Marco Cereste Chairman of NHS Peterborough talks to the BBC’s Antonia Brickell about his plans to cut £20 million from the NHS Budget as part of an effort to save £33 million required to balance the budget. Broadcast in the 17:00 Drivetime Show on Wednesday 19th May 2010 on BBC Radio Cambridgeshire.
ANTONIA BRICKELL: Now this afternoon another meeting was held to discuss how NHS Peterborough will make thirty three million pounds in savings. The main concern of course is how to still provide efficient healthcare services. Well, Marco Cereste is the Chairman of NHS Peterborough’s Board, also Leader of the Council. He’s on the phone right now. Hi, Marco.
MARCO CERESTE: Hi. Good afternoon.
ANTONIA BRICKELL: How are you going to make these savings without affecting the standard of healthcare?
MARCO CERESTE: Well first of all we’re not going to make thirty three million pounds worth of savings in financial year two thousand ten eleven. We’re pitching to make twenty million pounds worth of savings, which is just still enormous. So, you know, it’s not that I’m trying to say it’s any less of a problem. What we’re trying to do of course is to make the delivery of healthcare in the city more efficient and more effective in order for everybody to be able to still get what they need when they need it, but do it in a different way.
ANTONIA BRICKELL: But how are you going to keep things going if you’ve got to make twenty million pounds worth of cuts? OK, not as much as thirty three. But how are you going to keep the standard up?
MARCO CERESTE: Well what we’re going to try and do, in fact I think what we will succeed in doing, is .. we’ve got to reduce waste and duplication. We’ve got to use the NHS estate that we have at the moment far more effectively. And we’ve got to make our health service in this city as efficient as it is in other places in the country. In other words, what we’re trying to do is we’re trying to pitch the effectiveness and the efficiency of our health service to be in the top twenty five per cent of the top quartile in the UK.
ANTONIA BRICKELL: But how on earth can you do this, short of being a magician?
MARCO CERESTE: Well, no I’m not a magician, and it’s a huge task to ask for. But some of the things that we will be doing, for example, is we will be encouraging the community to use emergency services in a way, asking the hospital to do things in a different way, so that we can stop unnecessary appointments and admissions. But Peterborough, let’s get it absolutely clear, everybody that needs health care in the city will still get health care in the city when they need it.
ANTONIA BRICKELL: Is that not going to put more pressure on the emergency services?
MARCO CERESTE: Well the whole point is this is one of the problems was that actually the emergency services were being used inappropriately, and one of the .. one of the key targets will be to actually restructure emergency services in the city and get the community to understand how better to use them. So it actually doesn’t put pressure on them. We want to better use the City Care Centre and we want to better use GPs in order to be able to deliver this care more appropriately within the community.
ANTONIA BRICKELL: Can you accept that money has been wasted in the past?
MARCO CERESTE: I think that it would be stupid of me to say that money hasn’t been wasted somewhere. But I think we have to be .. we have to face the reality that last year if you look at all the figures, and these are public .. these are public documents that you can access .. and I can give to anybody that wants them, there’s been huge overspend. That means pressure and increasing use across the whole Board of services for which Peterborough NHS commissions, and we couldn’t turn people away, and we still can’t turn people away and still we have no intention of turning people away when they need services.
ANTONIA BRICKELL: So you call twenty million an enormous amount. What happens if you can’t save that amount, if there’s a backup plan and you overspend again?
MARCO CERESTE: Well we’re not going to overspend again because actually part of that twenty ..
ANTONIA BRICKELL: Why? How do you know that?
MARCO CERESTE: I’ll explain it to you. Part of that twenty million pounds recognises that this year we have .. we would have overspent by seventeen point two million. So actually part of the plan of reducing .. what we call making these savings .. is actually to deliver on the increase in services that we experienced last year, and to recognise that that pressure in the system is there today, and therefore we have to make sure that we’ve planned for that so that people who do need health care when they present wherever it is they present, whether it’s to the hospital or at the GP, and are actually catered for and their needs are taken care. Remember patients are the most single important people in the NHS. That’s what it’s all about.
ANTONIA BRICKELL: OK. In the past you said that the problem has been the number of immigrants using the service. Now this problem is still going to remain next year. So how can you fix a problem that is still there?
MARCO CERESTE: I don’t think that the problem that immigrants use the service is so big that it would have made twenty million pounds worth of difference to the health care in the city. If you look at .. if you look at the plan, if you look at where the money’s been spent, it’s been spent on places like Peterborough Hospital, Mental Health Trust, it’s been spent in Community Services, it’s been spent in Continuing Care, which has had nothing to do with the immigrants in our city. It’s got .. it’s been spent ..
ANTONIA BRICKELL: But it’s become out of control. We’ve talked about this a lot. Why are people living in sheds?
MARCO CERESTE: Well people are not living in sheds any more in Peterborough because we’re moving them out. And as you very well know we’re working on a pilot scheme with the Home Office where if we can’t rehabilitate people living in sheds .. that were living in sheds, or on the Embankment, or whatever they’ve been accused of eating our fish, and eating our swans, we’re going to send them back. You know, we’ve already .. four have already gone back, and there’s a process by which if people can’t become full members of our community, find a job, pay their taxes and pay their way, we’re going to send them back to where they came from, if that’s the situation.
ANTONIA BRICKELL: OK. There’s an example already of where cutbacks will face a standard of service. Richard Spiers revealed the dental checkups will be affected. Can you give us examples of other areas that will face cutbacks?
MARCO CERESTE: Well I don’t .. I’m not .. I’m not convinced that there will be huge areas where there will be cutbacks. What we will do is deliver the health service in a different way. So dental services you say will be .. there’ll be cutbacks. But actually the new .. you know the latest guidance the latest .. the latest clinical guidance is actually you need .. you need checkups once a year, not every six months. That’s what we’re going to provide. We’re going to be .. we will be cutting back on prescription costs. But we’re not going to be cutting back on prescription costs to the detriment of the public. What we’re doing is encouraging our GPs to use generic .. generic prescribing, wherever that’s possible. It’s huge amounts of saving, you know, without giving you the detail of which drugs, but there are some drugs which we take, and I take myself, which if you were to take ..
ANTONIA BRICKELL: Sorry to interrupt, but do you really have any idea what the plan is? You don’t sound very convincing.
MARCO CERESTE: Well I know exactly what the plan is. But what you need to understand and we all need to understand that the plan is predicated on making efficiencies and savings. It’s not predicated on cuts. And the places where we will be having cuts are for example at the PCT, where we quite righly are aiming to save thirty per cent in management and corporate costs.
ANTONIA BRICKELL: OK. Marco we’re going to have to leave it there. Marco Cereste is the Chairman of NHS Peterborough, the Board and also Leader of the Council here in Peterborough.