Janet Bertola attended the  public “engagement” drop in session about the future of Calderdale & Huddersfield NHS and social care at New Beginnings, North Halifax on 10th June.  This is Janet’s report:

I got there at about 2.30pm and by the open door there was a large 2 metre free-standing poster advertising the event. The hall was laid out in areas with posters and staff from the Clinical Commissioning Group (CCG), the Hospitals Trust and Locala available to talk.  It would have been better if the staff wore name tags so you could see who you were talking to and what organisation they represented, although the Locala staff member was clearly identifiable since she wore a uniform.

The posters were quite wordy and demanded a lot of concentration to read, absorb, and understand. All the displays behind the different organisations were indistinguishable in appearance, with the Right Care branding.

I found that all the people I spoke to wrote down some of my comments .

I asked if the changes were about cuts  to the budget  over the next few years and was told, no it was about better use of resources to provide better care.

Old people seemed to be the emphasis and the need to keep them out of hospital and provide home care through an integrated service helping them to better manage their conditions. I said, ‘Won’t this cost more money and take up more time in terms of travelling between patients?’ but they seem convinced that the reconfiguration will be the answer but did not offer any evidence of places where the system was working.

There was a real emphasis on the use of technology, tele–consultations and professionals sharing information on the job to aid decision making out in the field. I asked whether there would be a shortage of G.Ps. with a lot coming up to retirement and the government target for recruitment not being met this year and being put off for another year. The fact  some G.Ps will be leaving the profession was acknowledged but did not seem to be considered a problem. The clinician (a pathologist) said most of the G.Ps. were positive about the changes  but whether that was from a proper survey or just informal consultation was not stated.

I asked about Barbara Crosse’s comments in the Huddersfield Examiner stating Option 4 -closing both A&Es and sending everyone to Leeds A&E -might still be what is accepted.

Being a cynic I asked was this said to make us thankful when we only lose one A&E and not two?

I had a long talk to Melanie Giles, school nurse lead with Locala, her concerns for children were Type 2 Diabetes, Obesity,  Mental health problems. It seems these conditions are becoming as demanding as the problems of the elderly.

She was convinced a lot of A&E attendees could be dealt with elsewhere quoting people wanting a broken nail fixed or a repeat prescription, but did not say this was at Calderdale or Huddersfield.

I asked about Yorkshire Ambulance and travelling times from Todmorden and how longer journeys can effect outcomes. I asked if they were aware of any academic studies being done with regard to the impact on mortality when patients have to travel greater distances to A&E. I pointed them to what is happening two years on after the closure of Newark and the research of  Professor Jon Nicholl of Sheffield. I was told that ambulances already take people with different traumas and conditions to different hospitals. I asked if they had spoken to hospitals in the area that had become the area A&Es like Blackburn taking on Burnley area and Oldham taking on Rochdale area, no answer was forth coming and I don’t think it was noted. The impression I was left with was they did not think distance was a problem. They did admit it is very difficult to get A&E consultants and a lot of money is spent on locums. They did not think offering a premium and introducing a market forces approach was the answer as they felt hospitals would be chasing and competing with one another for a shrinking resource  (It seems the market in health care only works one way, that is to pay less!)

I spoke to a lady from the Trust who deals with Freedom of Information requests and asked her about whether the FOI is still open to the public when the company is private but contracted by the NHS to provide services. She seemed to think it is available with limited restriction. I also asked what is going to happen to all the empty space created by the loss of beds at Halifax was it going to eventually be sub-let to the private sector. She was very emphatic that the space would be used by the hospital for diagnostics (ultrasound, x-rays, MRI scans, etc) and other services.

I spoke to Martin Pursey about procurement. He said the CCG did not want to privatise everything but have to operate with the rules of the 2012 Health and Social Care Act.

I also mentioned the Transatlantic Trade and Investment Partnership that is currently being negotiated between the EU and the USA. He said this was not on his radar but someone at Mytholmroyd had mentioned it and he was going to see what he could discover about it.

There were very few people attending the event. I left at 6.45pm and on leaving I asked how many people had attended, only 10 despite the fact there are two surgeries on the street where the meeting was held.

The impression I came away with was that the people running the drop-in are very confident that the Trusts’ and Locala’s preferred option is the way forward and their confidence can be quite persuasive. On reflection and thinking carefully about the event, staff at the drop in reassured me several times that nothing is decided. So this impression was something I felt and I responded to how the event effected me. It was not a fact. But I thought to myself, people will believe this because they are not well informed.

Editor’s notes:

1.The broken nail reason for attending A&E comes from a video cartoon called Dee’s A&E Fail Tale that the Locala boss Robert Flack tweeted enthusiastically earlier this year.

2. The 2012 Health and Social Care Act lays down the “market competition” rules for how Clinical Commissioning Groups buy healthcare services. Under this Act Monitor (the NHS England regulator responsible for enforcing market regulations) will determine whether or not the Clinical Commissioning Group has to put the new care in the community services out to competitive tender or not.

3. The NHS providers’ preferred option is to set up the community and hospital service model proposed in the Right Care proposals, with Huddersfield Royal Infirmary as the site for a reduced number of acute and emergency care admissions (including A&E) and Calderdale Royal Hospital as the site for planned hospital care and a Minor Injuries Unit.)