‘Health care crisis’

Referring to a specific shortage in occupational therapists - one area affected by the £32m in cuts - UNISON says that, across Northern Ireland, if it “profiled the health service on waiting times and asked what the target is and what is contained in the trusts’ delivery plans, we would see a situation that has moved from creaking last year to near collapse this year.”

Jonathon Swallow made the comments at a briefing of the Stormont Health Committee as he outlined UNISON’s analysis of the Western Trust’s proposals for dealing with this year and next year’s budget cuts.

Patricia McKeown Regional Secretary, UNISON, earlier warned that with the Trust proposing £32m cuts with only half the financial year left “there was clearly a health care crisis.”

Ms McKeown told the committee: “The Trust proposes to make a total of £32m savings in this financial year. This means real cuts in service delivery and jobs.

“The Health & Social Care Board says there is no more money. The Western Trust’s proposals have a wide ranging impact on hospital patients, outpatients, vulnerable residents at home and in residential care.

“The Trust has only told half the story. It needs now to front up with how it is going to deliver its savings. It also needs to front up with patients and clients as to the extent its services, for all the best efforts of staff, have now deteriorated to this level of crisis.”

In a statement issued to the Sentinel the Western Trust said it works closely with the trade unions and that whilst faced with significant savings targets since 2008 it has demonstrated strong performance against regional targets and standards and remains focused on continuing to improve standards of care for patients and clients in 2011/12.

Ms McKeown itemised the main patient impacts across the Western Trust saying the local health authority has admitted “that services to children are under funded by 30 per cent; that the four hour A&E target is not achievable for reasons including a major increase in admissions and no funding for senior doctor cover 24/7; that the Trust is not meeting cancer targets (particularly upper gastro Intestinal; gynaecology; colorectal; and urology) due to lack of funding and staff; that the Trust cannot meet waiting time targets. Instead waiting times will be redefined as what is ‘reasonable’.”

She claimed overall waiting times for first outpatient appointments had slipped from 9 weeks to 21 weeks; that waiting times for treatment had increased to 52 weeks for Orthopaedics; 52 weeks for Urology; 52 weeks for General Surgery; 52 weeks for Colorectal; and 61 weeks for Ear, Nose and Throat.

She also said the Trust was very unlikely to meet the nine week waiting time for treatment from Physiotherapists and Occupational Therapists and that it needs eight more Physiotherapists, 11 more Occupational Therapists, and that there would need to be no vacancies, sick leave or maternity leave.

Addressing this issue in his briefing to the Stormont Health Committee Mr Swallow said: “Its current performance is between 26 and 30 weeks, not nine weeks.

“If we were to profile the health service on waiting times and ask what the target is and what is contained in the trusts’ delivery plans, we would see a situation that has moved from creaking last year to near collapse this year.”

Ms McKeown also claimed that the Trust cannot implement the best practice care models for Falls or Skin; that there is no money to meet decontamination standards; that it cannot meet the hearing aid target; and that there is no funding to provide services and treatment to men who perpetrate domestic violence.

The union chief went on to address the impact of the proposed cuts to the social care and mental health budget across the Trust arguing there are increasing delays in the provision of lifts and hoists to support clients living at home with 75 clients on the waiting list and the longest wait so far 28 weeks at the beginning of September.

She said there was no funding available to meet targets for care assessment and care plans for vulnerable people needing services with one client having waited 68 weeks without assessment at the start of September.

“Scandalously, children with acute mental health issues are being admitted to adult beds. The Trust is even failing to achieve the 15 per cent target reduction in this practice set by the Department. The target and practice should of course be zero,” claimed Ms McKeown.

“There is no money to discharge older people who have had inpatient treatment for mental health. Recent cuts, and cash limits imposed, have increased waiting lists for domiciliary and nursing/residential care. As a result targets for discharging vulnerable and elderly people into the community are not achievable or affordable.”

She urged the Trust to release the detail of cuts in posts, hours and working practices on particular sites and claimed “major job loss will take place in vital administration and clerical posts as the Trust tries to save £700,000 on a widely discredited Shared Services model.”

A spokesperson for the Trust said: “The Western Trust works closely with all trades unions including UNISON. All Health and Social Care Trusts in Northern Ireland are experiencing significant financial pressures.

“The Trusts are working with the Health and Social Care Board (the service commissioner) and the Department of Health Social Services and Public Safety to determine how best to provide services within the resources available and to reduce the impact of the funding gap on services.

“The Trust has demonstrated strong performance against regional targets and standards and remains focused on continuing to improve standards of care for patients and clients in 2011/12.

“The Trust has been required to deliver significant savings since 2008, however, we are continuing to work hard to sustain access to services and reduce waiting times for patients.”