Marco Cereste on the NHS Peterborough Deficit

Marco Cereste Chair of NHS Peterborough comments on the crticisms levelled at him following the announcement that this year NHS Peterborough overspent by a far greater amount than expected, and that next year it will need to reduce its spending by tens of millions of pounds to balance the books. Broadcast at 08:10 on Friday 26th March 2010 in the Paul Stainton Breakfast Show on BBC Radio Peterborough.

Marco Cereste Chair of NHS Peterborough comments on the criticisms levelled at him following the announcement that this year NHS Peterborough overspent by a far greater amount than expected, and that next year it will need to reduce its spending by tens of millions of pounds to balance the books. Broadcast at 08:10 on Friday 26th March 2010 in the Paul Stainton Breakfast Show on BBC Radio Peterborough.

PS: This is the big news locally that you’re waking up to. NHS Peterborough is planning to make twenty seven millions of pounds of cutbacks next financial year. But people in Peterborough seemingly won’t lose out on health care. Here’s interim Chief Executive Sheila Bremner’s guarantee, shortly after a meeting of the Board of NHS Peterborough.(TAPE)
SB: We will seek to maintain the quality of services that we provide and make sure that we meet the needsĀ of local people, absolutely.

PS: That’s what Sheila had to say. earlier in the programme we heard Labour Parliamentary Candidate for Peterborough Ed Murphy. He says its down to leadership. (TAPE)
EM: I’m very concerned that the eleven million deficit that we’ve got now, which has gone up over the year, it’s now turned into twenty seven.They’re going to try and make savings next year, at the expense of people’s health in Peterborough, to pay for the mess they’ve made this year. It’s actually down to leadership. The Board running the Primary Care service in Peterborough have not been in control of what they’re doing.
PS: Liberal Democrat councillor for Peterborough Darren Fower said consultancy fees were a major factor in this. (TAPE)
DF: The PCT has identified the context of cutting consultants as the main saving exercise. And yet the City Council, if you make that suggestion as the Liberal Democrat group have done on more than one occasion, it’s a complete no-no. And yet the chap at the top is the same guy, in Marco Cereste. And the Primary Care Trust is situated now in the Town Hall, which makes it almost entertaining. You can go to a meeting and be the Chair of the Board and say yes, I think that the way to save money is to reduce our reliance on expensive and unwanted consultants, then walk down the corridor, put The Leader hat on, and go, “Oh no, bad idea to do that”.
PS: Well English Democrat councillor Graham Murphy says someone should be held to account for this. (TAPE)
GM: Now is the time to look at who’s accountable for this. We’ve had a Chief Executive go. Angela Bailey stood down. We’ve had the Finance Director disappear. We’ve gone from four point six million in the last six months to now eleven point eight. Is it not now time for the Chairman to stand down and stay away from the Board. Because really somebody has to be accountable, and the Board is accountable for the NHS movements.
PS: Well a mountain of dissenting voices, unhappy people. I should think there’s a few people woke up this morning across the city very unhappy as well, and very worried. I’m pleased to say that Marco Cereste Chairman of NHS Peterborough is on the line this morning. Morning Marco.
MC: Good morning Paul.
PS: There’s going to be a lot of worried people out there this morning. And I’ve picked out one word from what Sheila was saying, that she will “seek” to ensure that services are not cut. “Seek” doesn’t fill me with a great deal of confidence.
MC: That’s absolutely right. But we will do everything that we possibly can to make sure that services are not cut. The reality of it is that we’ve now identified fully the scale of the situation, now that we have a new Chief Executive, and we had a new Finance Director start yesterday. That doesn’t necessarily mean that that is what will have to be recovered next year. Obviously we are in negotiation with everybody, and as soon as we have whatever the series of options may be we will make those public as well. So what we wanted to do was be completely open and transparent and tell everybody the size of the problem that we could be facing next year, so that we can start developing plans and options to address those problems. And one of those will be to try and recover the whole twenty seven million in one year. There may be a number of other options that do not require us to do that. And of course, we are exploring all of those, now that we’ve got at least a team in that is able to quantify what they are.
PS: Where does the twenty seven million come from? Is it the eleven point eight million shortfall from this year, which the Government has taken from the budget and then cutbacks which you need to make next year from the Budget?
MC: Well, the thing is, the reality of it is, the simple way to look at it, is that you’ve got eleven point eight million this year, and they’re what we call pressures. Because, you know, the people of Peterborough have to understand that the reason we’ve got eight point .. eleven point eight million pounds worth of deficit this year, is because it’s been spent on the health care of the people of Peterborough.
PS: What I’m trying to get to Marco is it .. is it twenty seven million plus eleven point eight we’re cutting?
MC: No no no no no no no no no no no no no no. Absolutely not.
PS: That’s included, right.
MC: That’s all included. And what happens is just a .. because I think it’s important that people understand .. is that you say eleven point eight, those cost pressures are in the system now. But they won’t go away just because the financial year is finished. So in the new budget for next year we have to include those cost pressures. That’s an easy way of sort of describing what the position is. Because, you know, if we’ve needed an extra six million pounds to Peterborough Hospitals Trust this year in services, or if we’ve needed six million pounds in providing elective health care, that may necessarily not go away next year. So we have to plan that.
PS: So there’s no way, then really is there, you know, realistically, that you can not make huge swathing cutbacks? Because to save twenty seven million, I mean in your own budget here it says you are going to save seven point seven million pounds from hospitals. We’re opening a new one in November. How are you going to do that? You are going to have to cut services.
MC: Well that’s why we’re talking to the hospital. And what you need to do .. there’s two ways of doing this. What you have to ty and do in the first place is first of all we take out as much costs out of a back office as we possibly can. Secondly we transform the way that you deliver services. Now for example, you know the amount of time that people spend in the hospital, it seems to be, clinically, and has been proven, that the better, the quicker you get people out of hospital, the quicker you get people at home, with support services, the quicker they recover and are happier. So we’re going to have to be doing a lot more of that stuff, which means that people will get a better service, but it’ll cost the NHS less.
PS: Seven point seven million pounds though, just getting people home a bit quicker. You’re going to have to cut ..
MC: No you’re not going to save seven point seven million pounds on people going home quicker. You’ve got to .. you’ve got to save all .. you’ve got to make savings in lots and lots of different places. And I’m not saying to you that necessarily that seven point seven million is going to be achievable in year.
PS: One point one million cuts in GP services, one point one million cuts in prescriptions, I mean that’s going to affect GPs, it’s going to affect, you know, your average Joe on the street. These are big cuts, aren’t they? Should we not be honest about the fact that we’re making big cuts?
MC: You can’t .. you can’t ..hang on a minute. Let’s be frank about this. You know, when you say cuts in prescriptions, it’s not going to be people getting .. not getting what they want. The man in the street will get exactly what he needs.
PS: So they’ll be open less hours .. or .. how are you going to save ..
MC: No no no no no. What happens with prescriptions is instead of using .. if you’re taking statins, you know, let’s take an example where you might be taking a steroid that I know very well, without mentioning the name. If you take a proprietary steroid then you go to the GP and he gives you a prescription for a steroid which is a proprietory steroid, with a brand name, the cost of that steroid to the public is ten pounds. You can get a generic steroid which is exactly and I mean exactly the same formula, and that steroid costs one pound ninety. And so that’s what we have to do. That’s where that saving will be. Nobody in the .. nobody in this city will get .. will not get a drug, or will get something of lower quality because we’re going to make those savings.
PS: But don’t we .. we need a bit of honesty here Marco, don’t we. I mean we can’t say to people that, you know, twenty seven million pounds worth of cuts in the NHS budget for next year is not going to be incredibly painful. We surely can’t say they’re not going to notice the cutbacks, and that you’re going to make these savings in getting, you know, cheaper products, and back office savings. You cannot save twenty seven million pounds doing that. You’ve got to .. you’ve got to ..
MC: I’m not saying that ..
PS: We’ve got to have some honesty here.
MC: No no no I’m not saying .. I didn’t say that. I said to you that if we have to make twenty seven million pound cuts it would be difficult. And it would be .. and you know. we would have to make cuts in front line services somewhere. That’s the reality of where we are. But the reality of where we are is that the people of this city need really good health care. And that money that’s been spent this year has been spent on the health care of the people of this city. So when you know .. one needs to say what does one do? You know if you take the money that’s been spent on the hospital. That money has been spent on the hospital, it’s not been given away. It’s not been poured down a drain. It’s been spent on people who turn up to hospital, they need treatment, and they’ve been treated. And that’s going to continue to happen. And that’s not going to change.
PS: Are you confident that ..
MC: No-one’s going to get turned away. No-one’s going to get turned away from hospital, and said “Oh you can’t have your treatment.” That’s a nonsense. It’s not going to happen.
PS: Good. Are you confident that the plan that’s in place, which I believe was put together by the old Finance Director, is the one that’s going to work? Because he’s not got a great track record, has he.
MC: No. No I’m not. I’m being completely open with you. We announced yesterday what we believe was the quantum of the problem. And that what we believe yesterday was the worst case scenario. Now, we’ve got a new Finance Director in place. We’ve got the staff working all hours that God sends to work out a proper plan to try and recover that position. And we’re going to try and recover that position in such a way that it doesn’t affect the health care of the people of this city.
PS: How do you respond to criticism of you in particular, and the fact that you run Peterborough City Council, you use consultants, you’re Chairman of NHS Peterborough, and you say you’re going to save money on consultants. How can you square that circle.
MC: Well actually, you know, that’s really political nonsense, isn’t it. You know ..
PS: It’s a fair point though ..
MC: No no it’s not a fair point, it’s a nonsense point, it’s a political point, it’s got nothing to do with the reality. You and I both know any decent businessman in this city, in this world, will tell you that you only use a consultant when you get a benefit from using that consultant. So if you’re using a consultant no matter where it is, if it’s in the NHS, or whether it’s in the City Council, and that consultant is either delivering you a service that you need, or saving you money, that’s got to be the right thing to do. What you shouldn’t do is use consultants that are costing you money. And that’s .. I would agree one hundred per cent any consultant that you’re using that you don’t need, or is costing you money, or is an additional cost to what you’re trying to do, you should get rid of.
PS: Are you happy, Marco, with the job you’ve done, as Chair of NHS Peterborough?
MC: No I’m not happy with the job that I’ve done as NHS Peterborough. I am terribly disappointed that after twenty five years of virtually perfect perfect service to this city, we’ve had a situation where we just .. you know .. the forecasting in what the costs of health care would be in the city was so .. got so terribly wrong. All I can say is that I genuinely believe that had we not had a good Board in place this would not have been picked up as early as we did pick it up, and we’d have an even bigger problem than we have now.
PS: Is it time for somebody else to be Chairman of NHS Peterborough Marco?
MC: And that may bery well be the case. But what we need to do right now is sort out the problem and make sure the people of this city are not disadvantaged from the position that we’re in. Because I repeat this money’s not been wasted. This money has been actually spent on people that have walked through the door either in Peterborough or in Papworth or Addenbrookes or Fitzwilliam Hospital, they’ve needed treatment and we’ve provided that treatment. A huge amount of money has been spent on what we call lomg term care. And these are citizens of our city who have had tragic accidents, or are in real .. or have real difficulties, and they’re in nursing homes, in special places which the legislation and the law says we have to provide and pay for for their healthcare. So this money has been spent on the people of our city, it’s not been wasted. It’s not been .. you can say we didn’t forecast it properly, absolutely right.
PS: Are you confident that the people of Peterborough .. going forward .. just quickly Marco, before we finish ..
MC: Mmm.
PS .. can you allay their fears and convince them that their health service, for the next twelve months, will be there for them when they’re ill?
MC: Absolutely, without question.
PS: Marco, thank you very much. Marco Cereste, Chairman of NHS Peterborough.