Don’t trust the Conservatives with the NHS

As anyone who knows me will tell you, I am a passionate supporter of the NHS. I absolutely believe in high quality local medical facilities. The  NHS has always been incredibly complex but has been made even more so by the “people upstairs” and it is making it very difficult for even experts to know what’s going on, let alone the man or woman in the street. Therefore I apologise in advance for the long and detailed post but I hope it helps explain the situation.

In summary

• The ordinary person wants local resources easily accessible. In Woking we have a wonderful community hospital and we need to protect it.
• I have been working on this for a long time
• I have brought the PCT and SCC to task on behalf of local people on many occasions
• The public have a right to a say in how the NHS is run
• No one would have blinked an eye about any of this if I had not made such a nuisance
• The NHS has been ruined by both Labour and Conservatives
• I don’t trust any of them and they will try and hide behind the recession and carry on dismantling the NHS out of existence which is what they wanted all along

Community Hospital Beds

There has been recent local press coverage in relation to the future of  Community Hospital Beds here and here.This is something I have spoken on extensively as a Member of Surrey County Council’s Health Overview and Scrutiny Committee (HOSC) over the past 18 months, The HOSC has extensive powers of scrutiny and indeed can refer to the Secretary Of State. This is the one avenue open to the public, through their elected representatives, to influence in any way what happens to the NHS. It replaced the former Community Health Councils which were very effective advocates over many years.

My concern is about the immediate situation and how it may affect Woking Community Hospital. This triggered my request to Woking Borough Council’s Scrutiny Committee, last October, to invite the Primary Care Trust along to give Woking Councillors an update. All Councillors were invited because of the importance of the issue to Woking residents.They attended the February meeting.

For the record I covered two distinct issues at this meeting :-

1. An explanation as to the status of the beds at Woking in the light of the closure of a ward of 20 beds at Walton Community Hospital  which I had referred to the Health Scrutiny Committee back in October. The PCT were insistent at the time that this was a management responsibility and that beds are “flexed up and flexed” down depending on pressures and “operational resources”. The representative  was unable to answer my question in relation to Woking even though the PCT had a month’s notice that the questions about the Woking Community Hospital would be asked. I asked her to confirm  that there were face to face discussions talking place between the Chief Executives of Ashford St Peters and the Surrey PCT about the Acute Trust acquiring beds at Woking to relieve the pressure on acute beds at St Peters.The Committee were told that the discussions were taking place and gave an undertaking that a responses would be sent in writing after the meeting. I asked for clarification about the status for referral by local GPs and what arrangements would be made for them to continue referring their patients to Woking Community Hospital if the arrangements goes ahead.
2. Another matter of concern for me was that there had been a Rapid Access Pilot Scheme set up by the PCT at Woking Community Hospital for two years in August and it had been brought to my attention that the pilot had stopped after three months as the PCT did not consider it “cost effective”. Yet this service was available to local GPs who had elderly ill patients who needed medical assessment, some of these patients have complex underlying health problems and a range of medical conditions. The main benefit of this service was that it avoided referral to A&E or the Emergency Medical Assessment Unit at St Peters. The patients could be seen locally by a Consultant, have all the tests they required at the same time in the same place on the same day with the results available to the Consultant to interpret quickly. An appropriate referral could then take place either to the acute hospital or indeed the Community Hospital depending on the clinical need. This avoids patients being sent to a range of different locations, on different days for blood tests, x-rays etc with the risk of a longer wait before the Consultant got sight of the results or indeed the results getting lost. Added to that there is the cost to the patient and their carer of transport and effort in trying to attend all those different appointments. Again we were told that this would be outlined in the feedback as the representative did not have the answer.

Follow Up

Having not had that feedback, a week later, I raised these matters again, this time at the HOSC during a  discussion on Community Hospitals.

It all started with Cranleigh Community Hospital Beds many years ago with local people in Cranleigh campaigning hard and indeed raising money towards new Community Hospital Beds ever since the local hospital was closed. The matter has come before the HOSC many times with local people trying hard to argue for a new replacement hospital. In effect the Cranleigh Village Hospital Association have fought tooth and nail for their local hospital

I was surprised  that when I spoke up for Cranleigh at the HOSE and expressed my clear intention to vote against any proposal by the PCT to permanently close Community Hospital Beds that  I was the only one voting clearly against and would have at least expected the County Councillor for Cranleigh, who happens to be the Tory parliamentary candidate for Woking, and present at that meeting, to do the same. There was also a suggestion from the floor that even though the PCT model of care was deemed acceptable for Cranleigh it would not necessarily be suitable for the rest of Surrey.  Fine words were uttered and recognition of the value to patients, how local people were “pragmatic” and how money for the NHS was tight but no one else was bold enough to say NO. It was interesting that this meeting was held on the 14th January but the PCT Board had already decided to close the beds at their meeting on the 12th January. The plan in Cranleigh is to provide home care and for the PCT to purchase Nursing Home Beds as and when required for those not able to cope at home. Local people, having lost the fight now want to have 6-8 beds locally so that people can be referred to one place. This was put as an amendment with no explanation or no advice as to how it would work. My main concern was about what that exactly means. Who takes responsibility for those beds, in terms of qualified staff in particular, is a big question. Could we get a hybrid which is something between a care home and a Community Hospital with limited nursing care , no access to physio and no indication as to who would take medical responsibility , especially out of hours. Cranleigh is a rural area and transport must be a real problem for older people in particular. It was interesting to note that in the presentation at Woking it was stated that there are more admissions to the acute sector from Nursing Homes with many patients then not suitable to be sent back, hence my argument for the need for Community Hospital Beds

Over the past 6 months we have heard of the 20 beds being “ flexed up and down” at Walton (in effect the ward remains closed), Haslemere had a ward closed in December so that a shower could be fitted, and it is still closed. Milford has 6 beds affected by the flexing . Other areas in Surrey have similar stories.

The answers I have had to specific questions I have asked about Woking both to Surrey NHS and Surrey Community PCT is that Woking is thriving, all beds have been fully utilised over the last 6 months and there are no plans to change that.

I will keep asking the questions and following up answers to the questions I asked about abandoning the assessment pilot. Surely three months is not enough time to come to a conclusion about what was to be a two year pilot, hardly enough time “to tick the boxes”. The problem is our NHS is fragmented and shattered. The language used is bureaucratic and confusing for patients, (relatives of patients at Walton were bemused by the phrase flexing up and flexing down) consultation is patchy and was certainly non existent with relatives when the Walton beds closed . My final point to the HOSC was that if all the beds have been utilized at Woking over the last 6 months and that a solution is being explored for the Acute Trust to take on Community Hospital Beds to relieve the pressure for acute beds why is this approach not being explored for villages in the Royal Surrey catchment area. Is it not essential to take an approach like this for the needs of patients in rural areas like Cranleigh , Milford,  and Haslemere where transport links are poor and expensive.

Not that long ago we had a fight on our hands trying to save local A&E Services. Woking sits between St Peters and the Royal Surrey. The fact that the issue went away was more about the imminent General Election is my view. I attended a briefing referred to as “The Storm” which made much of the huge financial problems in store for the NHS and that there should be no doubt that this issue will be revisited again. With that in mind and the proposed £18m deficit facing the PCT reported at its12th January Board meetin, is it really the right time to even consider closing any Community Hospital Beds? We may well need them and once they are gone we will not get them back. Apart from the impact on patients the big losers here will be Carers, many of them older themselves with their own complex health needs left to care 24 hours a day. Yes they will have visits from health care professionals but the care is required for 24 hours and things go wrong, emergencies happen, quite often in the middle of the night and over a long weekend, Equipment will be needed to support people at home, that involves cost and a wait while it is ordered. No mention has ever been made about how the out of hours service will be handled.

The PCT decision to announce the permanent closure of the 14 beds at Cranleigh casts doubt in all our minds in relation to the future of all the other Community Hospital Beds across Surrey. We need to keep a keen eye on what happens as the danger lies in picking them off area by area.

Yes the PCT can argue that they do not get enough money from the Government and that the recession will hit the NHS hard. The trouble is that there is very little meaningful public interaction.

I do not believe that the Conservatives really understand the concept of the NHS either. The rot set in when they were last in Government. They started the fragmentation of the NHS and new blue Labour under Tony Blair were only too pleased to pick up the ball and run with it. So no matter how many times they appear in pictures or spin statements, the bottom line has to be the NHS will never be safe with them. Mr. Lord has suggested we should allow the PCT to come up with ideas and he would like to hear of ideas from Scandinavian Countries and we should let them be creative. Daniel Hannon, Conservative MEP for the South East advises the Republicans on how to oppose healthcare measures in the US stating that the NHS was a” 60 year experiment gone wrong.”

Interestingly, under matters arising at the last meeting  I politely asked the Chairman of the HOSC what the process was to make sure my vote against the closure of the Community Hospital Beds was recorded. I was advised that this would be checked. The Chairman has since sent me a formal letter confirming how I voted on the issues but it cannot be minuted as I did not ask for that at the time.  At a previous meeting I asked about the procedure for referring the decision made by  the PCT to permanently close the Cranleigh beds on the 12th January to the Secretary of State. I was informed that it was a matter for the Committee. As I was the only one voting against and no one else on the Committee picked it up I was on my own.

Six months earlier I also asked the committee why the proposed closure could not be referred to the Secretary of State and was informed it was up to the Cranleigh Village Association to take that step.

There is no doubt that looking after our older population will be a challenge in years to come. Surrey County Council were named in November as one of eight Councils who failed  the elderly. Personally I was disappointed when the Conservatives refused to join a cross party meeting called by the Prime Minister recently on provision of free personal care. Whilst I could say “why did he not do this months /years ago”, the issue is so fundamental to our society that this is one issue where political differences should be put aside and cross party working set up to address the problems. It is the very least we could  do for our older generation and why I really do not trust the Conservatives with the NHS.