March 19th ‘What future for the NHS?’
There were three speakers: Janet Shapiro summarised the ‘long view of the NHS since 1948’, Rod Wells told us about the campaign ‘Haringey Needs St Ann’s Hospital’ (HANSAH) and Val Chagger introduced the work of Haringey Healthwatch. (Janet was standing in for Jan Pollock who was unwell that day.)
The ‘long view’ is a sad story. The NHS began in 1948 as a comprehensive service free at the point of delivery; it was centrally planned and managed. In 1948 it was – and still is – funded through national taxation, but now central control and responsibility is abandoned.
Aneurin Bevan nationalised hospitals, with consultants still in charge, but local authorities took over residential care. Primary care was delivered by GPs as private contractors. Free provision has been gradually eroded – some payments are needed for opticians, dentists etc. and we have prescription charges. For older people we regret the loss of Geriatric consultants that monitored care after discharge from hospital. But there have been clinical advances that allow fast recovery from major and minor operations.
The Secretary of State held control through regional boards; funding was allocated according to population needs. Unlike health systems prevalent in Europe that were insurance based, the UK delivered high performance care that was cost effective. (Workers in Germany make heavy payments for their healthcare.)
The % of GDP allocated to the NHS became scandalously low over the years, much lower than in Europe and USA, leading to long waits for treatment. John Major introduced Private Finance Initiatives (PFIs) for new build that proved to be very expensive leaving hospitals in debt.
This affected us locally when the collapse of funding delayed the development with shared clinical and social services of HornseyCentralHospital. A clinic without the promised beds & sheltered housing was delivered in 2009 using costly private investment – part of Ara Darzi’s Polyclinic scheme. The dementia day care centre opened the next year part funded by the Lewis and Mary Haynes Trust that had waited patiently for years.
The internal market, whereby different parts of the NHS bought and sold services from each other increased overheads. Local management was carried out by Primary Care Trusts (PCTs) with NHS staff who organised and monitored local services.
In 1997 Labour raised the NHS budget and reduced waiting lists, but introduced ways of working that fragmented the NHS. PFIs continued and private public partnerships like the Independent Sector Treatment Centres were encouraged.
The Commissioning Provider Split was forced on PCTs in 2009, putting potential service providers in competition. Central control and planning was lost, costs increased and staff security threatened. Hospitals were encouraged to become independent businesses – Foundation Trusts.
In 2012 the Coalition Government passed the Health & Social Care Act, a total revamp of the NHS. PCTs were abolished, their staff made redundant. Clinical Commissioning Groups of local GPs now commission health services; we have a complex structure of quangos, less public say and opportunities for private providers, many being global companies. On top of this upheaval huge budget cuts of £20bn.are imposed. In order to keep within budget many trusts lay off staff, make bed reductions and sell off property.
Rod Wells ‘Haringey Needs St Ann’s Hospital’ St Ann’s is the only hospital in Haringey. The Barnet Enfield and Haringey Mental Health Trust owns the land and provides mental health services on the site. Trusts providing other health services pay rent to the BEHMHT. After local campaigners objected to mental health in-patient services being run down and transferred to Chase Farm, ward closures were stopped. BEHMHT plans to upgrade wards but claims that this must be funded by the sale of 2/3 of the site to a private developer. Knowing that Haringey suffers serious health inequalities and deprivation, HANSAH wants a ‘needs assessment’ to confirm that the land to be sold is indeed surplus to requirements and demanded that Haringey Public Health conduct this assessment. As this was refused the group are attempting their own assessment. The lack of GP’s is undeniable, made worse by Haringey’s population growing by 10% in ten years. HANSAH is in contact with the Health & Well Being Board but is frustrated that no NHS organisation appears to take responsibility.
Rod brought HANSAH leaflets and asked us to sign the petition backing their campaign.
Val Chagger Haringey Healthwatch
Healthwatch Haringey (HWH) is the independent consumer watchdog set up to collect information and represent the views of the public on health and social care. It exists to give patients, service users and local people an opportunity to influence and challenge decision making about local health and social care services. Mike Wilson the Director spoke at the Dignity Action Day and the NPC Dignity Code is printed in their January/February newsletter.
Val is the Administrative Officer employed by Citizen’s Advice Bureau (CAB). She outlined that in response to local comments HWH was attempting to improve: – access to GPs and hospital out-patients, provision for mental health and patient transport. Five new board members had been appointed and HWH is recruiting volunteers to visit surgeries, hospitals etc. Val was asked what powers HWH had and explained that HWH must get a response to any representation.
Questions and discussion centred round the interaction between hospital and social services, poor communications, people going to A&E instead of GP, deterioration of premises and staff morale that led to running down of NHS. But the conclusion was that we must be vigilant and guard our services.
Rod helped with the raffle and speakers continued to answer questions over refreshments.
To book a place on the minibus for the trip to Kenwood on Wednesday June 18th please make it definite by telephoning Audrey Evers at 020 8347 7989. John Boshier has offered to be our tour guide.
Sylvia Roberts and Janet Shapiro attended the Greater London Region NPC AGM on March 27th. A Hackney solicitor, Wendy Pettifer, told us about the increasing distress to ordinary people because of cuts to legal aid. The AGM passed motions on important campaigns. Ask if you want details.
Age UK Neighbourhoods Connect sessions: Contact 8801 5775.
Social Media Drop-Ins –for help with using mobile phones, computers etc. Hornsey Library Fridays 10 am to 12noon, Wood Green Central Library Thursdays 9 to 11am.
Meet a Connector Hornsey Health Centre Tuesdays and Thursdays 9.30am-12noon, Thursdays 12.30-2.30pm – Wood Green Central Library– Thursdays 9.30- 12.00noon – Hornsey Library – Fridays 12.30-2.30]
Caring Connections Groups where you can meet people, chat and reduce loneliness. – Monday from 2.00-4.00 in the Garden Room at North Bank, Muswell Hill Methodist Church, Pages Lane N10 and Monday 11 – 1pm at Trees Extra Care Housing, 2 Broadlands Road, N6 4AN.
For details contact: Kathy Wiltshire 020 8885 8353 or email her at
Music at Muswell Hill Library
Saturday 12th April, from 3-4 pm. Listening to music and creative musical composition: the first of a series of fun workshops, run by Julian Silverman.
Saturday 26th April, from 3-4 pm. Piano performance by Alex Hall.
Social Lunches – 50+ Community Lunch Club’. Hornsey Vale Community Association, Mayfield Rd, N8. Home made lunch & activities £3 on 1st weds of month. Volunteers welcomed. Also at Jacksons Lane on last Thursday of each month from 11.45am-2.30pm at Jacksons Lane. There is often entertainment. Contact email@example.com or call 020 8347 2411.
News Local Barnet councillors and local people continue to challenge the proposed franchise by Post Office Ltd. of the East Finchley Crown Post Office to UOE (UK) Ltd. that plan to put the Post Office counter at a raised level without any consultation with local disability forums.
Planning permission is being sought for the new piazza public space in front of the Muswell Hill Odeon and the shopping parade beside it. Find details at www.haringey.gov.uk planning reference HGY/2014/0818. Comments to the Planning Department by April 15th.