Peter Reading On The Financial Crisis At The Peterborough City Hospital

08:08 Tuesday 11th December 2012
Bigger Breakfast Show
BBC Radio Cambridgeshire

PAUL STAINTON: A local MP and member of the Public Accounts Committee has revealed that theatres at Peterborough City Hospital could close,  as the Trust running the hospital continues to struggle with debt. The Hospital, which has been open for two years of course, was funded by that expensive PFI agreement, and has seen the Trust rack up over £50 million of debt, £1 million a month. Now, speaking to us earlier, MP for North East Cambridgeshire Stephen Barclay described the way the new hospital was funded and then managed as “disgraceful and shocking”. (TAPE)
STEPHEN BARCLAY: Well it was quite disgraceful, and it raises serious questions over the performance of senior managers in the NHS, many of whom are paid significant salaries, and their performance has been quite shocking. (LIVE)
PAUL STAINTON: Well the Trust has had to receive bailout money from the Government in order to stay open, and as Mr Barclay revealed earlier, the Hospital may have to close theatres just to stay afloat. (TAPE)
STEPHEN BARCLAY: What’s striking really is just how, firstly there were warnings at the time and those were ignored. And now for example one of the considerations of the management is potentially closing the four theatres at Peterborough. That would be absolutely crackers. We’ve just built, at great cost, four state of the art theatres, and yet they’re saying that if they can’t get the numbers, because Hinchinbrooke is also trying to increase its theatre usage, then one of the options they would consider is closing the theatres. (LIVE)
PAUL STAINTON: Well Stephen Barclay and Peterborough MP Stewart Jackson were just two of the MPs questioning both bosses at PCH and Hinchinbrooke yesterday. And the Chairman of the Public Accounts Committee, Margaret Hodge, was furious with officials, and suggested that people in charge of approving the PFI deal for Peterborough were negligent. (TAPE)
MARGARET HODGE: All failed to do proper due diligence before the decision. All four of you, and nobody has been held to account. It almost seems to me an issue of negligence here. That’s what I feel. And I’ve never felt that on another NHS report. (LIVE)
PAUL STAINTON: Well that was Margaret Hodge, who was particularly angry with health regulator Monitor and two Government officials, and the Strategic Health Authority. In fact no-one was spared in yesterday’s examination. The city’s MP accused the NHS Trust regulator of falling asleep at the wheel, after spotting potential problems in 2007, but then failing to act on them. David Bennett, the head of Monitor, was challenged by Stewart Jackson after initially mounting a defence. (TAPE)
DAVID BENNETT: On the decision to go ahead with the original investment, we wrote clearly twice, saying that we thought it was a very risky investment.
STEWART JACKSON: You didn’t follow it through. And if I may say so, the last two weeks you’ve been on a PR offensive of trying to distance yourself from anything to do with the decision. Today, in the Peterborough Telegraph, you’ve got the press release out. You want an “elite team to revive ailing city hospital“. But in your press release that you issued when the report was published two weeks ago was all about, well it was astonishing really, because you basically said, well we told them, they didn’t listen, and well, there was nothing we could do about it. That’s essentially what it was. The most astonishing sentence in the whole report, I think,, really given that you’re the regulator of the Foundation Trust, is on page 36, paragraph 3.8, where you say, “Monitor’s criteria for assessing financial risk ratings for Foundation Trusts does not take into account concerns about the long term financial health of the Trust beyond the current financial year.” I just wonder, what is the point of Monitor? have I missed something? (LIVE)
PAUL STAINTON: Well that was Peterborough MP Stewart Jackson. The criticism of just about everybody was scathing. Joining is now is the Interim Chief Executive at Peterborough City Hospital, Dr Peter Reading. Morning Peter.
PETER READING: Morning Paul.
PAUL STAINTON: It just seems from everything we’ve heard that historically, whoever’s to blame, in fact it seems just about everybody’s to blame, it was a complete farce and a mess.
PETER READING: I think the MPs said a lot yesterday, and much of it I wouldn’t disagree with, to be honest. My role at the moment is to try to get things as much as possible onto an even keel. And also, I would emphasise, I think in your coverage there’s been some sort of hint that staff at the Trust are somehow being criticised. Our staff are working their socks off. Lat night, when I came out of that Committee, we had 66 people, patients in Casualty. Our staff coped magnificently with the challenge. And they do, day in, day out.
PAUL STAINTON: I don’t think it’s the staff that are ..
PETER READING: No I just want to emphasise that.
PAUL STAINTON: .. it’s the management, or lack of it, and the buck passing to consultants, and the money that’s just wasted. That’s what’s been criticised.
PETER READING: Paul, I’d agree with that. But I do think it just needs to be remembered that this is a functioning hospital, providing very high quality care.
PAUL STAINTON: Yes and I think Stewart Jackson paid tribute to the staff yesterday on this show.
PETER READING: He did. He did. Um ..
PAUL STAINTON: Are theatres going to be closed Peter?
PETER READING: Well, what .. I think Stewart .. Stephen Barclay’s got a slight misunderstanding here. He and I met about three or four months ago. He then asked me to give him some information about the efficiency of the way that we used our operating theatres. And it is an area that we are looking at, and we are looking at it intensively, as I think every hospital in the country is. Because ..
PAUL STAINTON: It’s a possibility.
PETER READING: There is a possibility that we can start closing some operating theatres. But that’s not because we haven’t got the work to fill them. It’s because we can use them more efficiently. One of the things that we’re trying to do, really the main theme here to be honest, is to make this hospital as productive as possible, so that we can then create the space to get more patients in. And if we do that, we reduce some of the financial burden on the taxpayer.
PAUL STAINTON: Can I roll you back. You’re going to close theatres so you can use them more efficiently. What are you going to do with the ones that you close?
PETER READING: No. Paul, Paul. No. We have no ..
PAUL STAINTON: Theoretically.
PETER READING: Theoretically. Oh yes.
PAUL STAINTON: What would you do if you closed the theatre? How would you use them for anything else?
PETER READING: Well we’d get more patients in, It’s quite simple. This is the best hospital around in terms of facilities. It’s state of the art. And at the moment those facilities are not being used to maximum effect in every case. If we are able to use our operating theatres more efficiently ..
PAUL STAINTON: Would you put beds in there, or what? What would you do?
PETER READING: No. No. You get more patients in. You treat more patients. And that’s what our objective is here.
PAUL STAINTON: You treat more patients with less theatres. What are you going to do if you theoretically close an operating theatre? What are you going to do with that space?
PETER READING: No. No. Sorry. Stephen Barclay has talked about closing operating theatres. I’ve never talked about ..
PAUL STAINTON: You just said it’s a possibility.
PETER READING: No. There is a possibility that we will actually manage to use our operating theatres more efficiently, which will allow us to bring in more patients and treat more patients through the eighteen operating theatres we have. Our job is to get as much health care through this Trust as we can.
PAUL STAINTON: You’ve confused me now. Sorry, I’ve really got to get this very very clear. Is there a possibility that Peterborough City Hospital could close some of its operating theatres in the future?
PETER READING: There is a possibility that we could close them so that we can then get in more work, and then reopen them. That is our objective.
PAUL STAINTON: You mothball them then.
PETER READING: That’s what we would do, so that we can then get more work in. Sorry, I’m not explaining very clearly and I apologise for that. So, this Hospital is hugely expensive, as you’ve described very clearly. And the best way to get the best value for the taxpayer out of it is to use it as productively as possible. That means every aspect of the Hospital, whether it’s outpatients or the wards or the operating theatres.
PAUL STAINTON: Isn’t part of the problem though that you’re in competition with the hospital just down the road at Hinchinbrooke? You’re both essentially offering the same services in competition with each other.
PETER READING: One of the things I don’t think the NHS does very well at the moment, and it came out very clearly yesterday, is handle things strategically. And the reaction of Monitor last week with their decision to bring in a contingency planning team, which are these consultants that were decsribed in your interview with Stephen Barclay, is a response to the fact that across the NHS, we don’t seem to be able to come up with a strategic solution to how you run hospitals in this part of the country. And yesterday’s committee I think exposed very clearly some of the problems. We’ve got Hinchinbrooke down the road, we’ve got Peterborough City Hospital. And the sort of strategic approach that is desperately needed …
PAUL STAINTON: To stop you being in competition, effectively.
PETER READING: Well being in competition doesn’t always help. Competition can be helpful. It keeps people on their toes. It encourages people to be more efficient. It does have some benefits. But it also makes it more difficult to solve some of the strategic issues of deciding which patients go to which hospitals and how do you make the most efficient use of them.
PAUL STAINTON: You’ve talked Peter about potentially closing theatres. How many jobs are we going to lose as well?
PETER READING: We don’t know what the profile is for job losses. We do know that we’ve got to save £13 million this year and another ….
PAUL STAINTON: Will there be job losses?
PETER READING: … pounds next year. And it may mean a reduction in our workforce. At the moment, I have to say, we are not taking jobs out. We took out about a hundred through redundancies over the last year. We don’t have any more planned at the moment. But it may come in the future. However, I would emphasise that redundancy is very much a last resort in any organisation. There are better ways of reducing your workforce, if that is what you need to do.
PAUL STAINTON: How many more bailouts are you going to need Peter, and how much money are you going to need over the next year?
PETER READING: At the moment .. at the moment we’re going to need another bailout in January. And we’ve been promised that by the Department of Health.
PETER READING: It’s going to be more than £40 million. It will be the same as it was last year. And in spite of saving £13 million this year, because the income we get is being reduced all the time by the Commissioners, and because of inflation, we are saving £13 million effectively just to stand still in terms of our deficit. So the bailouts will continue for the foreseeable future. And that is why we are desperate to have some sort of strategic solution to how hospitals are organised in this part of the country. Not just Peterborough, but across thirty or forty miles around us.
PAUL STAINTON: So a wider plan needs putting in place basically.
PETER READING: It desperately needs ..
PAUL STAINTON: Have you sold the old hospital site yet? That would help, wouldn’t it?
PETER READING: It would help, but it would only help to a limited extent, because the amount that we’d get for the old hospital is dramatically less than ..
PAUL STAINTON: Have you sold it?
PETER READING: No we haven’t sold it. We have a preferred bidder. We are working.. as I said in front of the Committee yesterday, we are in the final stages of negotiations with the City Council planners, and the preferred bidder, to finalise that deal. And if things go well, then during the course of 2013, we will sell the hospital.
PAUL STAINTON: Is anything holding up the deal?
PETER READING: Nothing is holding up the deal, other than that we’re trying to get the best value for the taxpayer. And that involves trying to get the best deal with the planners, within the contraints that they have, and with the preferred bidder. So there are some ..
PAUL STAINTON: So the Council insisting there’s a school built on the site is not holding up the deal.
PETER READING: The school is not actually holding up the deal. What is holding up the deal is us at the Hospital Trust needing to be absolutely confident that we have got the maximum possibility of building new houses on that site.
PAUL STAINTON: Asbestos not holding up the deal?
PAUL STAINTON: No. Definitely not?
PAUL STAINTON: Definitely not?
PETER READING: Well not that I’m aware of. No. I don’t know where that’s come from. The final stages are very simple actually, which is we have an offer on the table. We think that we might be able to squeeze a little bit more out of it, if we can get the best planning solution. And we’ve got a meeting coming up next week with the City Council to look at that. We’re working very closely with them. They have to do their job. We have to do our job. And between the two of us I hope we’ll get the best value for the taxpater. But we’re not going to clinch the deal until the price we’re getting is the best that we can get.