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