Wednesday, June 20, 2007

Our Council Fights Back

Since the application for judicial review of the cutting A & E services at our local hospital was rejected on 8 June (posted here), I have learned some more - the SHA is also planning to cut both paediatric and maternity services.

So, on that Sunday a year ago, Kezia would have had neither A & E nor Paediatric!

(Blimey John, we would have had a Nurse Specialist diagnosing her with malaria based on arriving from Africa, on an enlarged spleen, no malaria test available on a Sunday, not believing African doctors and come back tomorrow).

The local council is fighting back!

I know it is politically expedient for local councillors and MPs to focus on local issues, rather than think of the good of a wider region but I think they may have a point in this case.

The council commissioned a report from a health policy expert at the De Montfort University in Leicester to examine the SHA’s Making it Better: Making it Real (Paediatric and Maternity provision) and Healthy Futures (A & E provision) reviews and to evaluate its decisions to downgrade (or should I say degrade?) services provided by our local hospital. And, obviously, since her paymasters were the local council, she gave them what they wanted to hear.

This document has been presented to the DoH’s Independent Reconfiguration Panel (IRP), reporting to the Health Secretary, by 26 June. The IRP is basically the last line of defense before our Health Secretary makes critical decisions about changes to the National Health Service.

I am wading through the expert’s report … and will certainly post more on it.

But just some quick observations …

In our post on Monday about translation/interpreting services, our SHA (which I noted was positive about the necessity of good translation (sic) provision) highlighted the problems that non-native speakers of English (either for cultural and/or linguistic reasons) might have accessing local public transport systems and that access to familiar local hospitals improved access rates.

We live in a borough with a high proportion of ethnic minorities.

The SHA has paid lip service to the impediments faced by ethnic minorities travelling on public transport. The SHA’s transportation data is based only on ambulance times between hospitals, not on public transport availability and times – so in-patients who do not need ambulance transport and visitors without private transport (33.4% for our local authority according to the 2001 census, above both the national and SHA’s average) have not been taken into account.

I remember very well taking 2 ½ hours one way to travel by public transport the 14 miles from the RMCH to our future home – a bus journey from the hospital to the centre of Manchester, a 20 minute walk from Piccadilly to Manchester Victoria railway station, a half-hour wait at Victoria, a half-hour rail journey, wait for a bus from the destination railway station to the town centre, another bus journey to our future home. And return. Five hours total … and that was with no treatment involved.

Two children in tow, one with leukaemia, not speaking English …

Even now, Nanda is not confident enough to catch a train into Manchester … but, hey, she is confident enough to administer chemotherapy and deal with the RMCH! Good on her!

Clearly, the transport times involved are not as lengthy between us and the RMCH and Lucia and the RMCH. On occasion, when Lucia has needed emergency admission during her treatment for ALL, the always-consulted RMCH has allowed her to be treated at her local Blackpool general hospital. I don’t know the facilities at this hospital compared to our own local hospital, but I’m sure she received adequate treatment and I imagine our local hospital would as well … but I imagine the RMCH makes decisions about distance, time, transport/ambulance availability, clinical need and, I hope, ethnic minority needs (language, availability of Languageline at night etc … do they follow a protocol or does the duty doctor, or even the on-duty nurse make a judgement?).

Yet the SHA recommends cutting services at the local hospital, obliging both native and non-native speakers of English to travel further afield on ropey public transport systems to seek essential healthcare.

The government claims to be increasing patient choice, yet it is cutting services at our local hospital. Limiting choice.

Thank you to our local hospital for having A & E and paediatric services. Thank you to my brother for not being part of the 33.4% - I cannot imagine travelling 14 miles on public transport on a Sunday after 36 hours travel time with my leukaemic daughter – and thank you NHS/RMCH, in spite of everything you are up against, for all you are doing for us!

Patricia Hewitt and Ruth Kelly – up yours!

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