Friday, July 06, 2007

A Ray of Hope??

An e-mail came to all inboxes at City Hospital and presumably to all healthcare workers throughout the country on the 4th July. It was from the new Health Secretary Alan Johnson and he was announcing a wide-ranging review of the NHS led by a surgeon who will continue to practise his craft.

This is most welcome news. What better way to convince the front line troops than with a person who knows what it's all about leading the way. May be some common sense can now effectively influence the decisions taken at the top of government.

Policy must be evidence-based with clinicians from both primary and secondary care, patients and local community representatives in the driving seat. From all my experience of talking to patients not one has said that that they want more choice. They want to see the local GP when they are ill, preferably before they get too ill. Seeing the same GP with some continuity of understanding of the problem as well as care would be good. Patients want to be seen at the local hospital for serious common garden complaints. They would prefer to have the children, themselves and their elderly parents cared for in the same hospital.

They would like the hospital to be clean, free from infection, the food to be adequate and edible without the need for the family to bring in extra rations. It would be good not to be taxed for parking the car in some grotty flooded car park especially when they are elderly, infirm and supporting sick family members.

They also find it hard to understand that the treatment you can get depends on where you live. Not only do people have to move address for the schools in 2007 but also to get the treatment they need. They wonder can it really be a NATIONAL Health Service?

The consultants feel sidelined and ignored. Primary Care Trusts now decide what they are going to buy. Let us be clear Primary Care Trusts do not represent GPs in my experience. They have their own agenda and I have great sympathy with my GP colleagues. When the GPs sit down with the consultants and work out what is best for patient care and where it should be done most effectively and economically we will really be reforming the NHS. I am hearing about patients with diabetes being denied a specialist foot clinic at the hospital in spite of developing gangreneous toes. I hear diabetic patients with renal failure may be discharged to primary care. This is going back to the past, not forward to the future. In parts of the country specialist nurses are being lost.

Much more money has been invested which is fantastic but I fear that much has been wasted. All these Trust Boards, all the non-productive people that are not contributing to patient care, all those management consultants, all the glossy brochures, all those organisations set up to monitor this and that, all those collecting data to determine if targets are being met, all those working in public relations and communications.

The NHS now has a business ethos. Money rules the roost. Looking after patients who are vulnerable and ill is something very special. We need an NHS that has a caring ethos but with business sense. Trusts are not accountable to local people. The Labour Government made a big mistake abolishing the Community Health Councils. They stood up for the health needs of the local community and gave the providers of health care a hard time when things were not right. They were the local watchdogs of the health service. Bring them back. It is true wisdom to recognise when mistakes have been made and then to correct them.

Turning to our vitally important local issue. I have today written to Secretary of State Alan Johnson setting out the key issues regarding the Interim Reconfiguration proposals and copied the letter to Professor Sir Ara Darzi. I am hoping that this will lead to referral of both Paediatrics and Emergency Surgery to the Independent Reconfiguration Panel. If this happens then I hope the evidence will speak for itself.

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