Sunday, 31 December 2006
Many of the problems which face Bedford are far from being unique: I hear tales of woe from all over the country, and on January 10th I am speaking to the Ipswich Medical Society. If you are a doctor and live in that part of the world, do try to come along.
In the meantime, I wish you all a happy new year
Friday, 29 December 2006
About four weeks ago, senior managers at Bedford Hospital, a former three star NHS Trust, now labouring under crippling debts, were called in by the East of England Strategic Health Authority for a dressing down. The message was unambiguous – they were not being sufficiently radical in closing services in a vain attempt to balance the books; having four wards shut (and another to go in January), over a hundred unfilled vacancies, and one in seven of the workforce on redundancy notices was not sufficient.
One particular reason for the SHA’s ire was the discomfiture being generated by the Save Bedford Campaign, and its vociferous leader, consultant dermatologist Dr Barry Monk. His campaign was first launched on 17th September amidst a storm of publicity. Health minister, Patricia Hewitt, accompanied by the chief Executive of the NHS David Nicholson, visited Bedford in an attempt to damp down concerns. Their visit was not an unmitigated success. Later that month, The Guardian described Bedford as Patricia Hewitt’s “worst nightmare”, and the BBC’s Politics Show said that the local Labour MP, Patrick Hall, defending a majority of just over 3000, was “a dead man walking”.
Clearly then, the SHA, no doubt under instructions from the Department of Health, expected something appropriate to be done to remedy the situation. So now Bedford Hospital has done what expected of it, and in a document entitled “Defining Our Future Role” have indicated that Dr Monk’s highly regarded department is not required.
Dr Monk commented “ the dermatology department at Bedford Hospital deals with patients who are affected by severe skin disorders which cannot be adequately managed in the community; we are highly regarded by our patients, and by our local GPs, we meet every government target, and we actually generate income for the Trust., so one an only speculate as what motivates these proposals.”
He continued “in the NHS we have become used to irrational decision making, but when personal spite is allowed to intrude, something has gone very seriously wrong.”
Dr Monk is undeterred; indeed his campaign to obtain proper local provision of healthcare for the people of Bedford is being carried forward with renewed vigour.
A GP colleague of mine has just had a letter from "The Directorate of Communication and Stakeholder Engagement, NHS Connecting for Health".
It goes without saying that the content of the letter was entirely unhelpful.
Thursday, 28 December 2006
Better information for health where and when it's needed
This is a fine sentiment, but how does it work in practice? I am grateful for today's Independent newspaper for this response to an enquiry made under the Freedom of Information Act:
Q. Can we see the report into the links between MRSA rates and bed occupancy written by the Department of Health's chief economic adviser?
A. This would be detrimental to the future formulation of government policy.
So much for better information where and when it's needed; so much for Freedom of Information.
"The increased financial scrutiny required by the review process and put in place through the HHCT financial strategy has highlighted further errors connected to the central return for payment by results transition. We are now able to report that the error, previously reported at £6.5million, is in the region of £11million. This is disappointing"
If someone had mislaid £11million of my money I would find it more than "disappointing" but I suppose NHS managers work by different criteria than the rest of us.
Three months ago, when I first drew the plight of Bedford Hospital to public attention, I hoped that by doing so I would encourage debate on the very real challenges that the NHS faces locally. I also thought that we might get some action that would give us optimism for the future of the hospital.
Sadly, the situation goes from bad to worse. Bedford Hospital’s debts are now projected to be some £12million by the end of the financial year. This sum includes a new surcharge of £500,000 which is being levied by the Eastern Regional Strategic Health Authority (SHA) as our contribution to helping out other hospitals in the region which are in an even greater financial plight. The SHA have told all Trusts in the region that balancing the books is to be the number one priority, apparently regardless of the consequences on patient care.
Currently in addition to some 100 posts that are vacant and “frozen”, one in seven of the staff are facing redundancy notices. The effect on morale can only be imagined. Four wards remain shut, and a further (surgical) ward is earmarked for closure in January. Major cuts are also being made in the budget for training our junior doctors (the specialists of the future) and educational courses that are an essential part of their training are no longer being funded. Cuts in the training budget for next year are likely to involve the salaries of four junior doctors, so these posts will also be lost.
The new financial year begins, for the NHS, appropriately enough, on 1st April, less that four months time. We know that the hospital will enter the new year with an enormous financial millstone around its neck, but to date we still have no idea what the hospital’s income will be, making it impossible to plan accordingly. What we do know it that the Department of Health are encouraging the purchasers of services to divert money away from hospitals. Locally this may well result in a further reduction of up to £5million from the hospital’s budget; the consequences of this do not bear thinking about.
Now, surely, is the time to stop playing political games with valued hospitals such as Bedford. We need a properly financed and resourced local hospital for the proper care of our local residents. It is what they deserve.
Sunday, 24 December 2006
It has been a busy time. There has been coverage on local and national television, an appearance on Radio4's Today programme, and Radio 5's Drive Time, interviews on local radio, and write ups in the Daily Mail, Daily Telegraph and the Birmingham Post. The Guardian described me as "Patricia Hewitt's worst nightmare". We have had coverage in Private Eye magazine and on numerous websites. Hardly a week goes by without the campaign featuring prominently in our local newspapers Bedfordshire on Sunday and the Bedfordshire Times and Citizen.
We have had enormous support from staff at Bedford Hospital, local GPs, and patients and relatives. There has also been tremendous support from NHS professionals in every part of the UK. The campaign has clearly touched a chord, and many hospitals face similar difficulties. Last month I gave a talk to doctors in Hitchin and in January I am talking in Ipswich, where the local hospital has grave financial problems.
The campaign is not a one man band. "Save Bedford Hospital" is now a political party registered with the Electoral Commission. At the next general election we will be standing in the Bedford parliamentary constituency, and standing with every intention of winning. I will let you all know how you can help.
This is my first venture on to a web site. I am not the world's greatest expert on computers, so please show some forebearance. I hope to keep you update on the campaign, but in the meantime, please have a restful holiday break.