Beyond a Radical Practice: a bright future for primary care?
A conversation between Dr Iona Heath, former President of the Royal College of GPs, Dr Katy Gardner, retired Liverpool GP, Dr Nadja Van Ginneken, Liverpool GP and Sustainability lead for Central Liverpool Primary Care Network and Roger Philips, former Radio Merseyside presenter.
Event details: Thursday 23rd May, 7pm, Quaker Friends Meeting House School Lane Liverpool L13BT. Cost £5.*:
https://writingonthewall.org.uk/myevents/beyond-a-radical-practice-a-bright-future-for-primary-care/
Primary care has changed hugely in the last 40 years, mostly, but not always, for the better. Princes Park Health Centre in Liverpool foreshadowed many improvements: engaging with patients as partners, being advocates, implementing evidence-based medicine and prevention.
However, these developments have also had negative consequences, resulting in in primary health care becoming dominated by rules and tick boxes. People have become over medicalised and although IT has helped to make health care safer, it has reduced personal, face-to-face contact, creating potential barriers between people, especially those more vulnerable, and their health care teams.
There’s been a reduction in continuity and relationship-based care, a change which GP and health editor of the New Statesman, Dr Phil Whitaker (‘What is a Doctor?’ Canongate 2024) refers to as “taxi rank medicine”. This event will explore: Can we keep the positive developments, restore relationship-based care and have happier patients and GPs? How can we as people/patients/activists help to create a more hopeful future?
This is the link to the book ‘A Radical Practice’ (Writing on the Wall 2021) : https://writingonthewall.org.uk/shop/a-radical-practice-in-liverpool-the-rise-fall-and-rise-of-princes-park-health-centre/
Labour tussles; the short version
In January (NfN 129) we reported a story about the ejection of a SHA activist from last year’s Labour Party Conference. Why was the organisation not more indignant, we asked? We expected to learn more, in due course, and so we did. The member expelled was a well - regarded young activist in the Socialist Health Association who became peeved at the way the health services discussion had gone and challenged standing orders. Nobody seemed to know exactly why this happened the way it did, and from what we hear the SHA was surprised and perhaps a little embarrassed. But there is no shame attached to the incident and it probably won’t happen again.
Source: SHA activists
We love Wes!
Wes Streeting is “up for a fight” and got one recently by writing for the Sun about the need for reform of the NHS. He hit some raw nerves. The NHS is a service not a shrine, he said, knowing that many of his critics worship at the shrine of St Bevan of Tredegar. Wes wants us to judge the NHS by how well it serves the public – the 7 million on waiting lists, perhaps - and not tolerate a 20th century service. An NHS that works round the clock will be needed, says Wes, with additional resources drawn in from our small private sector only where necessary and feasible. This will make middle-class leftists cry “betrayal” (he is right, they did) but he holds a class grudge acquired in early life, which is why he is up for a fight, especially with absurd commentators who say “a vote for Labour is a vote for privatisation”.
Not everything Wes wrote for the Sun will stick. A 24/7 hospital will need downtime, if only for cleaning. It may be more pragmatic to grow Virtual Wards and Hospitals at Home. The value of Artificial Intelligence is overstated and restoring the family doctor role to General Practice is easily said but will be difficult to do. But it’s a good start.
Source: Elizabeth Short, Streeting Jibe threat to NHS, Morning Star April 9th 2024
Politicians beware!
The NHS will never again meet the four-hour A&E target, according to HSJ’s Alastair McLellan (29 April 2024). The English NHS as a whole will never again achieve the target contained in the NHS constitution to admit or discharge 95 per cent of A&E attendees within four hours. Reaching the target would require the addition of well over 20,000 beds – plus staff – to smooth patient flow out of emergency departments and onto wards. The NHS needs a significant increase in social care capacity to speed discharge plus a massively increased contribution to meeting urgent care needs in primary care. A revolution in the use of data to identify and intervene with patients before they experience an acute episode will help, but as the Wachter review concluded, a beneficial impact of new technology is likely to take at least 10 years to materialise.
There is precedent for having ambitious targets. When the A&E target was set in 2003, about 75% of patients were seen within four hours and this improved to 98% by 2006. All of these things should and probably will happen but - realistically - not within the next two parliamentary terms.
No government will be able to afford the levels of investment needed, and even if they could the necessary staff could not be trained in time. Changes might give the impression of recovery but meeting the four-hour target means that A&E departments will be incentivised to treat the least sick patients as they are much more likely to be discharged within four hours.
Source: Alastair McLellan Politicians beware! Health Services Journal 29 April 2024
Workforce changes
The NHS in England employs some 1.5 million people, making it the country’s biggest employer, but it does not have enough staff to meet demand. In order to monitor key developments in staff numbers Nuffield’s NHS staffing tracker aims to provide transparency on progress against some important national ambitions regarding the number of GPs, mental health staff, and nurse vacancies.
Source: https://www.nuffieldtrust.org.uk/nhs-staffing-tracker
How long will it take Labour to stabilise the NHS? A) 12-18 months B) as long as Wes’ tenure at DHSC C) A decade D) Two decades
Read more News from Nowhere and articles on the NHS in ERA 3 at http://www.healthmatters.org.uk/