Saturday, October 10, 2015

Shropshire NHS Shambles.

Was over at a social function in Shropshire last night. All Shropshire's MPs were there. Though the occasion was one of joy and celebration, inevitably there were some private chats about what's going on with the reform of Shropshire NHS hospitals.

I can hear the teeth of some gnashing already. Montgomeryshire MP banging on about Shropshire NHS again. What about maternity at Wrexham Maelor or retaining services at Aberystwyth!! Well, the post-devolution reality is that I have a responsibility for NHS services outside of Wales (Shropshire) but none whatsoever in Wales - except through working closely with Russell George AM (which I do). I have no formal status in relation to the NHS in Wales. The Welsh Local Health Boards could tell me to mind my own business. But as long as I engage constructively and comment reasonably, they don't do that. But I must respect devolution. Services at Wrexham and Aberystwyth are the responsibility of the Welsh Gov't in Cardiff.

Anyway back to Shropshire. Last week, it seems to me that a catastrophic 'shambles' was created. I'm not suggesting it's easy. It's easy nowhere. Lets look at the wider context. Across the world, demand for health services cannot be met. Two obvious reasons. Firstly, we are living longer. More of us have complex, multiple treatable conditions. Much illness is associated with advanced age. And secondly, technological advance is delivering new drugs and new treatments which are hugely expensive. This also means a growing need for specialist health provision. During the first 3months of this year, the NHS Trusts in England are almost £1 billion in deficit - predicted to be £2 billion by the end of the year. And this when the NHS budget has been protected. Increased even. It's the price of success and 'good news'.

Shropshire's basic problem is that it has two major hospitals. It's population justifies one.  It's now obvious building the Princess Royal Hospital in Telford was a fundamental mistake. My good friend and regular squash opponent, Dr Paul Brown, was ranting about this 30 years ago. Paul's name is on the door of a PRH extension. He was a great man. But the powers that were built it. And then a new Chief Executive, Adam Cairns was appointed a few years ago, who decided to build a new Women's and Children's hospital there as well. Another catastrophic decision (in my view). 800 Montgomeryshire people turned out at public meetings to tell him. It was one of those 'going through the motions' consultations. As soon as he did the damage, he cleared off to Cardiff and the Vale, where he remains as far as I know!

There has been a long and expensive (£2million) process to decide what to do now (known as Future a Fit process The decision on the 'preferred option' was expected last week. I was away in the US. I'm told that initially, it was decided that both hospitals would remain - the Royal Shrewsbury becoming the 'Emergency' centre while the Princess Royal would become the advanced treatment and diagnostic centre. And that the Women's and Children's Hospital should be moved to Shrewsbury.  I'm guessing here, but there must have been a mighty row. I suspect arms were thrown up in the air in protest and horror. Anyway, no decision was taken. Deferred now until next summer. After all that consultation and expense, no decision. Catastrophe. Spokespersons for the Future Fit Board are trying to tell us the reason was that none of the proposals they were considering wiped out the predicted future deficit. What!! We know that. Known that for months. I'll take some convincing that it wasn't just a pathetic failure to take what would inevitably a tough decision.

Don't know where we are go from here. Current position is unsustainable. We are headed for massive deficits, (this years is expected to be £20 million) and serious winter failures, plus decisions being taken out of the hands of local clinicians, who should be the people best placed to take them. It was always going to be a tough call, followed by a massive public row. That's why £2 million was spent preparing for it. At present, the dust is settling and maybe the fog will lift in a few weeks to show us a way forward. But it looks a monumental shambles at the moment. Another post in November perhaps.

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