Monday, 23 February 2015

What does the future hold for our hospital?


Tomorrow night the Borough Councillors in Stafford will be asked to support a motion for a referendum on the hospital.  I have no way of knowing how that will go.

I have talked to thousands of people over the last few years the frustration and anger at the loss of services has been very apparent. Maybe a referendum will give people a way of expressing this feeling. It might also leave people free to use their election vote to choose the party that they see as offering the right option for them and for Stafford on the many different pressing issues that face us all.

In the years since the Stafford crisis broke there have been many changes in the health service, not least in the way in which hospitals are supported if they hit a tricky patch.  I think that everyone in the Department of Health recognised the harm that was done to Stafford by the years of reports, reviews, inquiries, and the administration process.  Now when it is recognised that hospitals are in trouble, both in financial terms, and in terms of attracting and retaining staff they get placed into “special measures” with the clear intention of turning them around.

In Stafford the reverse of this happened. The Investigation of 2008 isolated the hospital. The turnaround that was attempted in 2009 did not work – in part because of the strongly orchestrated demands for a Public Inquiry.

The first Inquiry gave patients and families a chance to have their voice heard. This was valuable and has certainly had a big effect on thinking within the NHS as a whole. It did also strongly make the point that there are genuine difficulties in managing the care of frail elderly people in our hospitals.
The second Inquiry always seemed to me to be about Andrew Lansley’s desire to demonstrate the structural flaws within the NHS, and to justify his reforms. These reforms were imposed and are now generally accepted to have been a very costly and distracting mistake.

The Inquiries and all that followed  have month by month eroded any possibility for our hospital to recover in its original form.

So if the motion tonight is passed – and if the referendum takes place and is overwhelmingly passed  what then?

Personally I believe it is na├»ve to think that we can return to the way things were.  Staff and teams  are scattered, the hospital and the whole health economy of this part of the country remains in serious financial trouble.  

The health service is changing. Most of us accept that there are some services which are best performed in large hospitals with specialist equipment and consultants on hand 24/7.

Improvements in surgery and other treatments mean that care which in the past may have needed a hospital stay can be done as day case treatment, much of which can and should be done as locally as possible.

The development of monitoring systems means that patients can play a major part in controlling their own conditions and staying well.

It is also recognised that acute hospitals are not the right environment to support and rehabilitate very frail elderly people.  The aspiration is to provide much more care for people in their own homes, to prevent unnecessary admissions, and to help them recover with their families around them.  That raises very serious questions about the availability and cost of social care and community nursing.

When the dust from the Election, and the referendum if it happens, has settled then I believe that there is an important role for all of us in mapping out the right future for our hospital and the wider health services in our area. It is unlikely to be the same as it was – but by working together perhaps we can make it better able to cope with the massive challenges that lie ahead.