ONE of Scotland’s most financially chaotic health boards is considering “unbelievable” plans to “reduce” its workforce by 1300 in a bid to balance the books.
Official papers reveal an “acceptance” by NHS Tayside that staffing levels need to fall by 10%, even though the Government has agreed to write off its £62m debt bill.
The board told The Herald on Sunday that any reduction will come from “natural staff turnover”, but Scottish Labour health spokeswoman Monica Lennon said: “A ‘reduction’ of 1300 jobs is not a rescue plan for Scotland’s worst performing health board. It’s a recipe for disaster that could risk patient safety and staff wellbeing at NHS Tayside for many years to come.”
NHS Tayside, which serves more than 400,000 people in Angus, Dundee and Perth and Kinross, has attracted adverse political and media scrutiny for years over its financial problems.
An Audit Scotland report covering 2016/17 confirmed that the board had received tens of millions of pounds in “brokerage” loans from the Government and was having to make £205m of savings over five years.
NHS Tayside also raided its own charity fund to pay for projects including a new IT system, following which Ministers put the body into “special measures”.
Jeane Freeman, who was appointed the new Health Secretary in the summer, then announced that several boards would not have to pay back their loans. The NHS Tayside figure is believed to be around £62m.
However the organisation, which employs around 13,500 people, is continuing to overspend and new board papers make clear that a big reduction in staff is being earmarked.
One document noted that the board’s workforce plan had been subject to “considerable review”, as it “did not reflect the requirement for the Board to reduce its staff by around 10% to be comparable with other Boards”.
An assurance report from September, in a section marked “other major issues”, also cited an “acceptance” that “staff levels need to reduce by 10%”.
A committee minute from the same month also showed workforce director Dr Annie Ingram discussing plans for a service redesign.
It noted: “Dr Ingram advised that this required having involvement of both front line staff and partnership. In terms of the workforce benchmark, it was noted NHS Tayside was 10% over-committed and this needed to be safely reduced.”
The comments of another senior figure, non-executive director Douglas Cross, were relayed in the same document:
“Mr Cross welcomed and took assurance regarding the direct approach and noted that benchmarking indicated that staffing levels required to be reduced by 10%. Mr Cross highlighted the importance of having clarity and honesty around that, how this message was delivered and ensuring staff engagement moving forward. The age profile of the organisation was noted with possible opportunities and risks from staff retrials and regionalisation.”
The minute added: “Dr Ingram highlighted the need to reduce and re-profile, achieve financial balance, achieve waiting time targets in addition to reducing the workforce by 10%.”
Mrs Lennon, who is a member of Scottish Labour’s shadow cabinet, said: “The dilemma facing NHS Tayside is the legacy of the former Health Secretary Shona Robison, herself a Dundee MSP and will cast doubt on the seriousness of her replacement Jeane Freeman to rescue the troubled health board.”
“The financial chaos and risk that has plagued NHS Tayside is not the fault of its loyal and dedicated workforce nor is it fair on the patients. For NHS Tayside to be considering reducing staffing by 10 per cent, at a time when staff are already overworked and stressed, is unbelievable and raises serious safety concerns.”
“Nicola Sturgeon claimed to Richard Leonard at First Minister’s Questions that health boards were not facing cuts but that has been exposed as complete fiction.
“Our health service deserves better and must have enough staff to deliver the care people need – not more cuts from an SNP government that can’t be trusted with the future of our NHS.”
Scottish Tory MSP Miles Briggs said: “Scotland’s population is increasing and getting older. So quite why any health board would reduce staffing numbers by a tenth is a mystery.
“Health boards right across the country are already under immense strain, partly because the SNP has failed miserably to plan properly for the future. Allowing this level of reduction will only make that crisis worse.”
Responding for NHS Tayside, Annie Ingram said: “Over the past two years, NHS Tayside has carried out a number of workforce benchmarking exercises which showed NHS Tayside’s spending on workforce is higher than similarly sized health boards.
“We spend around £540million on staff every year and we have a responsibility to ensure that our public funding is spent in the best possible way. It is important that we identify where efficiencies can be made whilst ensuring that services are being delivered with the best use of the resources we are allocated.
“Patient safety and clinical care remain a top priority for NHS Tayside but we must also achieve financial balance.
“That is why we are carrying out an organisation-wide review of staff numbers, grades and skills is being carried out in partnership with our staff and our trades unions to ensure we have a safe, affordable and sustainable workforce.
“Our transformation programme will present opportunities to redesign services delivering them in a different way with a different workforce.
“There is a no compulsory redundancy policy in NHS Scotland therefore no one will lose their job. Any reduction will be due to natural staff turnover.”
2012/13: NHS Tayside receives a £2.2m “brokerage” loan from the Government.
2013/14: The same board receives another £2.9m in brokerage from the same source.
2014/15: The Government gives NHS Tayside another £14.2m in brokerage.
2015/16: NHS Tayside overspends by £10.3m on workforce costs, £4.7m on prescribing costs and £2.6m on clinical supplies. Another £5m in brokerage is required.
March 2017: Independent advisers appointed to help NHS Tayside meet its financial challenges.
October 2017: Audit Scotland says NHS Tayside is projecting a funding gap of £49.8 million in 2017/18. The board already has £33.2 million of outstanding loans from the Government to repay.
October 2017: The same Audit Scotland report – “The board is facing an extremely challenging position which will make it difficult to achieve financial balance in the medium term.”
October 2017: BBC reports that NHS Tayside will suspend all planned, non-urgent operations for three weeks over the festive period.
April 2018: The Herald reveals that, in 2014, NHS Tayside bosses used their charity fund (money donated by the public) to bankroll a back office computer system.
April 2018: Health Secretary Shona Robison calls for the chairman of NHS Tayside to quit and says the chief executive’s position is “untenable”. Prof John Connell resigns as chair and the CEO is replaced.
April 2018: Scottish Labour leader calls on Robison to quit over the problems at NHS Tayside. First Minister Nicola Sturgeon defends her.
June 2018: Robison quits the SNP Cabinet and is replaced by Jeane Freeman.
October 2018: Freeman announces that NHS brokerage debt will be written off. NHS Tayside’s debt is believed to be over £60m
November 2018: The Herald on Sunday reports that NHS Tayside is planning to cut its 13,500 workforce by 10%
Source : HeraldScotland