Tuesday, 22 May 2012

The realities of providing local health services

I found myself in a minority of one when I got embroiled in an online debate about local health provision last week.

The decision to close the local and replace it with the new facility five miles away was not popular with residents. A quick glance at the discussion will show you that most feel as though an inferior service is being provided at the new hospital, particularly in relation to A&E, and they are bemoaning the lack of a hospital in the town itself.

My perspective is somewhat different.  The old hospital was well past its best, a crumbling ruin compared to the new one. The new location is also much more accessible to people in the North of the Borough. Whereas the old hospital had a ‘9 to 5’ A&E,  the new one has an emergency centre that can deal with most minor accidents, with more serious cases being referred to nearby general hospitals. This was essentially what happened when the old hospital was still open, so there really isn’t any change from what went before.

Needless to say, my views were seized on. Other contributors to the debate would have you believe the new hospital isn’t a patch on what went before.  I was well and truly demonized.

We cannot have the penny and the bun, especially in these challenging economic times, and our healthcare commissioners are placed in an impossible position. The reality of the choice is this:  the people of the Borough can either have a second rate A&E service in the new hospital (which was the case when it was an ‘official’ A&E at the old one) or a better standard of service that they have to travel to. I’m not saying that the service at either of the other hospitals is perfect, far from it, but it would be considerably worse if A&E services were spread more thinly.

If people are worried about the length of time it would take to get to an A&E, the research shows that it is the ambulance response rate that matters more than the time it takes to travel to hospital. I feel that inconsistencies here are a more reasoned focus for health campaigners.

No matter where a hospital is located, someone will always be dissatisfied and too many people get fixated on the building itself rather than the quality of the service.  The public protests begin at the first whiff of a suggestion that a hospital may close (although interestingly not in my town, to any great extent) and the local politicians start to dance to their tune. At this juncture, we need more honesty from our politicians, but the desire to make political capital from the situation usually wins through. We cannot hope to provide a first rate service in every single community, town and city etc within the budget constraints. A whopping 40 percent of the Welsh budget already goes on health provision.

A reasonable service within a reasonable distance has to be a better option than a patchwork of inconsistent community hospitals offering varying standards of provision, whether it is A&E, Maternity, Cardiac or Pediatrics.

Saturday, 19 May 2012

The benefits of housing associations

When local council home tenants voted against being transferred to a housing association, I think they missed a trick.

Housing associations are so much more than landlords. As not for profit mutuals, any surplus is channelled back into the housing stock and they offer planned maintenance programmes and responsive repair services. They also offer a range of other services to their tenants and work with support agencies to supply homes for people with diverse additional support needs, including those with learning disabilities, homeless individuals, young people leaving care, women fleeing domestic abuse, those recovering from substance-misuse and people with mental health problems. They invest in the communities they manage and take a proactive approach to managing anti-social behaviour issues.

Not only have local tenants lost out on the holistic packages of support that housing associations provide, the local authority is going to have to folk out £170 million to bring the council stock up to the Welsh Housing Quality Standard. They money may be there, but just imagine the other uses it could have been put to, especially in these challenging economic times.