Thursday 18th July 2019

Lobby against South Tyneside and Sunderland councils financing the “Path to Excellence” phase-2 capital programme.

We held a hastily organised lobby outside of South Shields Town Hall on the evening of Thursday 18th July 2019 in order to witness the delivery of our emergency petition against council financing for phase-2 of plans to downgrade our vital hospital services. As it was presented (on behalf of SSTHC by Councillor John McCabe), the petition contained 991 signatures on paper (most of which were gathered in one afternoon at the South Tyneside summer festival) and 1005 signatures gathered on-line. No discussion of the petition took place in this council meeting. Everything you need to know is contained in the abridged transcripts below.

Update (Tuesday 5th November 2019)

The council has responded to our emergency petition in a letter (dated 2019-10-31), which can be downloaded from the documents section at the bottom of this page. Their response to our petition is consistent with their amendments to the motion proposed by Green and Independent councillors, that was originally intended (in parallel with our petition) to oppose the council facilitating funding for phase-2 of the "Path to Excellence" programme.
Abridged transcript of speech by
Roger Nettleship
Chairperson
Save South Tyneside Hospital Campaign

T
hank you all for turning out on this Thursday evening to lobby the full council meeting. We are here today to witness the handing in of our petition to oppose South Tyneside and Sunderland councils funding in any way the "Path to Excellence". This came about because NHS England said that they would not fund phase-2 of the "Path to Excellence". Local hospital chiefs are on record as saying that if they could not get funding, the "Path to Excellence" would not go forward, meaning they would not be able to close local services.

Many of you are here because we have been fighting for the last 3 years against the threat to children's 24/7 A&E, maternity, our Special Care Baby Unit and the complete loss of stroke services in South Tyneside. That first phase was funded by the NHS, and on August 5th it will leave us with fewer essential health services in South Tyneside. When we challenged this in a judicial review, that funding enabled health chiefs to get the most expensive government lawyers to defeat our case at Leeds High Court.

They have already published their working ideas for phase-2. Those ideas include reducing South Tyneside hospital from 300 to 65 beds, and the closure of locally accessible critical care and acute services. South Tyneside may gain a shiny new Imaging Centre, but we won't have the vital services that we can currently access locally.

Health chiefs are hoping to get a cheap loan from our council, but we think that this will also force the council to 'buy into' this second phase without knowing what it really entails, and if they buy into it, then the council will be less likely to oppose the loss of services. Phase-1 was referred to the Secretary of State by the Joint South Tyneside and Sunderland Health Scrutiny Committee, but they may feel like they have less freedom to do something similar again if they are involved in funding phase-2

Abridged transcript of statement by
Emma Lewell-Buck
MP for South Shields

I
wrote to the leader of the council on the 28th of May 2019, asking specific questions about this loan being sought by the hospital Trust from the council. I received no reply to any of those questions.

In South Tyneside we have already lost our stoke, consultant-led maternity, 24/7 paediatric services and our Special Care Baby Unit. Now we are facing losing more with our A&E, emergency and planned surgery, planned care and outpatients and support services all facing changes under phase-2.

It is my opinion that this will downgrade our hospital, and the evidence is stronger than ever to demonstrate that. It concerns me greatly that the Labour Group statement mentions none of these losses. The prospect of the council giving a £35-million loan to the Trust to enable it to continue with this 'path to disaster' beggars belief! A loan of this magnitude will need sign-off from the councillors. The smoke and mirrors around this are - as always - obfuscating the reality. If the loan is granted by the council, then that becomes the responsibility of South Tyneside council-tax payers, in the same way that if you act as a guarantor, you are responsible if the loan is not repaid.

Do we actively want to facilitate the downgrading of our own hospital services? I certainly do not support it in any way and I urge councillors to do the right thing, with the interests of the people of South Tyneside at the forefront of their minds, by voting against this loan - because if the loan does not go ahead, the "Path to Excellence" is dead, the government won't pay for it.

To move our services to another local authority area, and ignore the dangers that it poses to families and individuals is not acceptable. To shift the focus to the bricks and mortar of the hospital site with no reference to the loss of services, dehumanises this critical issue, and only gives half of the true picture.

If my questions formally submitted as a member of parliament for this town are completely ignored, then in turn my constituents are being disregarded.

Wednesday 7th August 2019

Statement from South Tyneside Labour Group regarding “Path to Excellence” phase-2 funding

The Save South Tyneside Hospital Campaign has discussed the Labour Group statement (received July 18th) at its meetings, and we include here the Labour Group statement together with our questions and other responses.

The original Labour Group statement (dated 2019-07-18) and SSTHC's separate response (dated 2019-08-07) can be downloaded from the documents section at the bottom of this page.

STATEMENT from the South Tyneside Labour Group

Given interest both in the local media and on social media platforms, in relation to a potential loan from the Treasury's Public Works Loan Board to the South Tyneside and Sunderland Foundation Trust, we believe it is important to clarify the position.

Would this be as stated a loan from the Public Works Loan Board to the South Tyneside and Sunderland Foundation Trust, or would it be a loan to the council, who then loan the money (with interest) to the South Tyneside and Sunderland Foundation Trust?

1: The Council has received no request from the Foundation Trust to apply for a loan from the Public Works Loan Board although there has been an informal discussion as to whether the Council could use its borrowing powers to loan funds for visible improvements to their site at Harton Lane.

2: The Public Works Loan Board exists to facilitate investment in the public sector by providing low cost loans, at lower rates than commercial banks.

3: Any such request - if received - would not be to facilitate the closure of South Tyneside Hospital, but in fact quite the opposite. It would enable the demolition of out of date Victorian buildings and investment in new modern buildings including the provision of a new state of the art diagnostic centre and improved car parking - the loan would be used exclusively for the South Tyneside hospital site.

I don't think SSTHC, or any health body is saying the hospital will close as you state. It is misleading to suggest that this is a point that needs correction. The issue is, if you provide the finance what kind of hospital will it be? That is why people are opposing council financing of the "Path to Excellence" plans for phase-2. The pre-consultation documents on Phase-2 have stated that the capital funding is needed if they are to downgrade services currently accessible at our hospital and move them to Sunderland. To be meaningful, you should have said: “Any such request - if received - would not be to facilitate in any way, any further downgrading of services at South Tyneside Hospital.”

We don't understand the reference to "Victorian buildings". South Tyneside is one of the most modern District General Hospitals in the country, with a modern A&E, children's A&E, urgent care centre, diagnostic centre, theatres, maternity, wards, labs, etc. However, in this large estate there are Victorian buildings, some of which may have some historic significance but are either not needed (E.g. nurses homes) or are used for additional administrative services. Given that a substantial amount of the administration is being transferred to Sunderland, what will these buildings or replacements be used for if they are "modernised"?

4: The loan would be at no cost to the Council or the Council tax payers of South Tyneside, it is re-paid in full and with interest by the Foundation Trust.

5: The Borough Council, (not any individual elected member or Officer) will consider any such request received from the Foundation Trust and determine whether the specifics of the loan are in the interests of the people of the Borough and whether the loan will ultimately lead to improved health provision at the South Tyneside site.

Does "Borough Council" refer to the full council, or to the cabinet?

6: Rumours that the site has been earmarked as a large scale housing site are simply not true, misleading and without foundation. The Foundation Trust wants to invest heavily in the long term future of their site at Harton Lane.

Firstly, the Trust own substantial sites in Jarrow, Palmer Community Hospital, Primrose Hill Hospital and Clarendon Offices. Are these then not included in their plan for the long term future?

Secondly, we have noted that for several years a substantial amount of the hospital site land has been listed on the council's website as suitable for house building. Why would it be listed there if selling the land for housing is not the future plan of South Tyneside and Sunderland Foundation Trust?

The Strategic Land Review (SLR) published in 2015/2016 identifies 4 areas within the footprint of South Tyneside Hospital OSS61, OSS62, OSS63 and OSS64, which the review suggests could be classified as "suitable sites" for development.

The pressure to release land for financially driven development facilitated by the 2012 National Planning Policy Framework, coupled with the pressure on Trusts to sell land and buildings to mitigate their deficits and facilitated by long-standing government policy to dispose of NHS assets, creates substantial foundations for such concerns in general.

Thirdly, does the council have any statutory control to stop the Foundation Trust from selling its sites, and if not why would you guarantee your statements on this?

7: Clearly as the Clinical Commissioning Group (CCG) - which is a separate body to the Trust - continues its consultation on the reconfiguration of services between Sunderland and South Tyneside, it is important the Foundation Trust can demonstrate it will be able to deliver safe services from modern, state of the art buildings on South Tyneside, this loan - if applied for and if approved by South Tyneside Council - would help facilitate that.

Other points on which SSTHC is seeking clarification

  • Is phase-2 dependent on this loan to finance it? Note that Ken Bremner (CEO of South Tyneside and Sunderland Foundation Trust) has already said:

    If the NHS is unable to support this funding, then we have entered into some discussions with local authority colleagues about whether they may be in a position to locally support this investment using their own borrowing powers.

    Iain Malcolm has already stated:

    There is the potential that the council could borrow the money from the treasury...

    If you borrow the loan at a lower rate what rate will you charge the Foundation Trust?

  • Does phase-2 involve any proposed moving of services from South Shields to Sunderland?

  • What assurances are there that the trust would be able to repay a loan of this kind and are they likely to sell off public NHS assets in South Tyneside and Sunderland in order to do so? We note that in the case of the Powys health board repaying debts to county council had reached a stage in July that the council was considering legal action to recover £6 million from the health board.

  • Who would hold the liability for such a loan?

  • We have seen in the Health Service Journal (August 1st 2019) that in relation to the new Boris Johnson / Tory-led government announcement of capital loans, it has listed South Tyneside and Sunderland Foundation Trust as asking for a sum £70-million for "transforming" services. The article mentions North Durham as well as South Tyneside and states:

    The trust is in discussions with local authority leaders about securing potential loan funding, but there are doubts as to whether this would be subject to, and would obtain approval from, the Department of Health and Social Care.

    Can you comment on this?

Thursday 24th October 2019

Motion to oppose South Tyneside Council facilitating finance for “Path to Excellence” phase-2

SSTHC lobby on the steps of South Shields Town Hall before the full council meeting convened to discuss the motion

A motion intended to commit South Tyneside Council to not facilitating finance for phase-2 of the "Path to Excellence" was put forward by Green and Independent Councillors (John Robertson, Paul Milburn, Keith Roberts, Glenn Thompson, and David Francis) at a full council meeting held on Thursday 24th October 2019.

The original motion was subject to amendments proposed by Councillor Joan Atkinson. The amended motion was then put to a vote and was passed. A "named vote" in which the individual votes of our local councillors are made known to the public was not undertaken because existing rules require that a "named vote" must be requested by at least 5 councillors, and unfortunately only 4 of the 5 councillors proposing this motion were able to attend the meeting, and no other councillors attending the meeting came forward to request a "named vote".

SSTHC were told that the amendments would strengthen the original motion, however the amendments were only made available at the last minute, and it is now apparent that the amendments weaken rather than strengthen the original motion.

Most significantly, the amendment has completely replaced resolution 1, which was key to opposing the facilitation of financial support for phase-2 on the basis that facilitating phase-2 is equal to facilitating the further downgrading of our local hospital services. Therefore the primary resolution from the original motion:

The council resolves to: 1) Oppose a loan of this type if the loan would facilitate a further loss of services from the South Tyneside site...

has been replaced with a resolution that reflects the preferred emphasis of local health leaders, and ignores the inherent downgrading and closure of local acute services:

The council resolves to: 1) ...support a loan of this type ...if the loan would facilitate the development of the physical infrastructure of the site - including a new multi-storey car park...

Phase-2 of "Path to Excellence" includes plans for new infrastructure as well as plans for the downgrading and closure of local acute services at South Tyneside hospital. The amendment of resolution 1 ignores the latter, and inverts its implicit function from that of opposing phase-2, to that of supporting phase-2.

The amendments are consistent in their reticence of NHS transformation for privatisation and the role of "Path to Excellence" as the manifestation of NHS transformation plans in South Tyneside and Sunderland. Where this understanding is acknowledged in note 2 of the original motion:

The council notes that: 2) In South Tyneside and Sunderland, the Path to Excellence is our local Sustainability and Transformation Plan [STP].

The amendment unconditionally changes this to:

The council notes that: 2) That the STP is no longer a strategic plan for the NHS.

STPs are fundamentally about splitting the NHS into a number of separate regional health services. STPs themselves have evolved into Accountable/Integrated Care Systems (ICSs). ICSs are at the heart of the latest overarching plan for the NHS published in 2019 called the NHS Long Term Plan, which maintains a direction towards 44 regional health services, with health services in each area being subject to transformation in order to centralise and reduce non-profitable (predominantly acute) services. Local health system leaders are clear that their plans for "Path to Excellence" phase-2 are “fully aligned to the recently published NHS Long Term Plan”.

Councillor David Francis - who drafted the original motion - said that the amendments are disappointing because the issue at the heart of the original motion was the loss of services, but the amendments change this emphasis completely. However, Councillor John McCabe pointed out that the amended motion still retains the resolution to support our campaign.

SSTHC is grateful to those councillors who brought the original motion, but regardless of its consequences, SSTHC intends to continue to oppose any funding from NHS England or funding facilitated by South Tyneside / Sunderland Councils that will result in the downgrading of hospital services.

The amended motion (dated 2019-10-01) can be downloaded from the documents section at the bottom of this page. A video of the full council meeting (24th October 2019) is available to watch on the South Tyneside Council YouTube channel.

The following is the original motion.
The sections highlighted in black are not in the amended motion.

Motion Regarding Potential Loan to South Tyneside and Sunderland NHS Foundation Trust
The council notes that:
1) On a national level, the Labour Party say that “Labour will halt and review the NHS ‘Sustainability and Transformation Plans’, which are looking at closing health services across England, and ask local people to participate in the redrawing of plans with a focus on patient need rather than available finances.”
2) In South Tyneside and Sunderland, the Path to Excellence is our local Sustainability and Transformation Plan.
3) Phase one of the Path to Excellence has seen a number of services moved out of our borough, most recently seen in the loss of Childrens’ A&E from South Tyneside after 10pm.
4) The changes brought about by phase one of the Path to Excellence mean that it is harder for the people of South Tyneside to access some services and this issue can be worse for some of the most vulnerable groups in our community, who are often more likely to face challenges associated with increased travel time/costs.
5) The Joint Health Scrutiny Committee still have concerns over Phase One of the Path to Excellence, and members of that committee have said there are still a number of unanswered questions, along with concerns regarding travel & transport/patient’s access to services.
6) NHS England has said that it will not fund Phase Two of the Path to Excellence
7) It is reported that South Tyneside and Sunderland Foundation Trust has held exploratory talks with South Tyneside and Sunderland City councils over potentially borrowing money via the Public Works Loan Board - £35m from South Tyneside Council and £15m from Sunderland City Council
8) Similar loans have been used elsewhere, and in some cases the NHS trusts have been unable to meet the repayments on these loans.
9) There is a record of the downgrading of acute services in other areas, which has ultimately led to hospital closures and land sales.
10) Whilst an investment of £35m into services at South Tyneside Hospital seems positive on the surface, many local people are concerned that the borough could potentially be taking on additional debt that would help fund the removal of additional services from our local hospital.
This council resolves to:
1) Oppose a loan of this type, if the loan would facilitate a further loss of services from the South Tyneside site. Allowing a loan of this type, and potentially profiting from the interest on such a loan could contribute to the downgrading of South Tyneside Hospital.
2) Support the Save South Tyneside Hospital Campaign, in their work to protect our local access to NHS services in the borough.

The following is the amended motion.
The sections highlighted in red are not in the original motion.

Amendment to Motion Regarding Potential Loan to South Tyneside and Sunderland NHS Foundation Trust
The Council notes that:
1) On a national level, the Labour Party has stated that “Labour will halt and review the NHS ‘Sustainability and Transformation Plans’, which are looking at closing health services across England, and ask local people to participate in the redrawing of plans with a focus on patient need rather than available finances.”
2) That the STP is no longer a strategic plan for the NHS.
3) Phase one of the Path to Excellence has seen a number of services moved out of our borough, most recently seen in the loss of Children’s A&E from South Tyneside after 10pm.
4) The changes brought about by phase one of the Path to Excellence mean that it is harder for the people of South Tyneside to access some services and this issue can be worse for some of the most vulnerable groups in our community, who are often more likely to face challenges associated with increased travel time/costs.
5) The Joint Health Scrutiny Committee referred Phase One of the Path to Excellence to the Secretary of State and that there are still a number of unresolved concerns regarding travel & transport/patient’s access to services.
6) That to date, Phase Two of the Path to Excellence has not secured funding from NHS England
7) That South Tyneside and Sunderland Foundation Trust has held exploratory talks with South Tyneside and Sunderland City councils over potentially borrowing money via the Public Works Loan Board - £35m from South Tyneside Council to provide capital investment on South Tyneside and £15m from Sunderland City Council to provide capital investment in Sunderland
8) The public statements made by the South Tyneside and Sunderland FT that their site at South Tyneside forms an integral part of their long terms plans for health provision across South Tyne and Wear.
9) That any loan would be the responsibility of the NHS to re-pay and that a capital investment of £35m into the infrastructure at South Tyneside Hospital will lead to the development of new facilities and services at South Tyneside Hospital
This Council resolves to:
1) Only to support a loan of this type -- if applied for by the South Tyneside and Sunderland FT - if the loan would facilitate the development of the physical infrastructure of the site - including a new multi-storey car park -- to fulfil the commitment to improving and expanding local health services in the Borough.
2) Continue to support the Save South Tyneside Hospital Campaign, Trade Unions, and other key stakeholders in their work to protect and improve local access to NHS services in the borough.
3) Write to the Secretary of State for Health to enquire whether any NHS Trusts in England have taken out a PWLB Loan to facilitate improvements to the assets of their local hospitals and whether any have defaulted on their loan agreement.