France, Hinchingbrooke and Zermatt – a strange week

We start this week with a confession. I was on holiday last week. Now you probably didn't notice (thanks to our editor, Nancy Clinton) and don't care, but my wife and I were skiing in Zermatt. Before anyone thinks we've joined the ranks of the super-rich (and more on them shortly), I should explain that we don't do summer holidays so skiing is usually our one holiday of the year – and Zermatt, as well as being on the list of desirable destinations for oligarchs, has truly great skiing for pretty much all levels.

MHorn from goat runWe don't announce our absence here because my wife is convinced that the criminal fraternity reads Spend Matters avidly and would immediately target my collection of slightly beaten-up punk 45s if they knew the house was empty. So we don’t publish daily pictures of the Matterhorn in the sunlight or me knocking back the gluhwein.

But it was a strange week to be away from home. I can remember the days when keeping in touch on holiday meant finding the one newsagent in town where you would eventually get a two or three day old Daily Telegraph. Now of course our hotel had TV with 10 English channels and wi-fi, so we didn't miss a moment of the terrible events in France. There is nothing much to add to that other than our condolences and good wishes to anyone who was caught up in events in any way.

It was also strange to be seeing this from Zermatt, which is a little bubble of beauty and affluence. Despite some comments we heard that the decline of the rouble was reducing the number of Russian visitors, who form a significant percentage these days, the shops were still selling nice ski jackets for £1200 and upwards, and a meal in a mountain restaurant would set you back £50 or so (have a big breakfast and carry a muesli bar, that is our answer). But if things get worse, the tourist business will be just one European industry that will be affected by the Russian issues in 2015.

Then at the end of the week a secondary news item came through – the continuing problems in the UK health service. Not only did we see worrying figures for Accident and Emergency, with waiting times inexorably on the increase, but the first private firm to run an NHS Hospital announced they have had enough and are pulling out. Circle Healthcare have run Hinchingbrooke Hospital in Cambridgeshire for just two years, but are using a clause in the contract that gives them the right to pull out when their losses hit £5 million – which they will soon.

That actually distracted attention somewhat from the news that the hospital has also been placed in special measures following a recent Care Quality Commission inspection – the health watchdog rated the hospital as “inadequate.”

We'll come back to this, as we were sceptical from the start about the Hinchingbrooke experiment, for reasons we will go into at greater length later this week. But to be fair to Circle, they are facing the same pressures as every NHS Trust. The payments they receive from commissioners of services for carrying out work have been pretty flat or even decreasing in some cases, whilst demand has grown and costs are rising. This is why a growing percentage of Trusts – even many of the better run hospitals - are slipping into some financial difficulty now.

Whether or not the Circle events indicate the end, or the beginning of the end, for private delivery of major NHS work (rather than the “bits and pieces” outsourcing that may well continue), we will have to wait and see. But there is no doubt this highlights the financial pressures that are going to be a continuous feature of the NHS discussion in coming months.

Anyway, it’s good to be back. Maybe.

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