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Bonkers Blog October 2013

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1 October (Part 1) - Healthy debate. Councillors perform lobotomy on NHS

Leader While waiting to see if the public was to be allowed into a public meeting last Tuesday evening one of the more approachable councillors indicated he wasn’t feeling 100% but couldn’t get a doctor’s appointment. Join the club I thought and it proved to be a bit of a theme for the evening; five or six councillors made the same complaint.

Today marks the first day of Oxleas NHS Trust taking over Bexley’s health services. There will be just two NHS managed premises in Bexley, the old Sidcup Hospital and the half forgotten ‘cottage hospital’ in Erith which gets a new lease of life.

I missed the first eight minutes of the Health Overview and Scrutiny Committee meeting because I was at the Top Management Review Panel in the Board Room - for a couple of minutes until they went into secret session anyway. By the time I got into the Council Chamber, David Sturgeon from NHS England had just drawn his presentation to a close and was facing questions. Councillor John Davey suggested that smaller organisations were more likely to pick up local problems than big ones. Mr. Sturgeon had presumably been extolling the virtues of ‘going big’. He agreed with councillor Davey that “that is a challenge” - as if the NHS has not got enough of those already.

Mr. Sturgeon was not the only NHS presence, far from it. There were three ladies two of whom were called Sarah and because the name plates are not visible from the public gallery I am not going to attempt to distinguish between them here. Suffice to say that if you thought Mid Staffordshire NHS Foundation Trust and Daily Mail headlines have the monopoly on poor NHS managers then you really should have been in Bexley’s council chamber a week ago.

Councillor June Slaughter asked “What are the specialised services and why are they commissioned directly by NHS England?” “Because they are the low volume, highly specialised ones” came the answer. Well you’d never have guessed that.

Councillor Eileen Pallen complained that GPs do not offer appointments within a reasonable time and was brushed off with the answer that they are all subject to quarterly review. I wonder how that accounts for people like me who have been known to give up and in one recent case go to A&E instead? Chairman councillor Ross Downing made the same point. She said that Bexley had a very poor ratio of GPs to residents and when they get no response go to the urgent care services. She said she had also heard that some people have been removed from a GP’s list because their treatment was too expensive. This was said to be “not normal”. We learned that in Bexley all GPs have an ‘open list’ which means that catchment area is the only valid restriction.

Councillor Gill MacDonald (Labour) said that she never gets to see a GP only a practice nurse and was told there are no limits on the number of patients any single GP can take on. Councillor Roy Ashmole observed that many Bexley doctors practice in converted houses and space is a problem. He was told that London has historically had a lot of single handed GPs and they typically have lists of 1,500 to 2,000 patients.

Councillor Peter Catterall said that in his experience you’ll never see your own doctor, at best a locum. I think I see a pattern developing here. He was told that there are no KPIs on this. (Key Performance Indicators.) One of the Sarahs said that patients who don’t like it should change doctors. It was about the third time that the NHS representatives had come up with that lame answer.

ServicesThere was then an argument over a suggestion that Haematology is leaving Queen Mary’s and going to the Princess Royal in Bromley, that the Paediatric Assessment Unit was suffering clinical safety issues, overnight Elective Surgery is going to Lewisham and Hydrotherapy to Darenth Valley. It would appear that there is no smoke without fire but it was denied that Diabetes care was going and Hydrotherapy facilities will remain at Sidcup although it was acknowledged that Darenth Valley was better equipped. So presumably we can guess what might come next. The current closure of Sidcup’s Hydrotherapy pool is apparently only temporary due to a fault.

Councillor Pallen questioned the very recently announced closure of the Crayford Walk-In Centre and the suggestion that people would be happy to go to Erith Hospital instead when it is turned into an Urgent Care Centre. No doctors, just nurses in charge of diagnostic equipment is the plan. No one seemed to be over-impressed by that or the suggestion that walk-in clients should go back to their GPs.

Councillors showed signs of becoming impatient with the NHS managers and whilst managers might be able to pull the wool over councillors’ eyes on medical matters, on the subject of bus routes they were less of a pushover. The NHS report claimed a bus ride from Crayford to Erith Hospital would take only twelve minutes. This ridiculous figure was in danger of discrediting the NHS’s report to the council totally. There is no direct bus service and last time I found myself stuck in Crayford - late in the evening it is true - buses ran hourly. At any time you’d have to change in Bexleyheath, wait for the 10-15 minute interval 229 and sit on it for ten minutes, more if there is a driver swap at the garage, followed by a five minute walk. The NHS report said that Crayford to Sidcup would be 22 minutes. Again there is no direct bus service to the hospital. The 492 almost gets there in a scheduled 43 minutes, but for the infirm it’s still quite a long walk from Sidcup town centre. Was the projected saving of £1·4 million an equally flawed figure? (†)

Councillor Pallen thought the whole report “feels very very rushed” and was told by the cream of local NHS management that “we have to move quickly”.

Magazine extractThe normally mild mannered councillor James Hunt reminded us that NHS reports, and he specifically referred to the one on A&E closures, were “cobblers”, “absolute rubbish” and “a pack of lies”. Patients would not now be going to Crayford if it was convenient and possible for them to go their GPs. “Quite frankly” he said, “I would like to see this stopped. How many local GPs were consulted?” He repeated the word of the moment, cobblers.

James was told “it would be wrong to stop it”. Sarah had spoken, her word was law. He was reminded that a walk-in centre is not an A&E and then Sarah Something complained about his language. Chairman Downing mildly rebuked James and he apologised for his reference to shoe menders.

Next, councillor Stefano Borella (Labour) launched his attack during which he suggested the Crayford to Erith train might be a better bet than a bus. Stefano may have forgotten that it runs at half hour intervals and not in the evening or on Sunday but it is not such a bad idea at other times. Councillor John Davey agreed with the many concerns. He thought it would “potentially increase the number in A&E” and reminded us of the law of unintended consequences. Councillor Slaughter was not to be left out of the fray. “What annoys is changes to services with no one having a say. Residents deserve better”.

Cllr. AshmoleThe inoffensive councillor Roy Ashmole raised the temperature further. “I am not going to say that what we have now is wonderful but I’m not convinced that this plan is either. New strategic plans come one after another” and he implied they had all failed, “and this is not a strategic plan, it is not even costed”. The NHS reference to Sidcup as ‘a hub’ and Erith as ‘a spoke’ is “all gobbledegook”. He said he was “very upset about the plan and this is not the answer”. Referring to James Hunt’s use of the word cobblers he said that was a mild description compared to the one he was tempted to use. To mark his confidence in the new system that starts today, he said that if he had sick children he would just call 999.

So this is what councillors actually think about the scheme which council leader Teresa O’Neill has splashed across the cover and two pages of the Autumn 2013 Bexley Magazine. The truth is rather different from her version of events but almost no one will know because attendance at the meeting was three members of the public, the News Shopper reporter and me. By soon after the half way stage I was the only sucker left in situ. My guess is that the NS man had his story with the first use of the word cobblers and, in possession of more sense than me, duly scarpered.

On the plus side, Bexley councillors now know what they have to do to appear to be super intelligent and masters of their brief; invite along some managers from the NHS. The two Sarahs, by the way, were Valentine and Blow. While Bexley council disallows photography with zoom lenses and addresses guests only by their first names, more positive identification must remain a forlorn hope.

† Isn't this Crayford Erith business a bit academic? Surely Erith due to its more central situation will just pick up a different clientele? The move will likely please as many people as it annoys.
NHS England was due to deliver its report on a new GP surgery for Crayford the day after the Health Committee meeting. It confirmed that it would go ahead by December 2014.


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