Friday, December 22, 2006

Vox Pop

Another letter on about the Save our Service march in yesterday's Whitehaven News, this one from Kerry Maxwell who knows a thing or two about the community in Whitehaven.

"SIR – I attended the march and I felt I had to write, to express my congratulations to The Whitehaven News and the Rev John Bannister for organising the march to Save Our Hospital and Services.

This was an excellent expression of community solidarity. The turnout of 4,000 people proves that this community will not lie down and be complacent.

Mr Bannister made it crystal clear the issue facing our community if the hospital should close. Even if we get a new hospital we should insist that we have a fully operational service including those services that have been eroded over the past five or six years. We cannot let patients care suffer due to lack service in our area. Let’s keep up the pressure, and insist that government listens to us as one voice.


Thursday, December 21, 2006

Another health professional speaks out ...

Another letter published in today's Whitehaven News, this one from Bert Van Mourik who is a consultant anaesthetist at West Cumberland Hospital.


Well done to all at The Whitehaven news who were instrumental in organising last Saturday's march in support of local health services. Well done to the 4,000 or so who turned up to send a clear message to politicians and local managers.

Thumbs down to Jamie Reed for his naive and ill-timed attempt to give us all a bit of Labour party spin. What the people wanted to hear from him was what he is prepared to do to save WCH which is already in a government directed downward spiral.

Apart from starting a petition, I didn't hear anything that is likely to make a difference to teh plans that are already in progress to downgrade WCH. At least there seemed to be a wide appreciation of the fact that it is not just about CAT centres, and a new building. It is about saving what is left of the services and taking positive action to ensure their viability for the foreseeable future.

It is about regaining the services which have already been allowed to implode by stealth and neglect. Make no mistake, we are a very long way from achieving any of that and Jamie Reed will have to do a lot better and act very quickly to make a difference. Time is not on our side.

Oh, and where was Tony Cunningham? Do Allerdale constituents not use WCH?

Bert Van Mourik
Consultant anaesthetist
West Cumberland Hospital.

Wednesday, December 20, 2006

Catch 22 - hospitals to be fined for treating patients fast, or slowly!

The latest absurd idea to emanate from the Department of Health includes fining hospitals which are too effective in cutting waiting times by treating patients faster.

The plans were leaked to MPs this week: the Department of Health says that there will be an official announcement early in the new year. But it appears that hospitals will be fined if they either perform significantly more operations than originally planned, or if they do not perform enough, and waiting lists go up as a result.

It appears that the fines would be imposed at the discretion of the Primary Care Trust, subject to appeal to the Strategic Health authority, and could be up to 2% of the mean value of a hospital contract - which could easily be £2 million for a typical acute hospital.

The justification for this barmy idea is that if hospitals are too efficient and treat many more patients than planned, the system of "payment by results" would otherwise mean that they get more money, which may destabilise the budgets of the NHS trusts which have to fund these payments.

While it is clear that there has to be a finite limit on the funds potentially available to any given hospital, giving NHS Trusts the power to find hospitals for being too efficient in responding to patient need is absolutely the wrong way to go about it. Any such limits should instead be built into the contracts in a clear and transparent manner, so that doctors and hospital managers responding to a medical need can do so with a clear idea how much money is available to them and know that they will not be subject to arbitrary fines.

We will have to see what the new proposals say when they are announced early in 2007, but it looks like hospitals trying to cut waiting lists or respond to an outbreak of illness face a situation where they are fined if they do and fined if they don't.

Friday, December 15, 2006

Another Valedictory from a WCH Consultant

This letter from Brian Mucci, former consulant radiologist at the West Cumberland Hospital, was also published today in the Whitehaven News

SIR – I first came to Whitehaven as a medical student in the summer of 1979. I spent a one month elective period in the surgical department. The standard of care was excellent.

I learned a lot, had a good social time and fell in love with the western Lake District. Over the years I revisited on many occasions including a honeymoon at Wasdale Head: probably not a good idea in October. When Whitehaven advertised for two consultant radiologists in 1986 I applied. Dr Tim Eyre and myself were appointed to these posts on the same day. Over the last 20 years we have worked together in a small friendly hospital which, although never at the cutting edge, was able to provide a high standard of care. I tell this to emphasise that I have no personal reasons to take a job elsewhere: I am leaving my post for professional reasons and I do so reluctantly leaving a family and a home behind in West Cumbria.

Dr Eyre has used these pages to explain his reasons for leaving and I would like to add my own:

North Cumbria Acute (NHS) Trust was the result of a merger of the former West Cumbria Trust with its counterpart in Carlisle. Unfortunately the opinions and interests of Carlisle dominate the new organisation.

As a group the four radiologists in Whitehaven formally asked for help in the form of an external review by The Royal College of Radiologists. This was agreed to at the highest level in the Trust, but it has not been done. The Trust is unwilling to take advice from our professional body and has reneged on its promises to do so.

Untoward incidents happen in any clinical setting but in North Cumbria the reporting of these has become a blame exercise where lessons are ignored, especially if they are likely to cost money.

Management deal with clinicians expressing genuine concerns in a way which I feel is close to victimisation, harassment, and bullying.

The Trust takes medical advice from its clinical directors. However they are integrated into the management structure in a way which inhibits them giving proper medical advice, particularly when this conflicts with financial priorities in the trust.

The “Health Economy” locally does not have enough money to support both hospitals. The acute trust is unwilling or unable to admit this or engage the public honestly. Reorganisations driven by cost are being presented as service improvements. These inevitably seem to result in loss of services from West to East.

The people of West Cumbria deserve high quality medical care. They have and will always need to travel for some specialist services. However current policy in the Trust will result in most services being based in Carlisle. Patients in the West will be separated from many clinical services by time, distance and poor roads and this will be bad for the West Cumbrian population.

What can be done? Active campaigning is needed to protect services. People in West Cumbria need to pressurise their politicians and health officials. Do not believe what they tell you, but believe what you see happening. Do not be fooled by a new hospital building: closely question what services are to be included. Here is a simple test: see how long it takes to replace Dr Eyre and myself with radiologists working and living in West Cumbria.


Consultant radiologist

Time is of the essence when it comes to saving your life

This letter from Peter Greenhill was published today in the Whitehaven News.

Sir – May I congratulate you on the organisation of the successful march protesting against the possible erosion of hospital services in West Cumbria.

It is sad that the local MP is still in the “puppy walking” stage of his career and that he had to deliver an approved Labour Party diatribe when clearly the march was specifically local and non-political. But that was the only scuff mark on an otherwise clean sheet.

As a Londoner now living in Cumbria, I can well understand the failure of most Westminster-based politicians and Department of Health officials to grasp the dynamics of rural health care. Until moving here, I had not an inkling of the genuine problems faced in the delivery of any form of health cover, let alone one which serves such a widespread community.

Let me give you an example: where I used to live I had access to the following hospitals: Hillingdon, Mount Vernon, Ealing, Northwick Park, West Middlesex, Ashford, High Wycombe and Wexham Park. Not one of these was located more than 20 miles from my home. These hospitals were based on the population served, which – from memory – was 180,000. I should also make the point that hospitals in London itself were relatively easy to reach.

As a director of one of these hospitals, I well recall the thunderous row when a child with a serious medical problem was driven by ambulance the 12 miles to one or other of these hospitals where it was known that a) they had the clinical team capable of dealing with the child’s specific condition, b) they had the necessary scanning equipment; and c) they had a vacant intensive care bed.

Our clinical staff were accused of behaviour bordering on negligence to subject the child to such an ordeal as being driven 12 miles.

Here in Cumbria nothing is thought of a patient having to travel to Hensingham or Carlisle which from my home are 17 miles and 28 miles respectively. Journeys for other people are even greater, especially if you have no access to a car.

Anyone who has experience of dealing with potential (or real) heart attacks will have the words “The Golden Hour” etched on their brains. For many people in Cumbria a journey to hospital may well take more than that and if the ambulance also has to find the patient’s location in the first place, the Golden Hour is placed in immediate jeopardy.

Clinicians and nursing staff in any hospital work tirelessly to save lives but realise that even with additional time, not every patient can be saved. This leads to the obvious conclusion that the more time you take to get the patient to the care unit, the greater the risk of losing them. Of course, paramedic care is a wonderful additional and powerful tool, as indeed are the helicopters, but there are limits to their use.

Time and again the problems of my hospital came down to bed availability, and although we had the ground space we were not allowed to build a “recovery unit” where patients, as yet unfit to go home, could be certain of continuing care albeit at a less intense level but where urgent medical attention was within a bleep call. A facility like that could solve dozens of related problems which afflict every general hospital in the country but shutting down many existing services does not save lives.

Closing hospital units is lunatic and inhumane.


Sunday, December 10, 2006

5000 take part in "Save Our Services" march

The "Save Our Services" march was a massive success: it was initially estimated by the police that about 4,000 people attended to support local hospitals, and this figure was quoted in the rally at the end. Subsequently the police revised their estimate upward to about 5,000. The march had support across the community from Conservative and Labour politicians to Help the Aged, from Trade Unions in the NHS and at Sellafield to the Rugby Club, the motorcycle club, and everyone you could imagine.

People also came from throughout West Cumbria: I recognised people there from St Bees to Lamplugh and from Whitehaven through Egremont, Seascale and down to Millom, and I know there were members of the local communities in just about every other part of West Cumbria.

All of them came to send the Strategic Health Authority and Patricia Hewitt the message that we want to defend our hospital services.

As one speaker put it, what price can you put on the pain of an expectant mother with complications who has to travel forty to sixty miles over some of the worst roads in the country to Carlisle or Barrow if we did not have a consultant-led maternity unit in West Cumbria ?

It's been suggested to me that this was the biggest demonstration that Whitehaven has ever seen. The community is united to defend our hospitals. And we will keep up the pressure.