Hart of the Matter
And there was me thinking things might have improved in the management of primary health care around here over the last few years!
When I wrote a piece a couple of weeks ago about the shambles from the Suffolk Primary Care Trust (PCT) which resulted in the Crown Health Centre being located in Haverhill in the first place, I really expected the current crop of managers at the successor NHS Suffolk to represent a considerable improvement.
But, judging from the performance by poor Martin Royal, NHS Suffolk’s sacrificial victim to Haverhill Town Council’s meeting on Tuesday, there are further depths of inadequacy to be plumbed.
To be honest, the issue isn’t an easy one. I didn’t see the point in the health centre in the first place, but I have to admit it has done some good work here, and I can understand why people who have thrown in their lot with it are now furious about the proposal to close it.
Nevertheless, I don’t think anyone expected NHS Suffolk to present such a poorly-argued case to justify such an unpopular proposal.
They had no answer to the fundamental fact that they have not even been monitoring many of the key outcomes which the centre was put here to improve. So how can they know whether it really is a success or not?
Instead they just put up the fact that only 900 people have registered with it, as opposed to the 6,000 they had predicted for the first three years. Do they think we are stupid? It is patently obvious to anyone that this indicator has far more to do with money than any concerns about patient welfare.
To be not only self-serving as a care organisation, but to be transparently so, shows some failure of management or communication or both.
However, the town council might do worse than listen to the plea from the local GPs to keep in mind what happens to the £1.2million a year it costs if the centre is closed. It’s all very well to put up a strong fight against a public decision, but you need to have a Plan B in place, in case, as we all fear, this has been pretty much decided beforehand.
You can be fairly certain that, failings or not, the PCT will have a secure handle on where their best interests lie with regard to how the money would be re-allocated – assisting the budgetary cuts they, along with every other public service organisation, will have to come up with year after year.
Mr Royal’s efforts to argue that this would benefit the people of Haverhill as well, through potential improvements in a variety of services such as mental health or physiotherapy, fell on rather deaf ears because what they really want is to be able to see a doctor when they feel the need.
I am just guessing here, but I think Suffolk PCT, when they chose Haverhill for the ‘Darzi clinic’, suspected that the high number of A&E attendances from Haverhill was because the GPs were not available, or difficult to get to see, and people weren’t prepared to wait.
I don’t suppose there is a GP practice in the country which couldn’t produce a number of disaffected ex-patients who claim they were wrongly diagnosed and might have died if they hadn’t found a different opinion.
But in general, Haverhill’s GPs are quite well spoken of, and the fact that only 900 people have registered at the centre shows there has not been the mass exodus from the existing practices which the PCT perhaps expected. It is inescapable that people do actually prefer to see a doctor they know, if they can within a reasonable timescale.
The PCT made some grandiose promises when they opened the health centre but, as Mr Royal admitted in probably the most open thing he said all evening, times change. The economic climate is a lot different now from what it was in 2007, when the decision was made.
But the fact that they made the promises at all reveals how sure of themselves they were that they knew best. Sadly, this is one thing which has not changed. Mr Royal was adamant that the other services in the town could cope with the closure of the health centre. He cannot possibly know this, and to say it over and over again smacks of desperation.
After the PCT’s admission that it had not been collecting relevant data about the centre, it is very doubtful that it has relevant data about the needs of the rest of the town.
In the end money will probably be the guiding factor. After all, how accountable is the PCT to local people? It claims that because the out-of-hours provider will still be contractually obliged to see patients within half an hour, they will be seen within that time, despite there, possibly, no longer being a base in Haverhill.
That strikes almost everyone as laughable, but who will be accountable when it fails?
|
