NHS 'sustainability and transformation' plans for London

MQT on 2016-12-14
Session date: 
December 14, 2016
Question By: 
Andrew Dismore
Labour Group
Asked Of: 
The Mayor


The NHS has been secretive about its 'sustainability and transformation' plans for London's health services. Will you demand that all the plans affecting London are published and subjected to full public consultation, and also ensure they are subjected to rigorous scrutiny before any implementation?


Answer for NHS 'sustainability and transformation' plans for London

Answer for NHS 'sustainability and transformation' plans for London

Answered By: 
The Mayor

Sadiq Khan (Mayor of London):  Thank you for your question, Assembly Member Dismore.  I am aware that the NHS and local government partners across London have been working to develop sustainability and transformation plans (STPs).  I want to make it clear that the success of these STPs will depend on having them open, engaging an iterative process that harnesses the energies of clinicians, patients, carers, residents, local community partners, local government and the wider community.


The plans have now been published, five across London, although service change proposals have not yet been fully developed.  I said in my manifesto that I would campaign against NHS service closures or reconfigurations without proper consultation.  The duties of the NHS with regards to public consultation on significant service changes are clear; namely, that users of a particular NHS service must be involved either directly or through the representatives in the planning and provision of those services and any decisions made affecting the operation of the those services, too.


Furthermore, local authority health review and scrutiny committees must be consulted on any substantial development of the health service in their areas.  It is through this lens that my health team will consider the STPs.  Where significant service changes are recommended, we will challenge the NHS to ensure those affected are properly consulted and there is clear clinical leadership for the changes.  As you know, I regularly meet NHS leaders where we discuss the NHS plans for London.  I will continue to challenge NHS leaders in this forum.


Andrew Dismore AM:  Thank you for that and I am pleased that you have looked at these sustainability and transformation plans which show that the NHS funding gap for London is £4.3 billion by 2020.  North Central London, which includes Barnet and Camden, my constituency, alone faces a shortfall of £900 million.  In addition, the local authority funding gap for social care is a further £300 million.  Perhaps it is not surprising that NHS was keeping the scale of the problem to itself with likely cuts and downgrading hospital services that would inevitably follow. 


I am pleased that Camden Council blew the whistle on this and published the one for our area early.  Once Londoners get to see the details of these horrific figures, what do you think their reaction is going to be?


Sadiq Khan (Mayor of London):  It does not take a rocket scientist or a crystal-ball reader to work out what it is going to be.  This is why it is really important that we hold our feet to the fire to consult with users and residents.  In fact, all roads lead back to the funding crisis in NHS.  I am not criticising NHS staff and it is really important though that users are consulted.


Andrew Dismore AM:  Given the pitch by your predecessor, Boris Johnson [MP, former Mayor of London], in the referendum campaign that the NHS can have an extra £350 million a week if we came out of the EU, is it not about time you persuaded his Cabinet colleagues to honour this promise rather than the £400 million they are going to spend on extra civil servants to staff the Government’s Brexit department or do you think this was just another cruel lie from his forked tongue, as before?


Sadiq Khan (Mayor of London):  What is noteworthy is that some Members spend their time misleading people about what may have been on my website months ago, yet a clear promise with big posters about what would happen if the country left Brexit is forgotten about by this lot over here.  What did he promise?  He promised £350 million a week in the NHS, whereas I can say often, promise made, promise delivered is a promise made, promise broken.


Andrew Dismore AM:  Thank you for that and that is self-evident that it was a clear lie by those promoting the Brexit campaign, including your predecessor.  One way of easing pressure to time of the growing crisis in winter and when it takes longer than ever to get a GP appointment, as referred to earlier, it is when people are encouraged to go to their local chemist shop.  However, the Conservative Government is cutting funding from this month to March 2017 by an average of 12% compared to current levels and from April 2017, further cuts of around 7.5%.  It is inevitable that pharmacy owners will have to reduce their costs, for example, by reducing opening hours and their staff, perhaps stopping some services altogether.  Do you not think this is a rather stupid false economy by the Government to cut local pharmacies in this way?


Sadiq Khan (Mayor of London):  It does not make sense.  On the one hand, there are very sensible campaigns to divert us away from GP practices to chemists.  I had my flu jab this year from a chemist here in City Hall, a Tooting chemist; a first-time chemist, I hasten to add, to Assembly Member Cooper, who happened to be here.  Yes; chemists across London, pharmacies across London are struggling as a consequence of government policies.  You know, it is a false economy.  The impression that is given is that those in charge of the NHS in the Government are clueless.


Dr Onkar Sahota AM:  Mr Mayor, thank you for the answers to my colleague.  Of course, these STPs are secret players which were hatched up by the Government.  The ones which came to the surface were the ones which the local authorities published.  In a recent survey by the British Medical Association (BMA), 53% of GPs felt that they had not heard about the STPs and 87% felt they had not even been consulted about this.  There were two boroughs in Northwest London, the borough of Ealing and the borough of Hammersmith and Fulham, were given an ultimatum to sign this document 72 hours before it was meant to be published and they refused to sign.  Indeed, the councils of Ealing and Hammersmith and Fulham are standing up for the residents.  For secret players, which are really nothing more than cut-throat, and what we are seeing in Northwest London is just a rehashing of the Shaping  the Future which came out four years ago, which is about bringing cuts to the NHS.


Allowing for this, Mr Mayor, inequality is quite rife in London and I would be very grateful if you would kindly intervene and make sure there is proper consultation, as you say, and that health equalities are maintained right across London.


Sadiq Khan (Mayor of London):  The points you make are well made.  There is a combination of decisions made which should be clinically driven with public consultation.  Lack of transparency gives the impression that these decisions are being taken for political expedience or because of the financial pressures that Assembly Member Dismore referred to.  That is why it is really important that the STPs take note of what is being said today at the Assembly.  There are five across London.  It cannot be beyond the wit of the STPs to ensure they involve clinicians, users and local stakeholders when it comes to their plans and definitely, when it comes to any services being changed, a proper consultation, and I will champion their cause.


Dr Onkar Sahota AM:  Thank you, Mr Mayor.