Oh what a circus, what a show…

Legal Eagle

Image © Alastair Rose

The Administrators (TSAs) carrying out the consultation process into Mid Staffordshire NHS Foundation Trust, held a meeting last night before a massive audience. The traffic congested near the County Showground, an apt venue for this consultation circus, which has apparently; thus far cost many millions of pounds. It would be interesting to get a break down of the figures, easy enough to organise an audit, after all bean counters are dominating this process. No doubt some of the money went into producing the slick twenty-minute video, which the audience was subjected to and the administrators hid behind (a shield as well as a sword). The video a weak attempt to pacify the multitude, it only increased the anger; it simply highlighted what everybody already knew, provision reduced, or abolished. Maternity gone and Stafford will no longer have an Accident and Emergency department after 10pm.

You don’t need to be a brain surgeon or indeed a Doctor of any kind, to work out that if you are suffering from a potentially life threatening condition after 10pm in Stafford, a long journey into night, is not going to increase your chances of survival. It could well be a case of `Good Night Vienna` or more appropriately, `Good Night Stafford`. Some think this process is a prelude, one pessimist in the audience convincingly suggesting provision will mostly be abolished in three years.

There were many excellent contributions made from the floor, one man suggesting that the sick might avoid calling the emergency services at night, preferring to wait until the department is open in the morning. This could have devastating consequences, the same individual described the years of mismanagement at Stafford, for which the community suffered. They now it seems are to be punished again, this time with the removal of essential services, a total breach of natural justice, making a victim out of the victim. The administrators appear to be working from the premise that the best way to save the hospital is by destroying it. One of the excellent contributors speaking from the floor, a Consultant nurse informed the panel that they no longer had any “clinical credibility”. His devastating verbal critique led to several standing ovations and some crestfallen looks on the podium.

There were other excellent contributions made from the floor, especially from various managers and clinical specialists from areas at risk under these proposals. These people highlighting the significant role their respective departments have played (providing budgetary and a clinical overviews). More remarkable, was the claim made, that at no point during the consultation process have their views been sought. Indeed, they have been totally ignored.

This process looks likely to go before the High Court, the campaign to save Stafford hospital might well be forced to seek a Judicial Review.. They were enthusiastically collecting for a legal fighting fund last night. One does not wish to prejudge the situation but we could be looking at a successful JR here. After all, the very least one expects of a consultation process of this type, is evidence of consultation with specialists working in the field. The scope of a JR is narrow but the High Court can determine that a case before it was decided beyond the power of the statutory body i.e. ultra vires. Or that the decision breaches the rules of natural justice, including contravention of the HRA 1998, the court can also determine that the decision falls into the category of what is known as Wednesbury unreasonableness. The legal campaign could be critical; justice in Britain is accessible, like the doors of the Ritz. You can enter as long as you have the money, hence the drive to collect funds. Although, the Conservative led Coalition have mused recently about their concerns linked to ongoing campaigns seeking redress in the High Court, so the rule of law looks as fragile as the Welfare State.

The final decision in this process rests with the Secretary of State for Health. A representative of a government backing the Health Act 2012 which means he is very likely to endorse the findings of the consultation process. If he does, the Health Secretary will make the decision against the wishes of the people of Stafford (including it appears, its medical opinion).

Despite all of the outstanding contributions made last night no one mentioned the real problem, which harks back to decisions made in the 1980s by the Thatcher administration. Mrs Thatcher transformed a NATIONAL service into a local one through the setting up of regional Trusts, while at the same time developing a new strata of managerial bureaucracy at a massive financial cost, which also helped us move away from clinical excellence.  The movement away from a National service allows for the potential piece by piece dismantling of the NHS because it’s no longer national the response to defend it becomes regional.

Yes, Stafford can get rid of the Tory MP and the comments from the hall last night strongly suggest people will be looking for a political scalp. Also the campaign can go to law but it seems unlikely that one town can stop this process. The left in the guise of the Socialist Party are calling for the town of Stafford to be closed down for the day. They leafleted the meeting last night proposing a one day campaign calling for “every business to close, every worker stop work for a half a day to build a giant week day rally that can make crystal clear we will not accept the loss of our services”. But it is very debatable how effective such a proposal could be and even if it could be organised. Also it yet again regionalises an issue that has much wider national implications.

The Coalition are not about to fall into the same trap that Mrs Thatcher`s administration fell into. The start of her political demise was the Poll Tax, this policy hurt her government because it was a national policy (Scotland first, of course) which required a collective response nationwide. What looks likely is the demise of the NHS bit by bit, until eventually it`s privatised. So, remember the NHS trust administers circus may not be in your town or city yet but they might well be on their way.

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