We talked in the last newsletter of laughter and lunacy prompted by a 1956 Goon show and the goings on with the new NHS legislation. Things have got little better for patient or practitioner. The latest news is that Healthwatch is being stripped of its statutory status and so the patient voice is being downgraded again. Jeremy Taylor of National Voices reminds us that we must not fall into the trap of thinking that effective patient representation comes only from getting the organisational side right. We must not forget the behaviours. We say we need both and over the years, it has been sad to watch how much sustained and passionate effort from individual user representatives has been wasted and overlooked for the want of mechanisms and means to consolidate and re-broadcast those views in a way that has impact and creates action. It does seem sometimes that the only way to get a view over is to stand in the street in front of the Secretary of State and shout at him. Then of course you become a threat to public order and are liable to be removed but at least you get on the 10pm News. Does it advance the cause?
We don’t shout in the street – we write blogs and in a January one, Andrew Craig looks at one very intractable issue where even the strongest patient screaming will not be enough to break down what he identifies as major cultural barriers standing in the way of integrated health and social care services. The nature and size of this challenge cropped up again in a February blog about NHS Scotland success in bringing together management and workforce to plan for and improve patient services. The authors of this research identified the bringing together of health and social care as the biggest challenge facing this successful partnership working – much more effective in their view than the English and their market-based approach. The truth is that neither approach has grasped this particular nettle.
Some Not About Health
It is a great relief for us and we hope for our readers to look at life away from the bearpit that is NHS reform and perhaps to take a stroll in the park. Perhaps to enjoy the fruits of an £9m refurbishment funded by all those Lucky Dips that paid out precisely £0 – but wait “Are there chips as well as fruits on the menu?”. Such was the challenge that Caroline Millar wrestled with as she faced the consequences of being an agent of change and innovation. The upgraded café in Clissold Park and the absence of chips from its menu has now featured in the national press and the internet chat sites are rancid with abuse in the face of this betrayal of the Hackney working classes and their children who can’t even get a tea, a wad and chips for 4d from their very own cafe in their very own park. They have, it is alleged, been elbowed aside by the affluent arrivistes with their appalling insistence on expensive pomegranate frittata or something equally healthy, disgusting and expensive, taking up all the space in the premises with their monstrous buggies filled with Fair Trade attired infants tended by squads of au pairs. Was this why we fought the war? This issue is now being refreshed and put in a better perspective by people who like the new park and café and have taken the time to say so. So it goes – the yeah sayers are usually slower off the mark than the nay sayers.
Caroline wants to look a way of avoiding the screaming and shouting and have a debate that recognises both achievement and the possibility of change and improvement in a way that avoids the personal and the name-calling. Meantime she survives and lifts her eyes to the latest proposals in the school system where we are promised Commissioners who like Cromwell’s men or the fabled US Marshal to ride into town and sort them schools out. [ Can you add to the comment on the mythic stereotypes as seen in all the best Westerns (not a hotel) of the lone and righteous man facing down the forces of darkness or poor school performance?].
Mixing in High Political Circles or Not
Another opportunity of relief from Health and Social Care came with the invitation to Colin – Which? member, ex-employee and former Council member – to meet a senior political figure. Which? hosted a breakfast meeting where Ed Miliband set out a consumer agenda that seemed to chime almost exactly with the current campaigning priorities of Which? Ed invoked the shade of Which? founder Michael Young – Lord Young of Dartington in his later years – to reclaim Which? for the Labour Party and certainly the question that occurred to me – only afterwards of course in the classic ‘esprit d’escalier’ mode – was whether Which? with this impressive show of unanimity about what was broke in Rip-Off Britain with the Labour Party leader, had abandoned its traditonal neutrality as between one political party and another?
We did not get a chance to compare consumer agendas as between the Coalition and Ed’s party because we were not invited to the recent Health Summit in No 10. Andrew’s blog emphasises that the need for change and reform in the NHS is inescapable. Jeremy Taylor of National Voices, who was invited and went, made the point in the meeting that what was happening was creating a great deal of unease and anxiety about the way things were going and how little attention was being paid to the patient in whose name this whole exercise was being undertaken. Perhaps the new social media are the way to make the patient voice heard in future? Could this leap the barrier of insufficient organisational and statutory support?
News from Your Surgery – How to Do Service Right and Wrong (at the same time)
A very disturbing piece of research claimed that many GPs were totally stressed out but they manage to conceal that from their patients. Does that make you feel better? Our blog tells you what the danger signs are. The research was done before the advent of GP-led commissioning. But all is not gloom and burnout. An example of excellent service is described in Caroline’s blog on her latest GP experience – great service and the only person complaining about how dreadful it was, was the receptionist offering it. Weird – but then this is the NHS. Enjoy excellence when it appears and then ask for more stuff like that. Then tell someone about it – a site like NHS Choices or Patient Opinion – because patient and carer stories are, when taken together, a good indicator of what the clinical data are showing. So it is a shame when like Val, you want to tell a hospital how well they had done, you have to hunt down the comment card at reception.
In view of the spell of warm weather and anticipating Spring, we have joined the leaping hares in the field and published our March newsletter in February.