Back to the Future

Old hands will have seen (or heard) it all before. There is very little new in this world after all – Star Wars was a ground-breaker, Terminator 2, and Back to the Future (1) perhaps, and some argue for Ghostbusters, but as we all know that the NHS, for all its political hype, remains stuck in Groundhog Day.

The new NHS guy Simon Stevens wants small local hospitals. Yikes. Let’s wind back 30 years – we have just managed to close them all and sell off the land for housing developments, and close valued specialist units to centralise them in Tibet as centres of excellence. Everything comes full circle in the NHS if you wait. No need to think deeply on it if you are a senior guy – just pull out the minutes of meetings from around 1985 and re-circulate those with your name on – the ultimate in recycling.

I have a thing about stupid and unnecessarily long NHS names – stuff like the “AnyCity Teaching Hospitals NHS Foundation Trust” for example. What’s wrong with calling it AnyCity Hospital? Let’s be simple and clear. One of the problems for patients is that everything in the NHS is made to appear as complicated as possible. We could call these small local hospitals Anytown Hospital. Too simple?

Over the last decade or so there has been too much centralisation of services at the expense of the demise of the local community.

To live up to my pseudonym, I’ll just say I was born back in the year rationing ended in Britain. In those days we still had local maternity hospitals, and communities were strong. I went through my school years with the twins born in the next bed to me, who lived locally, and mums in the hospital developed new friends and support groups from each other which lasted all through the early years of nurseries and infant / junior schools, which were just a short walk away. Families knew each other, relatives were close, and other kids in the school lived locally and knew each other. Midwives, Health Visitors and District Nurses still prowled their areas and delivered and cared for generations of a family. That maternity hospital where I was is now converted to housing. When my kids were born a few decades later in a different maternity hospital, lifetime friendships were still made. That one is now a housing estate.

Where has that sense of community gone now when school children are shipped in by car from miles away in the morning, and shipped back in the afternoon? And the pregnant patients from my practice have to travel for almost an hour to the nearest inner city maternity unit which serves a vast area around instead of popping up the road to the old maternity hospital less than a mile away (and is now basically a minor injuries unit). How many patients see the same Midwife more than once, and will that person provide continuity of care? I think not.

To be fair, many of the older units are Victorian and unfit for purpose. The concept remains good however. What the NHS needs is a long term strategic plan which lasts longer than 4 years, and which all political parties will work towards, instead of a piecemeal approach which always seems to collapse just prior to each general election.  The NHS is too big for one political party to mess about with for their term of office, and some joined-up thinking is long over-due.

Now where did I leave the DeLorean Doc?


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