Speechless

I bumped into one of my colleagues on the way in to work this morning, a good, hardworking , caring consultant. I asked him how he was, and he replied that he was "speechless with rage" at the destruction of the NHS.

I understand exactly how he feels; the NHS is being sacrified to the vanity of politicians who would be incapable of running a whelk stall, let alone a country. But now is not the time to be speechless. If you care about the NHS now is the time to speak up loud and clear, not least by continuing to support the Save Bedford Hospital party.

Prison problems

The problems of the Home Office and of our prisons being at bursting point have been prominently featured in the news over the past few days. The prison population has never been higher and yet there isn't space for those convicted of serious crimes. What's going on?

Bedford has a large prison located in the centre of the town. I have been there on a number of occassions to see patients, and I regularly communicate with the prison medical team. It is clear that many of those in prison have major mental health problems, and frequently end up behind bars because of the almost complete collapse of the NHS psychiatric service. Mental health has always been an easy target for cuts because it is not something which people speak out about.

Prison is no place for those with severe mental illness; proper provision of secure psychiatric care would cut the prison problem at a stroke, and allow the prison service to do its job properly.

Why are we waiting?

The government seems happy to justify all the turmoil that is going on in the NHS by pointing to the fact that no one is supposed to wait more than six months for an operation.

But what if you are waiting for something else?

According to figures published on the Department of Health's own web site (www.doh.gov.uk) , over 80,000 people have been waiting more than six months for an audiology assessment (hearing test) and many thousands of others are waiting more than six months for other important tests such as echocardiograms, colonoscopies, etc. Of course some people can't even get on to a waiting list for an operation until their tests have been done.

What's all the fuss about?

The news is full of stories of funny goings on in high places, in relation to funding of political parties. Were honours sold in exchange for party funding? No doubt we will find out in due course, but the question remains as to why political parties think that they need so much money.

Save Bedford Hospital has been run with minimal financial input. It costs £150 to register a party with the Electoral Commission, nothing to set up a web site, and nothing to e-mail out our press releases. When an election comes we will have to pay for printing leaflets and posters and to hire a few halls for public meetings,and we will need £500 as a refundable deposit; that should cover things adequately.

So, to repeat myself, why do parties think they need huge sums of money from wealthy donors, and do they really think that these people give away their money with no strings attached?

Do you believe politicians?

Do you believe what politicians tell us? You don't have to answer.

In 2004 there was a parliamentary by-election in Hartlepool. Mr Blair said at the time that there was no question of the local hospital closing.

Now, less than three years later, the closure of the hospital has been announced. I know nothing of the local circumstances, and perhaps closure is the right option, but it does explain my cynicism when Patricia Hewitt and others tell us that there is no question of Bedford Hospital closing.

Where's the money gone?

What is happening to the vast sums of money being spent by the NHS, and why is so little of it available for patient care?

I was glancing through the annual report of the NPSA, the government agency which is responsible for the safety of medical equipment, and noticed that they employ a "Director of Patient Experience" at a salary in the range £90-95,000 per annum.

Meanwhile, at Bedford, we haven't got the money to replace the retiring consultant in charge of the stroke unit.

connecting for health?(again)

CfH is the government's much vaunted computer system for the NHS. It is already massively over budget and years behind schedule, and many of us believe that it will never work.

Today I received an e-mail inviting me to a major national conference on CfH to be held in Birmingham on 1st February. There is only one small problem, which is that consultants are not allowed to cancel clinical work with less than six weeks notice, so no one who actually sees patients will be able to go.

Keep watching

I will be appearing on Anglia Television this Thursday at 11.30p.m in their politics programme. I was interviewed today, and I understand that they will be talking to Patrick Hall tomorrow.

If you live in the East of England, do please watch (even if it's past your normal bed time).

Gathering momentum

Our campaign in Bedford, although it was triggered by local issues, was never intended to be totally parochial. The issues that face us in Bedford are nearly universal in the NHS.

This week I have been contacted (separately) by two doctors who are considering launching similar local campaigns. Going public is a major (and irreversible) step, but when they are ready you will be able to read all about them on this web site.

If there is anyone else who might be thinking about standing for election but who wants to talk things through first, please do feel free to contact me and I will be sure to maintain confidentiality until you choose to make an announcement.

Where's the money gone?

We are told that record amounts of money are being spent on the NHS, but is it being spent on patient care.

I am grateful to the BBC for this report from a cash-strapped NHS Trust in Sussex:


An MP has criticised a £243,000 pay-off to an NHS director who worked for a debt-ridden trust for three weeks.

The settlement was revealed in East Sussex Downs and Weald Primary Care Trust's annual report for 2005-2006.

The payment included a confidentiality clause, but Norman Baker, Liberal Democrat MP for Lewes, said the recipient was a Dr Iheadi Onwukwe.

The NHS trust said the legal settlement was properly agreed by its own board and the Department of Health.

The MP said Dr Onwukwe was put on gardening leave for two-and-a-half years, after working for just three weeks as director of public health at Eastbourne Downs Primary Care Trust (now merged into the new East Sussex Downs and Weald PCT).

He said there had been a dispute with a senior colleague, and the doctor eventually left his post in May 2005.

'Loss of office'

Mr Baker said the payout, at a time when Eastbourne Downs PCT was £4.6m in debt, was a "grotesque waste of money".

"It's unbelievable that someone who was only in a post for three weeks should be paid nearly a quarter of a million pounds to go away," he said.

Gosh

Since the Save Bedford Hospital campaign started I have received tremendous support from my medical colleagues, nursing staff, porters, secretaries, and patients. I do, however, appreciate that I have put our senior managers in a rather awkward position.

So it was all the more pleasing to be approached today by a senior manager in the hospital who thanked me for my campaign: just for once I was lost for words.

Riding for charity

My friend and colleague Dr Rob Oakley is in training for a charity cycle ride from Land's End to John O'Groats raising money for the hospital charity and the Sports Foundation. He has agreed to wear a Save Bedford Hospital T shirt in exchange for my sponsoring him, so our message is going to be carried from one end of the country to the other.

Contact Rob (via Bedford Hospital) if you want to support him

Media stardom!

I seem to be in demand: yesterday I gave an interview for Anglia News and Chiltern Radio. Today I was live on BBC Three Counties radio, and was phoned by Bedfordshire Times and Citizen. I have also been signed up for Channel Four's "Dispatches" . I'll post details of the programme when I have some more information.

What was he about to say?

Bedford Hospital was mentioned once again in the House of Commons today in questions to the health minister, Andy Burnham.

What is most interesting is what he nearly said: I quote verbatim from Hansard

Andy Burnham: I pay tribute to my hon. Friend because he has supported and encouraged his NHS to make the kind of progress that he has described. The NHS in his constituency is making progress towards the 18-week target, as is the NHS in other constituencies throughout the country. Instead of celebrating the hard work of managers and staff in his area to make such improvements, Conservative Members simply decry their efforts and demoralise staff by making exaggerated claims of the difficulties. We hear talk of a save Bedford—

Mr. Speaker: Order.

What was he about to say about my campaign before the speaker cut him short?

What a surprise

Four wards at Bedford Hospital lie empty because there is no money to staff them.

Yesterday, all elective surgery was cancelled at the hospital - because there were no beds for the patients. What a surprise.

(Oh, and by the way, another ward is to be shut later this month)

Beyond a joke

What do you do if your hospital is £12million in debt and cannot afford to replace vital clinical staff?

Well, if you're Bedford Hospital you have yet another management reorganization and create even more management posts - a "director of corporate support services" (whatever that may be) and a "chief information officer".

Perhaps one day the penny will drop that hospitals exist to treat patients; you can rearrange the paperclips as often as you like, but without doctors and nurses in post hospitals simply don't function.

Evidence based management

Evidence based medicine is a cornerstone of clinical practice. However, when it comes to management in the NHS, different rules apply.

The Department of Health recently commissioned a research study into patients' attitudes to choice: "patient choice" is the entire basis for the DoH's expensive and ill-judged folly called "Choose and Book". Unfortunately, the study didn't show what the DoH wanted; quite the contrary, it clearly indicated that patients by and large wanted GPs to make the difficult choices for them. In other words, they trusted the judgement of their GPs, so C and B wasn't really needed.

The research study was posted on the DoH website, but of course when they realized that doctors were not only reading it, but quoting it back to them, the posting was withdrawn, and the conclusions of the research disappeared into cyberspace.

A fuller version of the story appears in The Guardian, this is the link

http://politics.guardian.co.uk/publicservices/story/0,,1980852,00.html