Wednesday, January 09, 2008

The Latest Propaganda on TOWARDS 2010

I have been looking at the publication "Towards 2010" circulated to all staff by the SWBH Trust. On the front page it says that "local NHS staff believe care should be provided as close to home as possible." I think they must be talking about local health care managers who are doing as they are bid by government. I have not met many NHS medical or nursing staff who believe this to be true. I have not met many patients who believe this to be true either.

Apparently "we (the Trust in partnership with the Heart of Birmingham PCT, Sandwell Council and Birmingham Council) will help people to stay healthy, stop smoking and adopt healthier lifestyles." It sounds miraculous, it sounds too good to be true. Indeed if you examine the evidence for achieving these goals in the long-term others have failed where our crusaders hope to succeed.

There will be new larger health centres. GPs will be brought together into larger health centres offering a wider range of services with social care and other community services.

What do the existing local GPs think of these plans? Have they been consulted? What does the Birmingham Local Medical Committe think? Having spoken to a key person in that organisation the answer is--not a lot.

There are to be Community Diagnostic Services delivered from Community Hospitals so that most people could have tests done without travelling to a specialist hospital. It sounds nice, so convenient. However any sensible person must realise that for every advantage in this life there is a disadvantage. The more diagnostic services that you have divided up in different places the higher the cost. This may mean that the state-of-the-art specialist hospital has a distinctly less state-of-the-art X-ray Department than it should have.

There is to be more active involvement with people who have a long-term health condition to help them maintain independence, using telecare and rapid response teams to deal with crises locally. What can this mean? Does it make sense? Can anybody tell me what contribution telecare is going to have? Perhaps it means that fragile immobile people will have cameras in their homes so that when they collapse or fall over somebody watching the big screen can report it to somebody? This country already has more cameras watching every aspect of life from speeding to walking down the street and possibly in the future you will not be able to be seriously ill in private.

What about outpatients? This is very simple. Most outpatient appointments and specialist consultations will be provided in local communities. Why? Have the patients asked for it? NO. Will it provide better care? No evidence to support that contention. Will it train the doctors of tomorrow better? Definitely not. Will it destroy consultant led care as we have known it in the UK. It sure will.

Latest techniques. It says that they will use the latest techniques to ensure people recover quickly and need to spend less time in hospital. Are we using the latest PROVEN techniques now to get people better quickly? You bet, all doctors want their patients to get better as quickly as possible not to cut the number of beds, not to save money although that is important but first and foremost because it is good for patients.

Intermediate care. Where is that going to be provided? Oh yes in the community along with everything else. Who will medically supervise all this community care. Will it be the GPs? Will it be the Consultants? This is an important issue. The old community hospitals were a complete disaster. Mostly they were primary care beds. Patients tended to get neglected and overlooked and were often admitted to hospital to have things properly sorted out.

On the front page of this paper there are eight headings before we reach the last one about the new hospital. Does that tell you anything?

What will happen to the City Hospital site? The Birmingham Treatment Centre will carry on as normal. The Birmingham and Midland Eye Centre building will form the core of the new community hospital. The Sheldon Block may also be kept as part of that new facility. The rest of the site will be sold for redevelopment. Birmingham will lose the enormous expertise concentrated in the present Birmingham Eye Hospital, what a waste, what bad news for the people of Birmingham.

It has to be complete madness to give up prime NHS land in a prime very convenient site for the people of West Birmingham to have their hospital only to go and buy more land a mile down the road to build another hospital. Where is the sense? Especially as inpatient Children's services and inpatient Emergency Surgical beds are being lost years ahead of any new hospital.

There has to be very serious doubts about whether the new hospital will ever happen. All we have at the moment is an aspiration and a lot of very hot air.

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