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 naïve 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.
