The Surgery's Gone Down the Plughole

Just had a letter this morning, Richard Branson is our new provider. No mention of how/if they're going to recruit more GPs though.

Grey thoughts for a grey day. There was a piece on our local TV news last week about a protest somewhere in the Midlands about plans to move maternity services to a hospital 20 miles away. It's happening everywhere and all the time.

I'm afraid we will see considerable further reductions as budgets are slashed and all parts of the NHS struggling to maintain service.
The government talk about £22 billion "efficiency savings" needed during this term of Tory rule. This is easy to say and impossible to achieve.
Efficiency savings mean things like fewer and more centralised services. Patients will have to travel further. This has already begun under the coalition.
A real example i heard about, from a relative who retired as a consultant last year, was that his really ill lung cancer patients were finding the services they needed being centralised in the middle of London so that they would have to travel from somewhere outside the South Downs. There is absolutely no chance that any rural services will improve for the foreseeable future.
Efficiency savings is basically a mealy mouthed way of saying "cuts". There will inevitably be huge cuts in services and NHS staff numbers.
There is a move afoot by the Tories to change the election boundaries in their favour to help them get a majority in the next election. All I can suggest to people is that they join their local Labour party and help to build a strong opposition.

JessM the thing is that when the old full service hospital was knocked down and replaced with the smaller one, consultants holding clinics at the smaller hospital was part of the deal. And that's what has changed. The consultants are no longer travelling to the smaller hospital, so people have to make a 150 mile round trip to see their consultant. I wonder if the operating theatres in the smaller hospital are used now? My Mum's friend was taken by ambulance to the larger hospital last week when she was diagnosed with appendicitis to have her appendix removed.

I am aware of the situation in Wales because it's been on the news and I think it's dreadful.

The other thing about patients travelling for hospital treatment as an inpatient is the problem of family and friends not being able to visit. It's a bit much to for someone to do a day's work and then drive miles to see a loved one in hospital.

To be honest, I'm not sure if it's useful to compare the UK with other countries. We can count ourselves lucky to have the NHS, but there's nothing wrong with being unhappy with a reduction in the service.

Where DD lives in Australia it is a 2+ hour flight to see a cardiologist, for cancer treatment and other specialist treatments including neo-natal specialist care.
The local hospitals (2 hours by road) offer some treatment - if you pay of course! A GP appointment used to be £75, it may have gone up. People have private insurance to claim some of the costs back but it is not cheap.

Those of us who live near large, full service general hospitals are lucky. In the rural areas of the UK you would have to travel a lot more than 70 miles for some specialisms e.g if you live in mid or west Wales and you need cancer treatment or a special care baby unit - you will have to head to somewhere near the north or south coast (Cardiff, Swansea, Bangor etc)
It is probably not economically viable to send a consultant long distances to do outpatients clinics in distant locations.
In NZ, which has a very dispersed population, the country spends a similar amount per head on health care and they do try to provide things like minor surgery in small towns I believe. But you pay to see your GP.

It's about an hour and a half on a good day. I just don't think that is acceptable, but my Mum says people in rural areas are used to things being awkward or difficult because of their location and just get on with it. It does make me realise that it doesn't matter whether you live in the country or the city, both have their own problems. She does have an excellent GP service and it seems to work well with the local hospital.

A 150 mile round trip to hospital? I'm surprised there's enough hours in the day. The cardiothoracic centre is 20 miles away, but it's two hours and four trains each way, so by the time you've sat in the waiting room, seen the doctor, walked to and from the stations etc., it's between 5 and 6 hours.

I have noticed that there is a shuttle bus between all the hospitals in County Durham. Fortunately I've never had to use it. If you have to go to another hospital from Durham, it's usually in Newcastle, which is not served by the shuttle bus.

Couldn't agree more. Presumably running a shuttle service is cheaper than paying the consultants to travel. Some surgery can't be done at the local hospital, so a shuttle service would be cheaper than transport/ambulance transfer costs for those patients who can't get there under their own steam. It's only one step further for the consultant not to travel. It's not just elderly patients, it's patients who can't get to the larger hospital under their own steam.

Wilma it seems daft to me that several elderly people, not well, all have to travel that distance when one consultant could make the trip.
A friend used to volunteer for the hospital car service, but they only got expenses which was not enough to pay for the upkeep and maintenance of the car.

My surgery has put a big poster on the waiting room wall congratulating itself on providing a delivery service to my village; a service that was needed because they closed down the satellite surgery that was providing for all the elderly and housebound people who lived there. As a dispensing practice they just didn't want the local chemists to poach their business.

djen I am pretty sure my GP service isn't because one of the doctors I see would have mentioned it. He's a lovely doctor, but such a chatter box and never remembers what he's said before! I do agree though that you might not be aware.

rosequartz not only that, many of the patients who need to use the mini bus are elderly and such a long day can't help them when they're poorly. I can't see the situation being allowed to carry on. Surely something will have to be done. The local hospital is really nice and is equipped with operating theatres although I imagine only straight forward surgery was carried out there.

where, not which

djen Wilma* mentioned that her mother lives in Scotland which healthcare is devolved and may be run differently by the Scottish Government which is not a Tory government:

www.ournhsscotland.com/our-nhs/nhsscotland-how-it-works

The problem is, Wilma, that you do not actually know if your surgery is owned by a private company and leased back.

www.virgincare.co.uk/

Virgincare run 230 NHS services. However, they take a profit and send the money offshore, so not paying taxes properly and taking money out of the NHS.

It's a 150 mile round trip from my Mum's town

that really is unacceptable considering these are hospital patients and therefore not 100% fit!

At the moment I'm reading a lot about these kinds of things happening, but touch wood I have not experienced any of them or heard of them happening to family and friends in my part of England.

I do know that in my Mum's part of Scotland most consultant services were centralised in a larger hospital some time ago and the arrangement was consultants would travel to the smaller hospitals to see patients on a regular basis. Now though many of the consultants have have stopped doing this and their patients have to travel to the larger hospital. It's a 150 mile round trip from my Mum's town and some patients are collected and dropped off by a mini bus service which can mean a very long day if there's several patients involved.

No, but Wales has problems too; some of the funding has been removed for services at the GP surgery we attend, one of which is a service I use regularly.
Orthopaedic procedures are just a vain hope for some date months or years in the future - go private was the advice
Cataract patients were sent to a facility over the border in England - a choice of three hospitals offered to a friend of ours fairly quickly (otherwise wait for ever in Wales and perhaps lose your sight)
Heart patients have been sent to a private hospital in Bristol funded by the Welsh NHS - they got excellent treatment there but were lacking one piece of equipment which was needed on rare occasions for just one or two patients, and I believe that the Bristol NHS hospital was refusing to take these urgent rare cases.

Yes it is a crazy bill that has was pushed heavily by Lord Saatchi in the Lords last year. A quacks charter. By the end of its previous life there were so many amendments it was disappearing up its own backside.
Trouble is that there are not enough MPs with any scientific education, not in any of the parties.
This is another depressing piece of legislation in a depressing few months during which all kinds of ill thought out and ideologically driven bills are being pushed through before there are any by elections to reduce the tory majority.
Crumb of comfort is that i don't think it will apply to Wales.

These private companies are all over England these days and I read articles in Private Eye all the time about them.

They operate on multiple sites grouped in 'hubs' which is exactly what the government originally wanted GP practices to do on a large scale to save money. That never happened mainly because it was impractical in most areas, so the next best thing was more private sector involvement.

The chances of patients seeing the same doctor are slim because doctors get sent where the need is greatest. The companies are often only meeting the minimum terms of their contract in the first place to make as much profit as possible, so it's easy for them to drop below that minimum standard when staff leave. They often have a high turnover of staff because of the way staff are treated. This includes GPs, so new GPs are very common.

When a provider is not delivering the agreed level of service, it takes ages to deal with this. Time is given to rectify and review the problem and often the end result is the company cannot provide the service it contracted to provide and moves on. This is common with any private sector contract when it is not working well, not just in the NHS. Monitoring private sector contractors must be costing us a fortune.

The NHS is selling off buildings to rent them back to the private sector, which generates income, but at the cost of an asset.

Forget about continuity of care and the NHS is definitely being privatised through the back door. Time and time again we see examples of things going wrong and it costs money to put things right. In the meantime patients and their families, and the tax payer loses out, whilst someone makes money. In all seriousness I would like to read about where privatisation of core in the NHS is working well and has been for a while.

Just had another letter.

After several paragraphs of PR-speak, the news is that the NHS have sold the building. It says they're in negotiations with the new owner, so perhaps they're wanting to rent it back until the temporary contract with Provide runs out next June, and then close it down.

www.theguardian.com/politics/2015/jul/06/terminally-ill-benefit-claimants-asked-when-they-expect-to-die-mp-says

Just read this. This is not supposed to happen. It's a sick society that asks this.

Has anyone else received a questionnaire from NHS England to complete? It is supposed to improve GP and dental services in our area. If I put crosses in the boxes it will look as though all is well but it isn't.
There is no way of saying how we have to start phoning at 8.00 am if we want an appointment and often have to try over 30 times before we get through and then wait while we are told how many people are ahead of us.
I remember feeling really ill and trying to get an appointment. In the end I gave up and went to bed. Fortunately I lived to tell the tale!
The GPs and nurses are lovely if we manage to get an appointment but I think you have to be fit to go through the torment of actually getting one.
I am not sure what is going on about cataract operations locally. It seems as though an American company are doing the operations at a local hospital and the service is fantastic. Two of our neighbours have had operations within days of their optician saying they needed one. Our next door neighbour came to our house the other evening. He had seen his optician that morning and had a phone call a few hours later asking him to go to the hospital next morning so he needed a lift!

Difference between Berkshire and Durham, Deedaa?

Nearly missed a telephone consultation on Thursday because the GP rang from her mobile instead of the surgery phone!