Lynne's Parliament and Haringey diary

Having done my usual advice surgery this morning, this afternoon I met with David Sloman (Chief Exec of the Whittington Hospital). We had our usual discussion on the progress of their application for foundation status - which is seemingly progressing.

We then went on to discuss the issues around the Hornsey Hospital development as I suddenly saw a real possibility of how the new facility could be made to work well. David was saying that if the IT system that is installed was linked to all local practises and the Whittington - then we (the people) would get a proper health network whether we went to our local GP, or were referred on to the polyclinic (click here to read about polyclinics) or the Whittington. Also, he was saying, that it would be more natural if the local health trust were to commission the Whittington say, to facilitate the phlebotomy department (taking blood) at Hornsey Hospital or other natural extensions or outposts of the services.

Anyway - the point I made was that David needs to make sure he (and the Whittington) are at the table with the GP practises et al when the specifics of the new health facility are being hashed out. That's why I keep saying - it could be great or it could be a disaster - it will depend on real, real partnerships and not the Trust simply saying this is what you will have.

Labels: david sloman, polyclinics, whittington hospital

Well, well, well! So Health Secretary Alan Johnson has outlined plans which aim to make the NHS more user-friendly for patients in his speech to the Labour conference. He said patients should be treated close to home and GP surgeries should open "at times and in locations that suit the patient, not the practice".

I will be quoting this incessantly at Haringey PCT if they try and move our GP practises into the polyclinics! That's the point I keep making. We need to be treated close to home.

As for this shenanigans with Brown and the election - a real man, a real Prime Minister - would put the country first! I rest my case!

Labels: alan johnson, gordon brown, nhs, polyclinics

Wednesday evening met with Peter Hendy, Commissioner of Transport for London. My three asks were: extending the 603 bus route to run all day and evening (as always); the transport issues around the new London Health Trust plans including the polyclinics (we need to ensure there are good public transport links for any such); and whether he would think about encouraging car clubs (where people share cars) via a congestion charge incentive.

So - number 1 - the 603 bus from Muswell Hill to Swiss Cottage. Well - the possibly good news is that it comes up for review next year. So our job is to make sure we feed into that review with thousands of requests to extend the operating hours from its current school run times only. People keep asking me about this - so we will have to ramp up our campaign again.

On number 2 - well it was interesting - because there are huge transport implications in the proposals to restructure health services. Firstly - the need to access in emergency for stroke, heart attack and major trauma the proposed super-specialist hospitals. Surely travel time trials from every part of London need to be done to establish the worst scenario time taken when traffic is bad and no air ambulance available? If we can't get the victims to the right place in time - then this plan won't work.

Secondly, the establishment of polyclinics - which are to serve up to 50,000 residents - may raise big transport issues. Will people be able to get to the polyclinics in reasonable time and at reasonable cost?

Peter was saying that this could be an issue and was going to arrange to meet with the Government to talk over the transport implications. Hurrah!

On number 3 - yes - Peter is considering how best to encourage the expansion of car clubs - so he agreed to look at the congestion charge in that regard - but I think any discount will be along the lines of discounts to people within the zone but not outside. Anyway - it is in and on his mind.

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

Labels: 603 bus, nhs, peter hendy, polyclinics, tfl

Muswell Hill and Highgate Neighbourhood Assembly - centred for its theme on older people in the area. Featuring were both the plans for Hornsey Hospital to become a polyclinic and the abandoning of the idea from Haringey for a restaurant in the centre of Muswell Hill Library - at which we cheered as the detailed case had never been made for it.

On the rest of the plans for the library (which is much in need of care) - there was still no timetable at all - and the Director of Libraries who was there didn't know the timetable and didn't have information about some of the basics of the plans. Not impressive. And the tragedy is that some of the ideas that have been talked about have been excellent - but it's all being lost in a mess of vagueness and foot dragging.

And then the poor woman presenting the Hornsey Hospital update got it in the neck for the shameful consultation process taking place at present on the local Primary Care Strategy. Sue Hessel said that only seven people attended the first meeting and the second which is tomorrow night may attract just as few. They said they were happy to go to other meetings if invited but as I pointed out - having a meeting isn't consultation - nothing like. So I've written my Highgate Handbook and Muswell Hill Flyer column on this issue (will post after it is published) as local people need to know what is going on.

Update: my article about polyclinics is now here.

Labels: hornsey central hospital, muswell hill library, nhs, polyclinics

Spend the morning in Ealing for the by-election. Seems very jolly over there and upbeat. Main community event of the day back in the constituency is going to Avenue Gardens Residents' Association to do a 'Question Time'.

Key issues from the evening included Haringey's lack of consultation with residents over planning proposals - in particular - Haringey Heartlands. And - even if there is a consultation - they ignore it.

One resident raised the issue of the proposed polyclinics - and the potential of these plans to denude us of our local GP practices. That is what we need to make sure doesn't happen.

It was interesting when I met with the Trust and asked what I would think is a critical question - what proportion of GP visits require further action (diagnostics, referrals to a clinic, etc), they couldn’t give a full answer.

But this is key to the polyclinics idea – because if, say 90% of doctor’s visits require follow up with one of the services that will be at the polyclinic – then having the GP and those other services all on one site can have advantages of saving further trips (and so further delays). But if those 90% instead don’t require further services, then having GP practices centralised isn’t nearly so attractive.

Anyway - back to Avenue Gardens Residents' Association - we also ranged over excess of traffic, HGVs, the tick-box society, the quality of councillors, the poor quality of decision-making at Planning Committee, and other topics too. I enjoyed it - as I always do. Meeting people at events like this always reaffirms the point to the whole process. It is always about peoples' lives!

Labels: nhs, polyclinics

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.

Labels: nhs, polyclinics, richard sumray

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.

Labels: david sloman, nhs, polyclinics, whittington hospital