The Annual Meeting of the Members of the Great Western Hospital Trust took place on Wednesday this week. The meeting received presentations from the Chair of Governors Bruce Laurie, Chief Executive Lyn Hill-Tout and Director of Finance Maria Moore. In the Annual Report of the Trust the Chief Executive says:
“After a long period of increased investment in the NHS it is clear that the next few years will require us to work even harder to continue to deliver safe, high quality services within the money available and to innovate and change services so that quality and patient experience improves, whilst costs are reduced. This will mean that the Trust will need to engage with staff and other stakeholders to ensure that we deliver increased productivity, improve efficiency and deliver savings.”
This is a bit like the holy grail, improving the quality of patient care whilst funding falls sharply. The scale of the cuts (nationally £20 billion over the NHS from 2011 to 2014) was explained by the Finance Director. GWH will this year spend £7.8 million less than 2009/10. Over £5 million of this is actually the result of losing Child and Adolescent Mental Health Services. Spending will then fall by £10 million a year for each of the 3 subsequent years. So £37.8 million will be cut from £192 million expenditure. When you bear in mind the level of spending which the trust would have had if an inflation level increase in its funding had continued – with, let’s say 10% inflation over three years – the Trust will have to manage on around £154 million instead of roughly £213 million. (The figures may differ depending on the inflation rate, of course. In July it was 4.8%.)
Another point of interest from the annual accounts relates to the cost of the PFI scheme under which the new hospital was built. It transpires that it cost £28 million this year for the PFI (capital, interest and the services provided by Carillion), more than 14% of expenditure. The contract provides for an increase in line with RPI, so as the funding goes down then the portion of money devoted to the PFI will push up towards 20%, cutting the amount available for provision of health care.
An interesting difference of opinion emerged between the Chair of the Governors and the Chief Executive. The Chair said the situation we faced was difficult, but not very difficult. The Chief Executive thought it would be “horrific”.
I will finish a more detailed report next week.