Tag Archives: nhs

What's a polyclinic?

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Main meeting of the day was with Richard Sumray, Chair of Haringey Primary Care Trust (PCT). For me the key question was around the proposals for Hornsey Hospital which has now become part of the wider Primary Health Care Strategy. This strategy proposes (and is part of the London-wide strategy as well) something like six polyclinics in Haringey.

Hey – what’s this poly thingamajig – I hear you say. Well – it’s a sort of community hospital without beds – i.e. it’s a super, duper, all singing all dancing health facility with clinics for various things like diabetes, services like chiropody, diagnostics and the kitchen sink. I say that – because the array of services proposed for Hornsey Hospital is yet to be consulted on and we hope (despite our experience – so hope against hope) that the services can accommodate what local people want not simply that which is prescribed by the PCT.

There is some confusion around consultation because there is a consultation by the Enfield Haringey Health Trust on the local Primary Care Strategy – which is really with health stakeholders etc and then there is also to be a consultation on Hornsey Hospital itself.

The polyclinics really come up in the Primary Care consultation – and this may contain the key issue which I believe is what loss will there be of our local GP practices as part of the move to polyclinics? The idea is to improve local health services in these new facilities and provide some of things we are used to going to the hospital for nearer to home.

But the polyclinics will need some rental income, I believe, from GP practises based in the polyclinics. Of course – if a local GP practise moves into a polyclinic – it may mean for the ordinary person who is ill, just needs the doctor and a prescription or not without further treatment, a longer journey. That in turn raises issues of travel, access, car usage, parking and public transport connections – all very difficult.

So – on the individuality of each polyclinic – including Hornsey Hospital – Richard promised me that there would be a separate consultation – a continuance of the public meetings twice a year that we all have had on Hornsey since it was closed. I would also wish to put pressure on the consultation to demand that no area of the borough should be denuded of a local GP practice – and that any practise or doctor who wants to move in to a polyclinic ought to consult with their patient list.

The polyclinics sound great – but we have to make sure that local people have a say in what is provided and a say in what happens to their local GP practices and that there is a net gain. Perhaps local people want out of hours services, doctors that will visit in the home (which might solve some of the access issues as you don’t feel like getting on a bus when you are sick), and so on and so on.

There is so much involved in all of these changes – I have to say to people get involved, respond to the consultations. I am happy to have a spanking new facility on the Hornsey Hospital site as has been promised to me and local people for years now – but it has to deliver a great slab of what local people want and not remove the very local doctors that people rely on.

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

The future for local health services

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Straight on to meet David Sloman, Chief Executive at the Whittington. His issues are around the Health Strategy for London which will begin on 11th July and the Whittington’s own move towards foundation status. This is a bit different from Fortismere’s problems – firstly it is mandatory as the Government as decreed that all hospitals must do this within the next few years. What the Whittington gets out of it is the ability to plan for the long term, revised engagement in terms of real community voices in decision-making, legal and financial freedom. I will consult with colleagues on this in due course.

On the London-wide strategy: some of it seems ok – like stroke victims and heart attack victims going straight to special centres – so long as there are enough in London (i.e. not just shipping people miles away, especially as the first hours are so vital). The local community hospitals like the Whittington are fine too.

Where the battle lines will be drawn – and this refers back to what I said about Hornsey Hospital and the proposed polyclinics. For example – there will be something like five or six in Haringey each serving up to 50,000 residents and will provide super-duper clinics, diagnostics, etc etc. However, it will only financially be viable if they bring in our local GP practices to operate from there. Now – I wouldn’t mind if they swept up the individual single-handed or two men doctor practises and put them in there – that would be improving the service – but I bet they will be after our other practices and I don’t think the community will want to have the normal visit to their doctor that doesn’t require other services moved away from the local.

Maybe I am wrong. We do want after hours services which would be provided on such a site – but I though that the huge hike in doctors pay and contracts was to create extra provision. Ain’t seen nothing yet! So I suspect that may prove controversial. Polyclinics – great – but don’t take away local GP practices.

Breast cancer screening update

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Went to meet Tracy Baldwin, Chief Executive of Haringey PCT (Primary Care Trust) to discuss what has been done to get the breast cancer screening program – which was stopped because of administrative errors – started again.

Sadly Tracy was unwell and so I met her deputy – Gerry. The assurance given at the meeting was that the system has had a rigorous overhaul and that the 8,000 women identified as a top priority for screening would be seen between now and October. Overall it will take three years to get the screening program back on track, and whilst there is a small number of women whose period without screening will have been extended beyond the normal three year period – the longest period of that extension will be 10 months.

They have overhauled the way the program is run – including better quality control, so there should be no repeat of the five incidents and eighteen months it took before action was taken. They are investigating every case on an individual basis to follow through and see if there are any consequences from the suspension of the screening program.

They will publish a report on the findings of their investigations in around two weeks time. We await the report.

As I was there – I took the opportunity to try and find out what was happening on the ‘consultation’ about the Primary Health Care. A local campaigner had contacted me really upset that the promised two open meetings were being held in the summer when many people would be away, the second of which is at the Muswell Hill Assembly on the 23rd July.

Having checked with Cllr Gail Engert who chairs this Assembly, it would appear that this Assembly is focusing on health issues for the older members of our community – and that is what the Trust will talk to. This brings in an update on Hornsey Hospital – but it isn’t the promised ‘open meeting’ to discuss the future of Primary Health Care in the borough.

I will write to the Trust to get the promise of these two meetings confirmed – as I, like the campaigners, fear consultation occurring in holidays or not being carried out in a way that will engage local people properly.

It is absolutely vital that the whole community has a say – as the proposals for poly-clinics which will cater for up to 50,000 patient lists will also mean that GP practises have to move in there too. Whilst the idea may be viable and produce spanking new facilities – which we welcome – I have a sneaking suspicion that funding will be needed and that the plan is to get it from renting to GP practises. And I thought that the new GP contracts were to provide services locally. It might work if the practises could stay where they were – but pay for the fantastic clinics and diagnostics available at the poly – clinics. Anyway – that is why the consultation is vital! We all love our local GP practises and we need to be sure that what is provided adds to our facilities – not detracts from them.

Is this the future of dentistry?

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Hot Lynne Featherstone MP opens Denchic in Crouch Endweather – not much choice of suitable clothing on inspecting wardrobe. Anyway – off today to open ‘Denchic‘ Dental Spa. Not sure what this will be – but when I get there am just delighted to find such a beautifully designed place. This new idea is designed to take the fear out of dentistry, with not just expertise but also and absolutely beautiful surroundings (design is rather a thing of mine – and the benefits of good design are far too often overlooked!).

Anyway – this lovely ‘dental spa’ (which is private) is a great new small business for Crouch End. There is a good NHS dental practise just up the road – but not everyone can get an NHS dentist any more. The place is the long-cherished plan and dream for two exiled Iranians, who lived in Sweden for many years – met in dental college there and came to Britain around ten years ago. They are married with one son – Sam – who was running around at the opening – very excited. Kian and Cath Nikdel are absolutely lovely people and they have clearly poured their heart and soul into this venture.

This sort of excellence, with lots of thought and care given to what it is like for the patient, should also act as a spur to the NHS – as those are the standard we should aspire to for everyone through the NHS too. Easier to say than do mind…

Met a local author and playwright at the opening, Max Arthur. He has just had his play, Forgotten Voices (about the First World War), accepted and put on for six weeks at the Riverside Studios, Hammersmith. So that’s something else to celebrate!

Darfur, doctors and debt

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Hurrah! My glasses were found in the back of the car that brought me back from The Westminster Hour – thank goodness. Tuesday has been a busy, busy day and I hate it when there isn’t even breathing space between events.

To highlight the best of the bunch: met with an interesting organisation called Waging Peace about the ever-deteriorating situation in Darfur. My take is that the world is standing by and letting genocide take place. The Sudanese Government is playing us for fools and toying with us suggesting that they are on our side against Al Qaeda when really they are not. The Arab militias continue to kill rebels and the suffering is spreading into Chad and Central Africa. We need action from the EU and the UN. Sanctions, travel bans and arms embargos would be a start and for goodness sake – China is applying more pressure than we are.

I also met constituents about the mess that the changes to the way junior doctors are employed have caused. It’s a terrible tale of diving in without a clue where it will end up – and now peoples’ lives and careers are being ruined. And are they stopping it? No. This is a nightmare for those caught up in the changes. This should have been thought about, piloted and rolled out in a measured way rather than being steamrollered through across the board.

More Maxitech good works as they start teaming up with Age Concern to deliver free computers and training to our older citizens. The event to mark this is held in the Lords and really it is quite clear that Maxitech has solved the problem of big corporations like HSBC, John Lewis and British Airways (all in attendance) who want to be good and give their old computers for good causes – but need to know that the computers will be properly wiped clean and they won’t be caught by legal liability issues.

Then onto Spurs to see the launch of the Bounds Green United football team – set up and initiated by the (police) Bounds Green Safer Neighbourhood Team. Spurs are doing their community bit – hurrah – and some of the wards in the borough are getting teams together to compete. The first match will be on Tuesday. It’s a great project and I get to stand one inch from the pitch – the hallowed turf. It is a tremendous feeling. Thanks to the police Safer Neighbourhood Team – without whom this just would not have happened.

Then on to the CASCH AGM (a Crouch End residents’ association). Nice to be able to get here tonight – as Monday and Tuesday nights are usually impossible but I try to get to all local events that I can. The new Met volunteer organiser is there – and talks to the members about perhaps joining the team. It is so great to see what feels like my ‘baby’ growing up. The re-opening of the front counter at Muswell Hill police station was fantastic and the volunteers who run it are fantastic – and now it’s the second generation organiser is in place. Very rewarding. As they go on to the business of the Association, it is time for me to run as I have a radio car coming to my house at 10pm to interview me on vulture funds.

Vulture funds are these companies that feed off the debt of the third world. The High Court ruled today to cut Zambia’s debt repayments to them:

A “vulture” fund seeking more than $55m (£27.5bn) from Zambia had its wings clipped in the high court yesterday by the judge who limited its claim to $15.5m and cut its award of costs because of its “dishonesty”.

(From The Guardian)

Debt relief was a good move – and it is horrifying to think that anyone would prey on these countries and exploit a legal loophole. We need a government that takes action – not just wrings its hands ineffectually as this one is doing.

Then get a message that there is no radio car available to come to where I live – so go home to bed!

Funding our health service: the future of St Ann's

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Met with Carl Lammy – Chair of Haringey Mental Health Trust. The promised development of St Ann’s (and much needed and vital development – have you seen the antiquated mess of buildings that form St Ann’s?) has run into a storm of objections from local people concerned that what this really means is a sell-off of public land. Well – yes probably.

In this, yet again, we see this Labour government’s steam-roller approach to their avowed intent – which is to remodel the health service into specialist centres with local super health hubs within which 15% of the budget will be spent on private providers.

We didn’t ever get to vote on that. If such a switch to private providers had been from a Tory government it would have brought forth a howl of protest from Labour supporters – but this is from Labour itself. Put this together with the sell-off of public land assets to finance new builds – and you get protests.

Hence the problems St Ann’s renewal is encountering: they suffer the rage of those of us who never agreed to this program – but they have no real choice or voice in this. Local campaigners together with local politicians including my Liberal Democrat colleague Wayne Hoban and others campaigned against the closure of the X-ray service on the St Ann’s site – and that bit has had a reprieve, but it is only a reprieve. We need an X-ray department at St Ann’s. The very important eating disorder services that are there – and many others – that need frequent x-rays.

Anyway – the point is that the facilities at St Ann’s are ancient and failing. To change them to modern day standards and comfort needs money – and Labour will only make funds available on its own terms, making people jump through the hoops that it wants, regardless of local opinion. And that will see land sold, I am sure.

We have seen this happen in education and in housing and now it is health’s turn. Labour’s modernisation program means – do what we say, sell-off land and involve private companies. Now – selling off land and involving private companies can have their place on occasion – who would want to die the in ditch to say that every single last square millimetre of land owned by the NHS anywhere in the UK must be kept for all time? – but the problem with Labour is that they impose, top-down, a one-size fits all solution rather than taking individual cases on their merits and listening to what local people really want.

Selling assets and involving private firms through PFI, PPP, LIFT etc is a live now, pay later philosophy – where we getting new buildings for our aging hospitals and schools but then the pain comes down the line when we are still paying high costs year after year and all the family silver has gone.

Salt Awareness Week

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It’s Salt Awareness Week this week. I put toooooooo much salt in and on my food. My blood pressure is borderline high (that’s my job I reckon). But blood pressure is a silent killer – and so I am off to my local hospital, The Whittington, to visit the cardiac department. They say about two thirds of us walk around not knowing that we have high blood pressure – and the ward I am visiting, the Montuschi ward, is where we will end up if we continue to take no notice of health warnings we are told.

The Lynne Featherstone MP at Whittington HospitalWhittington has kindly arranged for me to meet the whole team taking care of patients who suffer from heart failure, attack or other heart issues. Introducing me to everyone was Dr David Patterson, who is the consultant cardiologist. I met the Head of Catering, Cecil Douglas, who has virtually banished salt from hospital food – or at least got the daily intake for patients below the 6gm max figure. He has a job and a half: to get ill people to eat something and yet give them good nutritious food that won’t cause more health problems. And yes – there are a small number of remarks about blandness, but a hospital must be an example and they give you some education in nutrition whilst you are there. The problems really are when you go home and just cook with and/or and add salt for the rest of your life.

I learned something today in particular – that the Afro-Caribbean population is even more vulnerable to these diseases and that pickles and piccalilli carries huge doses of salt.

I also met one of my constituents who happened to be there and after talking to him what concerned me is that there is seemingly no real support package for when he returns home. He is elderly with a serious heart condition – can barely move his hands through arthritis – so how is he going to cook for himself, let alone worry about things like salt content?

Anyway – a very big congratulation to the Whittington with their Charter Mark for their cardiology department’s high levels of patient care and service provision. Very impressive!

Then I meet with David Sloman, the hospital’s Chief Executive, for my two monthly ‘chat’. I have been concerned over the Government’s outrageous cash grab in terms of top-slicing from budgets of health trusts etc – thus punishing those who have maintained their budgets properly. The promise is that after three years this ‘loan’ will be returned. Pigs might fly! But I have also been worried about the Government’s aversion to District General Hospitals – which the Whittington is. Of course we must provide the very best specialist hospitals giving the best care in the world for diseases – but that is not the staple diet of need. What the Government ignores is the fact that people want their services locally – including a general hospital that can deliver the medical treatments near their homes.

Straight onto surgery at Jacksons Lane – except I get a call from Ed (my head of office) to say that having arrived at Jacksons Lane they have discovered it is closed because of building works – and no one has told us. But quick thinking Ed gets Highgate Library to let me do surgery there. Thank you Highgate Library!

Hornsey Hospital: protesters go to Number Ten

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Rush Lynne Featherstone MP presenting petition to 10 Downing Street about Hornsey Central Hospitalto Downing Street to meet three very, very old ladies who have come to present a petition to Patricia Hewitt via No 10! The Prayer (wording) on the petition reads:

We the undersigned condemn: the neglect of Hornsey Hospital and its site; the neglect of older peoples’ services in Haringey; the failure to inform and consult with local people. We the undersigned demand that services promised for older people at Hornsey Central are provided at the site with no sell-off of NHS property.

It is signed by over 500 signatories – but there could have been many, many more. I myself have met with both local and London-wide NHS officials to try to ensure that the proceeds from the sale of part of the site go back into the redevelopment of the site – as despite our protests I fear they are steamrollering through the sale of the land.

The three ladies were fantastic. I just hope I am like that in my advanced years. Hetty Bower is 101 years old, Violet Reiners was born in 1915 and Alison Flora Selford was born in 1920. I met them, and Janet Shaprio (who organised all of this) outside the railings at Downing Street. So we went through security. The police and guards were all soooo nice to us and we took lots of photos before knocking on the door of No 10. Sadly, T Blair didn’t open it and invite us in for tea! I thought how lovely it would have been if he had! Although I think he might have got the wrong end of our tongues if he had. The trio of ladies may have been old in years – but vigorous of conviction they definitely were. It was a joy to meet them.

Now I must pursue a request in the covering letter from Janet Shapiro to ask for a debate in the House of Commons on recent changes in NHS funding, and in particular the involvement of private partners. So that will go to Patricia Hewitt – and I will try in Business Questions next week to catch Mr Speaker’s eye to also ask for that same debate!

Hornsey Central Hospital

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At last – finally I have my meeting with Ruth Carnell, the new London Health supremo. Her body is the one that matters in terms of making sure that if lands are sold off around the Hornsey Central Hospital site then they monies come back to develop health services on the rest. I had been wanting to meet her for some time to ask for guarantees to ring fence the proceeds for the Hornsey Central site.

At first they refused – and said I had to see the local Health Trust (Enfield and Haringey) which was useful – but they do not have the authority to say where money will go. So having got the meeting (and I am genuinely grateful to Ruth for coming over to Portcullis House and giving me her time – with 31 separate trusts to deal with she is just a bit busy) – I put the case.

Ruth was willing and is going to write a letter saying that we can have the proceeds provided there is a credible plan on the table. I guess that is as good as we are going to get and if the bid to the Government for the other £7 million that is needed succeeds – then there should be a credible plan.

Obviously whilst I had the opportunity, I put some of the points I’ve been campaigning on with my Lib Dem colleagues: the need for net gains in terms of GPs; the need for ordinary local people to have a real input in terms of what is provided on the site in terms of services; issues around fears that private providers might be brought in and about the knock on dangers this would have for the Whittington, etc.

We didn’t see eye-to-eye on all the issues – particularly the role of private providers in providing NHS services – so I’m sure there will be more debating in the future. But for now – things are moving forward in pretty much as good a direction as we could have given the rules and policies Labour have drawn up for health services. And in the New Year, my colleague – Health Spokesperson Cllr Richard Wilson – will be publishing the Liberal Democrat Prescription for Hornsey Central Hospital.