JOINT BOLD (Building Our Local Democracy) and 38 Degrees Manchester Meeting.
Open Meeting to discuss the state of the NHS and its future under Devolution.
The meeting was held on Monday, 21st. March 2016 in the Sessions Room of the Olde Boar's Head, Middleton.
Speakers: John Coppinger (former procurement officer NHS), Estephanie Dunn ( Sec. NW College of Nurses), and Dr. Michael Taylor (GP and former member of local CCG)
There were 19 others in attendance including Dr. Mo Jiva ( Lead for new Middleton Hub and chair of Bury and Rochdale GP group)
John Coppinger. (long career in NHS and management experience)
John's main themes were the creeping privatisation and chronic underfunding of the NHS. To illustrate that there has been a degree of private funding in the Health Service since its inception. He recalled seeing Company signs above beds in the old Salford Royal showing they were for their employees. These firms knew that healthy workers were more productive.
John felt there were many companies, and he quoted Virgin as one, who are 'muscling in' on NHS contracts and quoted there are 853 not for profit organisations working in the NHS currently. Rather than quote all the figures John mentioned, they and many more, can be found in the NHS Confederation Report published on January 15th., which is attached.
In terms of Devolution the low base line in terms of healthfor the population of Greater Manchester has to be taken into account.
In summation the NHS is surviving and delivering, but doing more with less.
Estephanie Dunn RCN. (NW Regional Director)
Estephanie started by saying the NHS was the 'victim of its own success', trying to maintain standards whilst experiencing more pressure on services.
Whilst delivering more immunisation and wider range of services, the ageing population meant that more complex and diverse ailments were being treated.
In terms of nursing staff there were many factors, apart from increased workload which were demoralising colleagues. Reorganisation had seen career banding pushed down and targets were becoming harder to achieve. She described the career structure as being like a Christmas tree with just a few at the top rather than a 'jelly baby' structure where there were more people accessing better pay levels after a certain length of service. As with doctors, the feeling of being undervalued was leading to many nurses to seek work abroad where they would be under less pressure to work long hours. They have, like Junior Doctors, the added incentive to leave so they are not having to pay off debts incurred in training.
In terms of recruitment there were 50,000 applicants for 30,000 vacancies because NHS England had reduced the number of places on offer.
The need for better co-ordination of Health and Community Support is paramount as many of the elderly are being 'pushed' into hospital because of lack of support at home. Estephanie quoted a figure of £70,000 for one elderly patient which could have been avoided if there were enough people in the care system with the right skills.
Manchester and other city regions have greater health problems due to external factors such as relative poverty, lack of access to good housing and associated problems of drug and alcohol dependence etc. In this region the abolition of business rates due next year for SMEs (small & medium enterprises) will cause problems to fund pro-active measures such weight management programmes which have been cut.
Again one got the impression of having to do more with less.
Dr. Michael Taylor (Heywood GP, former member of CCG)
Dr. Michael felt it important to take a balanced view of the NHS. Politics had a part to play but the NHS is too important to be politicised to the extent it has. Some degree of privatisation is inevitable but the money spent on buildings under Tony Blair's reign in office was not rewarded with a good return in terms of improved services. Although he felt productivity had gone up under this government he was pessimistic for the NHS if ever George Osborne became PM.
Dr. Michael stressed the need for the public to be more responsible for their own health. Although diet, especially sugar intake were important factors it was the sedentary nature of our lifestyles that needed addressing. Calorific intake overall had not increased over recent decades but many people spend up to and above 23 hours a day without weight on their legs. He cited other pro-active measures for the public to monitor their health, such as having their own blood pressure machine in the house.
The NHS was still performing well relative to other advanced nations according to the Commonwealth Fund. This despite spending less of our GDP on health than many countries. Going forward under Devo Manc there is a need for the public to be more involved in decision making and getting their voices heard. More people needed to come along to these types of meetings and have a say in the way services are run. Dr. Michael commented on the lack of proper consultation over Devolution. However he felt that a good choice had been made in the appointment of Sir. Peter Smith as chair of the Greater Manchester Combined Authority was a good one, and he had already negotiated more funding.
Better health, he believes, starts with Primary Care in GP surgeries and in people's own homes and neighbourhoods. People looking out for each other, and participating in the debate as was happening with meetings like ours.
Comments came fast and furious from the audience. Some scathing comments about the interim mayor, Tony Lloyd and the Leader of Manchester City Council, Sir Richard Lees. The secrecy and lack of democracy in how the Devolution and appointment of a mayor had come about were the main bones of contention. Tony Ettenfield emphasised the need for people to get in touch with their councillors engage with the CCGs whenever possible, go to Township (or equivalent) meetings. Dr. Taylor felt we could play a part in involving more of the public in shaping how DevoManc worked. To this end, Dr. Jiva (lead doctor in the Middleton hub and chair of Bury and Heywood GPS) was keen to encourage more public involvement and would be hosting an open meeting on Wednesday, 13th. April, in the Middleton Masonic Hall, in which he would shed some light on the implications of DevoManc.
There was some concern over how the new hubs, 4 in Rochdale MB, set up to provide extended GP surgery hours would work, especially with regard to making obtaining a doctor's appointment easier. An audience member was concerned that a person could be dropped from a GP's list if no response to 2 letters. Although this could happen there was a problem Dr. Taylor said of many GP lists having 'ghosts', that is persons who had passed away or moved out of the area. Dr. Jiva said there were improvements in record keeping now which meant he was able to see not just those on his list but all Rochdale MB patients.
Tony Ettenfield briefly mentioned the threat posed by TTIP (Transatlantic Trade and Investment Partnership) to further privatisation of our NHS.