Getting the wheelchair you need

After several hours of angst at Friday surgery – it is pretty draining sometimes – I go off to the Bernie Grant Centre to give a speech on Primary Health Care in the borough. This event is hosted by Camidoc – who are the current providers of Out of Hours Service (OOHS) in ours and three other boroughs.

Their contract has just been extended to September ’09 – but this service will be up for tender at that point. My fear is that Haringey Primary Care Trust will use a private provider – perhaps some big company – that has no local base and no local experience. I can’t endorse any provider myself – obviously – but I will say that I have used Camidoc extensively (given my children seemingly only ever tell me they are ill as the doctor’s surgery closes on a Friday night!) and found their service very, very good and very professional.

Anyway – most of my speech was about the proposed polyclinic scheme and how we, the human beings, want our local GP to remain our local GP. The clinics may be super duper – so long as they provide extra services and in consultation (real consultation) with us provide what we want in accessible form.

Then on to see a lady whose daughter was perfectly normal until the age of 13. She loves music, films, drama, clothes, shopping and spending her parents’ money (so her mother told me). She was bright, did very well at school and was very active at sport. She then developed Rasmussen’s Encephalitis, a rare neurological condition which presents as intractable seizures, and loss of function on the affected side. She had a hemispherecomy operation in April ’06 which left her paralysed on her left side with significant cognitive and visual difficulties. She is gradually regaining some mobility but will never recover the use of her left arm and hand, her fully cognitive functions or visual field.

Anyway – the point of my visit was to highlight the appalling provision of wheelchairs. You can have the basic model – which means you have to be pushed by someone else – but you can’t have a powered chair unless you fit very, very strict criteria. The daughter has already lost a lot of confidence. Being able to move yourself is all the difference in the world in terms of independence. Otherwise you kind of become someone who waits – waits for someone to push you. You have no power over your own life. No independence. I think this is vital. As if it’s not bad enough to have a disability which means you need a wheelchair for all or some of the time.

(There have also been some health and safety arguments wheeled out as to why a powered chair won’t suit in this case, but they don’t stand up to close scrutiny.)

We shouldn’t have a health care system that says you have this basic chair which will condemn you to always need someone around to push you – will give you no independence – and which is cheap (basically).

82 year old with foot problems denied care on the NHS

Lynne Featherstone with Mrs KellySince 2007, when her local Fortis Green clinic closed, Mrs. Audrey Kelly, 82, who suffers from severe foot problems that often leave her unable to walk, has been refused treatment or referral to an NHS chiropodist by her GP.

Mrs. Kelly, who is on income support, has been told that, as she is not considered a ‘high risk’ patient, the only way she can get foot care is to go private.

It is outrageous and completely unreasonable that the NHS will not treat her foot problem. Mrs. Kelly is in such severe pain, and being unable to get treatment on the NHS, she tried self treatment, which left her worse off with severely bleeding and infected feet.

Since the Fortis Green clinic closed, I have seen a real issue with elderly people being unable to get foot care on the NHS, despite NHS assurances that the service has not been cut. This is clearly not the case and Haringey PCT needs to deliver on its promises.

This is not the sort of NHS we should tolerate.

Is a private US firm about to take over a key part of our health services?

Sorry about the short notice but I’ve just discovered that our local Health Service is consulting about out-of-hours GP services – and we only have until Friday to respond.

Our out-of-hours services are the people who provide help when we are at our sickest. They are the doctors who come and look after us when we call them out in the dead of night or who we can go to – currently Camidoc. Without them, every time we got ill in the middle of the night we’d have to drag our sickly selves to A&E – which is not what A&E was intended for, waiting for hours before receiving treatment and wasting thousands of pounds in taxpayers money – or worse still – go without treatment and get really really sick.

So why are they consulting? Well that’s a very good question. Currently our out-of-hours service is provided by Camidoc, and most people agree they do a good job. I’ve met with them myself and that was certainly my impression. They are local and they know the area well. However Camden, Islington, Haringey and Hackney & City Primary Care Trusts (the people that run our NHS) have clubbed together to see if they can get a better deal by tendering the service again – and seeing if anyone else wants to bid for it.

Whilst it is right to try and get the best service for local people, the situation now is that literally anybody can apply to run the service. In Camden, United Health – the largest American for-profit healthcare provider – have just caused uproar by winning the contract to run three GPs surgeries and they may well bid to run our out-of-hours service.

Now I’ve always thought the NHS was my party’s greatest achievement (it was the brainchild of a Liberal – William Beveridge) and I’ve always thought it works best when it’s run for the greater good – not for profit.

But there are practical arguments against a private takeover as well. Camidoc is run by doctors who know the area well. Under Camidoc you may well know the doctor treating you – and even if you don’t you can certainly be sure that they know your area and how to find your house. When you’re at your illest and most vulnerable you’re probably not going to be best able to give directions over the phone to a faceless, nameless doctor who has never been to Haringey before.

So please respond to the consultation straight away – and certainly before Friday night. It is right to have an open tender – and you may not have the same view of Camidoc that I do – but if you are very worried about private American-style for-profit organisations taking over this important service then please take this opportunity to say so.

The easiest way to respond is to email PALS@camdenpct.nhs.uk and you can find out more about the consultation and read the documentation at http://doctorsinthenight.notlong.com

Parking at the Highgate Group Practice

Lynne Featherstone MP at Highgate Group PracticeVisited Highgate Group Practice to look at the appalling situation they are in thanks to Haringey Council.

With the introduction of a CPZ by Haringey Council, this fantastic local practice worked to try and help Haringey Council get it right. Transport and parking is important for a GP service – because, by its very nature, many of the people coming to use the service have difficulty getting about because they are old, ill or both. To make the situation even more pressing – the site is badly served by public transport. So – there is a need for people to be able to visit by car.

Now, there is a two-hour slot in the day when there are no surgeries – and the CPZ being introduced was due to be for two hours a day. Ah – problem solved! Well you or I might think that – but whilst the surgery down time is 12:00-2:00pm, Haringey insisted that the CPZ had to be in force at 10:00-12:00 rather than 12:00-2:00pm. Aaaaargh!

Ok, said the practice – why not then introduce 12 pay and display slots in View Road, which has empty residents’ parking bays virtually all the way? Yes said the council. Ah – problem solved! Oh but no. Because Haringey Council said it would introduce the bays back in September – but still hasn’t. Now they’re promising they’ll do it in February. Let’s hope the 700 signature petition helps keep them to this promise!

Adding insult to injury – the welcome idea of introducing a bus stop opposite the practice has been a farce. They’ve sloped the road in order to bring pavement level down to where buses would load – but they have not actually introduced a bus stop. And if they did introduce the stop at the site where the pavement work has been done – it would obstruct all the traffic on this relatively heavy flow road. Nil out of ten to Transport for London. I will be raising this with Peter Hendy on Wednesday.

Ho hum!

Visiting the Whittington

Having done my usual advice surgery this morning, this afternoon I met with David Sloman (Chief Exec of the Whittington Hospital). We had our usual discussion on the progress of their application for foundation status – which is seemingly progressing.

We then went on to discuss the issues around the Hornsey Hospital development as I suddenly saw a real possibility of how the new facility could be made to work well. David was saying that if the IT system that is installed was linked to all local practises and the Whittington – then we (the people) would get a proper health network whether we went to our local GP, or were referred on to the polyclinic (click here to read about polyclinics) or the Whittington. Also, he was saying, that it would be more natural if the local health trust were to commission the Whittington say, to facilitate the phlebotomy department (taking blood) at Hornsey Hospital or other natural extensions or outposts of the services.

Anyway – the point I made was that David needs to make sure he (and the Whittington) are at the table with the GP practises et al when the specifics of the new health facility are being hashed out. That’s why I keep saying – it could be great or it could be a disaster – it will depend on real, real partnerships and not the Trust simply saying this is what you will have.

Hornsey Central Hospital: the latest plans

Haringey PCT presented their update on Hornsey Hospital to a meeting yesterday. The good news (potentially) is that they have financial closure and the building will be built. The battle now is over what services get provided, which GPs will be based there, how local pharmacies will be impacted as they want a bit of a pharmacy on site, whether extra public transport can be provided (it is served only by one bus currently) and how all of this will be decided. Will consultation be wide and reach all users and stakeholders? And will we and our GPs be listened to?

It was an extremely robust meeting. The Better Local Healthcare Campaign group are extremely concerned that this is a privatisation of our health care. They raised the issue of the building actually being used for residential or commercial purposes. Richard Sumray, the Chair of Haringey PCT, denied this categorically and said whilst it had been in early proposals as alternatives – it had fallen as they had managed to find funding without the need for either of those proposals.

There is no doubt that there will be some private provision. That is Labour’s avowed proposition – that 15% of our health provision will come from the private sector. However, from what I could tell at the meeting, there is a fundamental commitment to this being and remaining an NHS service. I guess that we all have so little faith in what the Labour government tells us – especially because there have been so many varied incarnations of promises on Hornsey Hospital – that we are all concerned that what we are told may not be what happens.

My key issue is GP practices. The Trust is quite clear that some current GPs will have to move into the new, super-centre – otherwise it would not be viable. They deny absolutely that they are looking for a 50,000 patient list – but that they will commence with 15,000 rising to 25,000 years hence. Moreover – all practices will be able to use the new facilities – and thus a network of better health services will be provided locally.

My concern, which I raised pretty strongly, was that all the GPs and practices are really brought into the planning of this new facility. I have had reports from GPs of feeling pressured, being concerned that if they don’t move in or do what the Trust wants they will be punished financially and so on. So I asked the Chair about coercion, punishment, engagement etc with GPs and they absolutely promised that this (engagement, not punishment!) starts now. If they do work together – then this could be a real step forward. If the Trust steamrollers its way through and doesn’t listen to local people and GPs – it will be the opposite.

In terms of the concerns around local pharmacies in Crouch End being adversely affected – the Trust seems to be talking to them about them forming a collective to run the new pharmacy themselves. If this could come to fruition that would be a good way forward and an inclusive one. I haven’t heard recently from the local pharmacies – so I hope that it is as we were told at the meeting.

Lastly – transport. You couldn’t choose a worse placed site for lack of public transport. Only one bus now runs there. I have twice met with Peter Hendy, Commissioner of Transport in London on this issue – as the last thing we should be creating is more car journeys or poor access to such a facility for local people. On each occasion Peter has said – when it is a live project – let me know.

Well – with financial closure this is very live! And as my Lib Dem colleague Cllr Gail Engert (Muswell Hill) pointed out – it takes Transport for London a couple of years generally to get going on a new route (let alone the decade it took for the 603). So after the meeting I suggested to Richard that now is the moment to really push the transport aspect forward.

More generally – Richard Sumray has promised that over the coming weeks and months we will be given specifics and be consulted on this. I have over the recent weeks put out a health survey door to door (cos not everyone goes to these meetings or even hears about them) and part of the health survey is about what local people want at Hornsey Hospital. When they all come back – I will be feeding in the views to the Health Trust too.

Plans for the NHS

Well, well, well! So Health Secretary Alan Johnson has outlined plans which aim to make the NHS more user-friendly for patients in his speech to the Labour conference. He said patients should be treated close to home and GP surgeries should open “at times and in locations that suit the patient, not the practice”.

I will be quoting this incessantly at Haringey PCT if they try and move our GP practises into the polyclinics! That’s the point I keep making. We need to be treated close to home.

As for this shenanigans with Brown and the election – a real man, a real Prime Minister – would put the country first! I rest my case!

Meeting Peter Hendy

Wednesday evening met with Peter Hendy, Commissioner of Transport for London. My three asks were: extending the 603 bus route to run all day and evening (as always); the transport issues around the new London Health Trust plans including the polyclinics (we need to ensure there are good public transport links for any such); and whether he would think about encouraging car clubs (where people share cars) via a congestion charge incentive.

So – number 1 – the 603 bus from Muswell Hill to Swiss Cottage. Well – the possibly good news is that it comes up for review next year. So our job is to make sure we feed into that review with thousands of requests to extend the operating hours from its current school run times only. People keep asking me about this – so we will have to ramp up our campaign again.

On number 2 – well it was interesting – because there are huge transport implications in the proposals to restructure health services. Firstly – the need to access in emergency for stroke, heart attack and major trauma the proposed super-specialist hospitals. Surely travel time trials from every part of London need to be done to establish the worst scenario time taken when traffic is bad and no air ambulance available? If we can’t get the victims to the right place in time – then this plan won’t work.

Secondly, the establishment of polyclinics – which are to serve up to 50,000 residents – may raise big transport issues. Will people be able to get to the polyclinics in reasonable time and at reasonable cost?

Peter was saying that this could be an issue and was going to arrange to meet with the Government to talk over the transport implications. Hurrah!

On number 3 – yes – Peter is considering how best to encourage the expansion of car clubs – so he agreed to look at the congestion charge in that regard – but I think any discount will be along the lines of discounts to people within the zone but not outside. Anyway – it is in and on his mind.

Update: you can read my article subsequent article about polyclinics here.

Muswell Hill Library and Hornsey Central Hospital

Muswell Hill and Highgate Neighbourhood Assembly – centred for its theme on older people in the area. Featuring were both the plans for Hornsey Hospital to become a polyclinic and the abandoning of the idea from Haringey for a restaurant in the centre of Muswell Hill Library – at which we cheered as the detailed case had never been made for it.

On the rest of the plans for the library (which is much in need of care) – there was still no timetable at all – and the Director of Libraries who was there didn’t know the timetable and didn’t have information about some of the basics of the plans. Not impressive. And the tragedy is that some of the ideas that have been talked about have been excellent – but it’s all being lost in a mess of vagueness and foot dragging.

And then the poor woman presenting the Hornsey Hospital update got it in the neck for the shameful consultation process taking place at present on the local Primary Care Strategy. Sue Hessel said that only seven people attended the first meeting and the second which is tomorrow night may attract just as few. They said they were happy to go to other meetings if invited but as I pointed out – having a meeting isn’t consultation – nothing like. So I’ve written my Highgate Handbook and Muswell Hill Flyer column on this issue (will post after it is published) as local people need to know what is going on.

Update: my article about polyclinics is now here.

Avenue Gardens Residents' Association

Spend the morning in Ealing for the by-election. Seems very jolly over there and upbeat. Main community event of the day back in the constituency is going to Avenue Gardens Residents’ Association to do a ‘Question Time’.

Key issues from the evening included Haringey’s lack of consultation with residents over planning proposals – in particular – Haringey Heartlands. And – even if there is a consultation – they ignore it.

One resident raised the issue of the proposed polyclinics – and the potential of these plans to denude us of our local GP practices. That is what we need to make sure doesn’t happen.

It was interesting when I met with the Trust and asked what I would think is a critical question – what proportion of GP visits require further action (diagnostics, referrals to a clinic, etc), they couldn’t give a full answer.

But this is key to the polyclinics idea – because if, say 90% of doctor’s visits require follow up with one of the services that will be at the polyclinic – then having the GP and those other services all on one site can have advantages of saving further trips (and so further delays). But if those 90% instead don’t require further services, then having GP practices centralised isn’t nearly so attractive.

Anyway – back to Avenue Gardens Residents’ Association – we also ranged over excess of traffic, HGVs, the tick-box society, the quality of councillors, the poor quality of decision-making at Planning Committee, and other topics too. I enjoyed it – as I always do. Meeting people at events like this always reaffirms the point to the whole process. It is always about peoples’ lives!