Election 2015: Political spotlight to shine on special measure trusts

Recently the Conservatives have fought back against Labour’s Cassandra-like warnings of an “NHS crisis” in the summer. Health secretary Jeremy Hunt stood in the House of Commons and proudly said that five of the 16 trusts in special measures were exiting, with the rest showing strong signs of improvement.

Arguments over the management and quality of the NHS aren’t exactly new. However, with a general election only nine months away, trusts still in special measures and the extension of such a system into failing care homes, this is interesting.

‘Those trusts that were in special measures were also in constituencies that will ultimately decide the next election’

Many of the original 11 trusts that were placed in special measures were located in the most marginal Conservative constituencies. So are they truly liberated from Whitehall interference or are they actually a political plaything?

Mr Hunt’s announcement and the extensive Cabinet reshuffle around the same time obscured the fact that those trusts in special measures were also in constituencies that will ultimately decide the next election.

The Conservatives know this, which is why Number 10 policy advisers have been looking closely at the potential this may have to hurt the party’s election chances. They are investigating policy proposals around ensuring the viability of the “cottage hospital”.

Unwelcome interference

However, many of these trusts are already going ahead, or planning to make changes to the way they deliver care in the near future. This will inevitably create pressure, whether from local politicians, hospital boards or from chief executives, to suspend any changes to delivery until the election is concluded and the new government is confirmed.

What cannot be kicked into the long grass is the intractable problem plaguing those old seaside towns and former industrial heartlands where those trusts that were in special measures’ hospitals are located.

The number of people claiming benefits in such areas is, on average, five times higher than the rest of the country.

Hospitals struggling to deliver quality care, maintain finances or both are situated in areas experiencing high levels of deprivation and a history of industrial decline. This issue awaits whoever is in charge at the Department of Health in May 2015.

‘What can trust leaders do to ward off those eyeing them up for political advantage?’

The backdrop of inequality is important for all NHS leaders, because to know your future you must understand your past. It matters that someone in Blackpool South earns £10,000 less than the UK average, and it matters that Skegness is no longer the thriving seaside resort it once was.

Knowing the local issues applies to parliamentary candidates, MPs, party head offices, NHS staffers and chief executives alike.

Fight short termism

But what can trust leaders do to ward off those eyeing them up for political advantage?

Chief executives are currently battling to lift the morale of their staff, raise the standard of care for patients and heed constant overtures from the Care Quality Commission and Monitor. They are fire fighting issues with different groups of clinicians on a daily basis. They shouldn’t also need to tackle the inevitable short termism that comes with electioneering.

We conducted an analysis which shows that in the last two years factories belonging to household names such as Pilkington Glass, Warburtons, Tata and Remploy have closed – and the list goes on. At first glance, this may seem irrelevant, but the hospitals that have been placed in special measures in the past 12 months are in the same communities.

‘Jeremy Hunt was lucky to avoid the winter crisis that never was in 2013. He might not be so lucky this time around’

When factories close or when tourist destinations lose their sparkle, discussion revolves around broken promises, a loss of community identity and a lack of investment.

Community resilience and health isn’t just beds and needles, it’s a way of being. Labour has understood this, which is why they have an election strategy focused on the constituencies with trusts that were in, or are still in, special measures. The death of industry and tourism in a local area isn’t typically linked with analysis of national NHS policy but perhaps it should.

Labour’s private member’s bill “to save the NHS” is tabled for November and timed to cause a political storm in the last few months of parliamentary business as accident and emergency departments come under increasing pressure.

Mr Hunt was lucky to avoid the winter crisis that never was in 2013. He might not be so lucky this time. It could be time for him to dust off his predecessor’s tome that caused so much change and remember that the original promise was to liberate the NHS from the politicians.

Jenny Ousbey is an associate director at Lexington Health