propo

I accepted at first that, in general, all healthcare organisation would be against the bill from the start. Belatedly, however, it was not this week that I found that one of the most powerful supporters of the bill were that foundation trusts and, by default, their councils of governors.

By law Foundation Trusts are required to keep the Council of Governors up to date about their intentions, this is so when the Trust intends to go beyond the 5% barrier on private care.

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But I do wonder how many governors are properly informed are over this important issue or, more importantly, that one of the major options in the Health & Welfare bill is giving the foundation trusts the ability to pass the 5% barrier on private care without informing their governors.

Putting the phrase "private patient income cap" into the search facility on the RDASH website reveals that there is has been no information passed on to governors, the members of the Foundation Trust or the public since the bill began its passage through Parliament.

I think it is reasonable to say that this lack of public information is not related to the amount of time the Board will have spent on this issue. Rotherham, Doncaster & South Humber NHS Foundation Trust was one of the first healthcare organisations to apply for trust status.

In order to achieve this status the the mental health had to collect a membership. This was done by 'selling' the benefits of becoming a foundation to the general public. I was one of the very first members but I cannot recall any of those benefits the Trust promoted being the ability to cater for private patients.

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If that option had been promoted I would not have become a member and I believe it is reasonable to argue that many others would not have done so. What evidence is there that the Foundation Trust intends to cater for a number of private patients over and above the 5% they are already allowed to cater for.

There is no hard factual evidence as has already been noted but the Foundation would argue that such information would have commercial interest and thereby escape the scrutiny of governors, members and the public.

There is circumstantial evidence: 1 The Foundation Trust has already shown an eagerness and willingness to extend its management of services over and above those in its local area. A move quite soon after becoming a Foundation Trust was to tender to manage an Early Intervention Service in another trust. This happened despite the disruption in management caused to to the local service.

2 The Foundation Trust has also recently accumulated a number of other services that were not initially within its remit as a mental health trust.

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3 More significantly the Foundation Trust has removed the term 'mental health' from its title. The reason the Trust gave for this change was that it was no longer just a mental health trust – the stated reason foundation status was sought in the first place. The Foundation Trust also stated that there was no discrimination towards people with a mental illness. I would argue that it was an act of gross discrimination against the very people without whom the Trust would not have existed. (I have searched for evidence on the RDASH website that governors and members were consulted about this significant change of status – I found none, nor did I receive information as a member.)

A question that does concern me is, when, and not if, the Foundation Trust extends beyond the 5% of private patients it is already allowed – and I do have to say that I know of no such patients being cared for by the Trust – is where those patients will be located.

The Trust opened excellent new accommodation for mental health patients in Doncaster several years ago and had done so in Rotherham quite recently. Despite the old accommodation in Rotherham being classed as unsuitable from the moment it was put into use it took a number of years before that happened.

However, not all patients were moved into more comfortable and up-to-date accommodation. To enable this move to happen older people's services were moved into old accommodation less suitable and less attractive than the wards.

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Considering these latter statements, and in the believe that this Trust will move to provide services for private patients, where will those services be located and how much disruption will there be to the services for mental health patients who do not have the ability to pay. 

Alan Pearman, Marlowe Road, Herringthorpe.

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