Speak Up! - It's your health

The Great British Public is known for its civic-mindedness. (As I know much of humanity is).

People such as Tom who often drives the family from home to the hospital and back, is retired and an official volunteer (non-emergency) ambulance driver, unpaid and using his own car, just receiving an expenses-per-mile reimbursement.

There are many such as Tom – who devote their spare time to public and charitable service. They work in charity shops, soup kitchens and night shelters for street-dwellers, St John's Ambulance at public events, shake charity donation bottles on the street on Saturday morning ...

When the July 2005 bombs went off on the London Transport system (both terrestrial and sub-terrestrial), Jane and Joe Public stopped in the middle-of-the-road and went to help.

That is Great British Public.

Over the last two years the “local” Strategic Health Authority and the “local” Acute Care Trust (directly responsible for the local general hospital) have conducted their consultations to “reform” hospital services in the Greater Manchester region. Regardless of what us “punters” said, regardless that we (in one of the most impoverished areas of the UK) didn't want them, the cuts in services at the local general hospital, have gone ahead. No longer will Kezia be diagnosed with leukaemia on a Sunday afternoon at the local general hospital – there will no longer be A&E, paediatric or obstetric services – don't have a baby on the weekend!). We were consulted about “cuts”. Nobody wanted them. We were told to “fuck off”. We were shafted.

Now the local Primary Care Trust wants to consult us. Well, we ain't got much confidence in NHS consultations any more ... our town's citizens must be saying “You've just ignored our opinions in two major consultations – what the fuck is the point of completing another loaded questionnaire, attending another public meeting?” (Sorry, wrong jargon - “Consultation Event” - “see page 14 for further details” – the pdf download has no page nos, there are no details about where exactly and at what time these “Consultation Events” will take place - what the fuck company have they paid to produce this document?) ...

... and I think they realise.

So they are bribing us to complete their biased questionnaire, following Lord Darzi's example.

On offer:

1st, 2nd and 3rd “out-of-the-hat” will be offered either a) Wii and Wii Fit (what the fuck are those?) b) a weekend break for two (where not specified and who's going to look after the kids?) or c) a one year Leisure4Life leisure pass for two (repeat comment on a) plus where can we use it?).

The next hundred “out-of-the-hat” will receive a calendar clock.

We are not told if we will receive a canapee at or even a bus-fare to a “Consultation Event” (so why bother going?).

Such is going on throughout the country.

NuLabour is taking the “Great” out of the British Public.

P.S. for Dr Rant – I'm not as good at expletives as yourself! You should have been struck off long ago!

The Hippocratic or Hypocritical Health Service?

Last year it was decided under the two NHS reviews in the Greater Manchester area ("Making it Better" and "Healthy Futures") to reduce or cut A & E, maternity and paediatric services at our local general hospital.

The final version of the Department of Health's Darzi report "High Quality Care for All" was published in June of this year, and was immediately followed by each Strategic Health Authority (SHA - 2nd tier of the health bureaucracy) publishing its own reform/consultation (Ed: shouldn't that be the other way round?) "strategic plan" within a month - the first appeared about a week after the publication of Darzi's report so they had obviously seen the report and been instructed before the public and Parliament had seen the Darzi report.

Now the SHAs have instructed the Primary Care Trusts (PCTs), Mental Healthcare Trusts, acute care hospital trusts, ambulance trusts etc etc (3rd tier of the health bureaucracy) to produce their own reform/consultation (Ed: shouldn't that be the other way round?) plans pronto.

I am happy my PCT has managed to produce a ("Speak Up, It's Your Health") website with an online questionnaire, a telephone hotline and a paper copy to every house in the borough in such quick time (something in NHS IT works?).

We have until 7 November to give our responses. Obviously not in the diverse linguistic communities of the borough - come on what is the point of putting a pamphlet in English that says "If you want a copy of this pamphlet in Urdu, then write to or telephone ..." through a letter-box in a part of town that is predominantly Urdu-speaking ?

In the last two years the local population clearly expressed its opinion in a community-led campaign "Hands Off Our Hospital" (a theme repeated up and down the country) about proposed cuts in A & E, maternity and paediatric services at our local general hospital. It even went to a final "independent" review. But maternity and paediatric services were 100 % cut and A & E is to become an "Urgent Care Centre". Admittedly, the local hospital is not the responsibility of the Primary Care Trust but another 3rd tier organisation, the Pennine Acute Hospitals Trust ...

I can only assume that they too will produce their reform/consultation plans to be popped through the letter-boxes of our town's confused residents.

What the hell is an "Urgent Care Centre" anyway?

Can it diagnose paediatric leukaemia on a Sunday afternoon?

The Axe Has Fallen

Alan Johnson is determined to make sure that "more services are delivered closer to home".

Thus the Healthy Futures and Making It Better proposals for restructuring health services in the Manchester area have been approved by the Independent Reconfiguration Panel and the Health Secretary himself.

Thus the town of Rochdale will no longer have A & E and maternity services. You can no longer be born in Bury nor Salford.

Reports here and here.

Shame on you Mr Johnson.

Healthy Futures, Making it Better and the IRP - Update

If you recall from earlier posts (here, here, here, here and here), the North West Strategic Health Authority has been planning to “reform” (or “shake up”) the structure of paediatric, maternity and neonatal services across the whole area through the Making It Better proposal and to the healthcare of all in NE Greater Manchester through the Healthy Futures proposals.

(An aside – what the fuck is it with such “trendy” New Labour speak for consultations to be named as “Healthy Futures”? Why not just “A Review of Healthcare in NE Greater Manchester”?).

Our local council protested the recommendations of the proposals, as it will reduce some local services, particularly A&E. Some other councils in the area were also unhappy. As a result, the proposals were sent to the Independent Reconfiguration Panel (IRP), seemingly a non-governmental body of government-paid advisors, that reviews protested health decisions for the Department of Health. The request for IRP review was submitted in Patricia Hewitt´s time (thank you, Patsy, at least you didn´t make a dumb decision this time – but …) and as the submittal date to the DoH was just before her demise and Alan Johnson´s appointment to the Secretary of State for Health post …

The IRP submitted their report on 26 June and was meant to be published (i.e. put in the public domain) on 28 July.

However, the publication of the IRP´s report has been postponed “indefinitely” (quoting a local newspaper report) to give Alan Johnson more time to study its implications.

According to a DoH spokesperson “Given the level of complexity, size and scope contained in the Manchester reconfigurations, the Department of Health would like to understand what plans there are for implementation of any changes and more time to give the matter proper consideration”. (DoH press statement here).

Good on yuh Alan for not making rash decisions – and I am sure you have important things to think about today, 1 August, with the fallout from MTAS and tomorrow or the day after or the day after … with the NHS´s Programme for IT, etc etc.

You have publically committed yourself to send all disputed consultations to the IRP (did Patsy not?). Good on yuh!

However, I am curious as to why the Independent Reconfiguration Panel´s recommendations are not made public before the ministerial decision is made.

Healthy Futures and Making it Better Review

The reviews of the Healthy and Making it Better "reform" programmes by the Independent Reconfiguration Panel were submitted to the Health Secretary yesterday but will not be available on their website for approximately a month.

I'm sure, given George Brown takes over as Prime Minister today and is expected to announce cabinet reshuffles today and tomorrow, we cannot expect an immediate decision.

In related news the local Rochdale MP has criticised the Pennine Acute Trust for publishing a business plan for developing a £3 million children's A & E unit and £25 million maternity unit ant North Manchester Hosiptal ahead of the IRP's review and the health secretary's decision.