Tag Archives: st ann’s hospital

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.

Hornsey Central Hospital

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Off to the Three Compasses (my HQ) for a council of war on what is happening to health in this borough. The cuts are cutting now deeply. Five family planning units gone or going for example. The X-ray unit at St Ann’s saved – but many, many other front line services disappearing. And why? Because of this Labour government’s lack of understanding about how best to run the health service. They have flung a fortune at the health service – most of which has gone into poorly negotiated doctor and consultant contracts. Their budgeting regime has meant that if a Trust balances its budget (much of which is achieved by cuts) then the following year it must make more ‘efficiency savings’ so that it can give its ‘surplus’ to a Trust that has failed to keep to budget. It is theatre of the absurd. It demotivates the good Trusts and rewards the ‘bad’. Except that the ‘bad’ are those Trusts that ‘overspend’ – but overspending means that they are trying to meet need in the community where elsewhere they are cutting front line services – as here.

Amongst other things, we are meeting to kick off the arrangements for the campaign to force the pace on the progress (or lack of it) on Hornsey Hospital. After the meeting we go off to Hornsey Hospital to set up the campaign shots. It looks so forlorn these days with its closure notices. It is six years since we were promised that if we (residents and Lib Dem politicians) stopped our campaign to save the hospital – then the Trust would together with us to a create new health facility for the community. So we worked with the PCT. There were public meetings and plans and public meetings and working meetings and lots of commitment – even complete planning permission at one stage. But after six years – we are nowhere.

… and on a technical note (highlight of my week this!) I’ve added links to each post so you can easily post them on del.icio.us / digit. Thanks to Technology Wrap for the tip on how to do it easily.

More school places in Crouch End

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Flashed over to St Ann’s for a road show and meeting on the “restructuring” of mental health services in Haringey. If this is more care in the community then it had better be better resourced – given that so many people with mental health challenges come to my surgery as the support for them in the community is not adequate. The police, doctors, CAB, politicians who hold surgeries – and ultimately prisons – are all paying the price for inadequate care in the community. Don’t get me wrong – the more someone can stay in the community the better – but the services and the support just is not there in enough quantity to support the number of people who need it.

In fact – and interestingly – Haringey is the one of the ‘worst’ health authorities because they have mental health inpatients for longer than most anywhere else. However, their return rate is one of the lowest. Methinks someone should be looking at that as perhaps an indicator that shoving people out too early (much like in general health) can mean lots of return visits.

I asked for a comparative figure for the budget for drug therapies used versus budget for talking therapies. It wasn’t a question the Chair and Chief Exec could answer on the spot – but they acknowledged it was a good question and that they had no means of collecting such data. Behind my questions lies the fear that the Government is willing – as are health trusts – to fund drug therapies but not talking therapies to the same extent. I suspect this is partly because of cost – though drugs can be very expensive – but mostly because they can’t measure outcomes so easily in this target driven world we live in. Patients like talking therapies – they find it therapeutic – and possibly therein lies the point.

The other question – even better than mine – was from a user who was asking what choice the patient had in their treatment. If the patient feels better and more secure with a particular method of treatment their recovery would be better. So why should the patient have no say at all? The Chair and Chief Exec agreed that there was no choice!

The scooted over to a public meeting on the proposed expansion of Coleridge Primary School in Crouch End. Lord knows – residents, colleagues and I all campaigned and worked to get Haringey Council to buy the old TUC building to provide desperately needed school places. Crouch End parents, not surprisingly, have been going mad over the last few years over the shortage of places for their little ones.

Anyway – the building was purchased. The issue now is that the site is directly opposite an existing school – Coleridge – with a busy road between the two. So, should Coleridge be expanded, using the new site, to be a four-form entry? This would make it one of only twelve schools in the country to be that big at primary level.

The Head, the Council and the architects had obviously done a huge amount of work on designing a structure and form that would make the children still feel like it was a small family atmosphere school. However, all the work in the world could not offset the anxieties of the existing parents that their children would be ‘swamped’ in such a vastly expanded school.

The argument from the panel against creating a second school across the road, rather than expanding the existing one, was that it would split the community. But they really didn’t seem to have spent much time on an alternative – and the proposal to expand was clearly what they all regarded as the only viable option. I suppose there is some truth in that if there was a second school parents who put Coleridge as their first preference but ended up at the second school might feel that they got second best.

When asked if this was a genuine consultation and that if enough people were against the expansion would that change the outcome, Ian Bailey (Deputy Director of Education) said yes. But it did feel like the only game in town from the way it was presented.

It is now vital that they consult even better – as many people at the meeting had only just about heard about the plans. The main thing, however, whichever way this goes forward is that there will be more school places available in the area for local children – which is brilliant.

Care in the community

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Today’s surgery was full of really difficult people. “Care in the community” often just means that the care isn’t adequate and people can’t cope in the community.

Often what is considered anti-social behaviour is then ASBO’d, which is then broken, which then means a custodial sentence when really this is just a vulnerable person with mental health challenges – not someone who the police or prison is left to deal with.

I am extremely worried about the restructuring of Haringey’s mental health services which are being launched on Monday – because I bet you my bottom dollar it will be all about getting them out of residential care back into the community. And it will be sold as better for the individual – but it won’t be. It will just mean that they can downsize the residential care, save money, and parcel of the land round St Ann’s for development. You watch!

Hornsey Central Hospital site

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Visit the Mental Health Trust on the St Ann’s Hospital site. Haringey has the longest inpatient stays in London but it does a very low re-admission rate compared to other authorities. So – what I take from that is that the Government needs to be very careful about its push to shove people out of in-patient facilities towards care in the community. While I am sure that being at home and not institutionalised is a laudable t aim, if the patient isn’t ready and the support networks are not adequate then we will see more and more problems on street or left for the police to deal with.

The other issue that struck me was the number (and cost) of secure beds that we pay for and that extraordinary numbers of people with mental health problems who end up in prison (also expensive) as opposed to getting preventative care prior to getting hospitalised or imprisoned. This resonates with my experience of warning after warning to the council or police that a local person is threatening neighbours etc. The authorities are always saying they cannot do anything until something happens. Eventually, the person assaults someone. Then they are put in prison and/or evicted. When they come out – they are found accommodation (if they are lucky) and the whole cycle starts all over again with new neighbours.

So – more early intervention and prevention needed. Otherwise we are just going to be creating more arrests, more problems, more misery.

I also have an appointment with the Primary Care Trust (PCT). Main issue on the agenda for me is the news (known for some time but not released to us mere mortals) that the future plans for the redevelopment of the Hornsey Central site are in jeopardy. Haringey Council has pulled the plug on their part of the proposals for the site and has, in the most ad hoc of fashions, decided not to proceed with the care home facilities. This leaves the PCT up the creek as they need the funding from that to fund the other community health services to be offered.

They have come up with a possible way of funding it. I’m not supposed to say publicly what it is yet (though can’t quite see why) – it is quite controversial and supposedly ‘commercially sensitive’. I think they need to be bolder and work with the community on this funding problem.

Local campaigners, myself and others have been at this for years and years. We campaigned against closure originally. Continued through the wilderness years. But when the PCT was set up relations improved with campaigners. Now Haringey Council has jeopardised all of this by pulling the rug out.

The PCT was planning to present the options to their board in September. I suggested to them that rather than go to the board and then to a public meeting thereafter when their possibly controversial proposals were a ‘fait accompli’ it would be much better to share with the key stakeholders the challenges they faced and the options available and then go to a public meeting to genuinely consult. The acting Chief Exec, Geoff Sandford, said he would give that suggestion serious consideration. I hope he does!

Alexandra Park School gets a new science block

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American Independence day! No relevance to my day. My first visit of the day is to St Ann’s Hospital, where the George Marsh Centre is a facility supporting sickle cell and thalassaemia sufferers.

As sickle cell affects mainly members of the Afro-Caribbean community it is a big issue here in Hornsey and Wood Green. I am there to open the ‘awareness day’ – an afternoon of talks and discussion about the condition and how to support the community and spread awareness. Some of the support staff were chatting to me before the opening and saying – ‘well Lynne – what are you going do to raise awareness?’

I thought my best use – apart from opening things and turning up to things – was to put down parliamentary questions pushing the government into more action and support, perhaps be able to have a Westminster Hall debate on the issue and so on. And I will.

Then Alexandra Park School science block opening – a grand occasion. Mike Tomlinson (he of the report that the government is ignoring) is opening the block itself – and I am opening each of the classrooms. So Mike gets to pull the red curtain back on the plaque. I get to pull bits of red paper off the sign on each classroom.

At each class one of the children reads out the reason that a particular name has been chosen. For example – Albert Einstein – and then I pull off the paper to reveal the name.

We go into each classroom where the kids and their teacher are doing scientific things with Bunsen burners. Looks absolutely fantastic fun – and such talent being nurtured. Almost revised my opinion of government policy on specialist schools…!

They we trooped over to a classroom for ‘maths in the 21sst Century’. I loved the way they taught maths. If I had had such an enthusiastic and innovative and alive maths teacher as Iraj – I might have learned more myself. So – the key to the amazing atmosphere in the maths department I think had a lot less to do with the razzamatazz of the white boards and the IT and far more to do with having a brilliant teacher – who sadly was about to leave.

Then run to Commons arriving literally as the division bell rang to vote. Phew!