ELMSWOOD SURGERY PPG, Q & A with local MP Chris Leslie
Present: Heidi Beard, Kay Bellamy, Paula Brady, Jane Bramley, Richard Buckwell, Shelagh Clarke, Gillian Dobson, Dave Groom, John Hackett, Jeremy Jago, Jackie Leithead, Irfan Malik, Magrit Mitchell, Janet Norris (St Luke’s PPG), Amanda Roberts, Pauline Sault, Helen and Edward Skardowa, Rose Thompson, Charlie Wilson. (20)
1. From Rose Thompson
The question: Ask him to explain the difference between Public Health England and NHS England and if Public Health has fulfilled its role under the local authority.
In our experience they do tend to cover similar areas and the transfer of Public Health to the local authority not only caused a mass exodus of experienced staff (Many former PCT health professionals jumped ship to form their own Community Interest Company in Nottingham.... Nottingham City Health). Smaller voluntary sector CIC orgs cannot hope to compete with larger CICs staffed by former PCT staff.
The greatest loss of experience in Nottingham City impacted the leading role (Director of Public Health). After the 10 yr Post holder moved on and a succession of short term DPHs followed, ending with one over both County and City. Not the best decision as the needs differ and too big a job for one person who isn't familiar with both.
From BMECCs observation there is a lack of understanding and awareness of what a mutually beneficial Partnership relationship with grass roots Community Orgs should be and that community based orgs need to be respected for the work they do in their own right and costs covered as part of any Partnership. Public Health has been a casualty of the reforms and in Nottingham failed BME and low income household communities affected by cancer. Smaller orgs like BMECC picked up the financial tab that should have been funded by Public Health when the budget was healthy. (Healthy Communities Collaborative funding).
How will Chris ensure that Commissioning of health services is fair and reaches the most disadvantaged via Reverse Commissioning as outlined in our Hear Me Now reports www.bmecancer.com
(takes service user needs into account first and works in reverse quickly, rather than lengthy procurement, designed to protect statutory bodies with little consideration for the requirements of community partners).
During the Hear Me Now prostate cancer meetings with BME and other community organisations in 4 cities,
London, Leeds, Nottingham, Birmingham; it soon became clear that everyone around the table was not happy with Public Health.
Will Public Health survive the cuts and damaged public reputation?
Chris’ answer: Chris agrees that the NHS is a very complicated organisation where it is often not easy to see exactly where the buck stops. Treatments are the concerns of the Central Commissioning Groups and hospitals and prevention is through Public Health England and funding for all NHS services come in parcels of money from the quango called NHS England. He will be supporting and pushing for a National Cancer strategy to ensure best practice throughout the country. In particular he noted that the free prescriptions for 5 years for anyone who has cancer should be more widely publicised.
2. From Janet Norris (St Luke’s PPG)
The question We've been in correspondence about the Urgent Care Centre so I'll see if he's made any progress in respect of public transport.
This is quoting from an e-mail that Janet had received that morning from Andy Gibbons of Nottingham City Council “Ideally we would extend the free electric Centrelink service there, since this currently serves all parts of the City, connecting into other bus, tram and rail routes. However, this will cost at £120,000 pa since would require an additional bus in the circuit.
In my view this should have been funded by the development itself, since we consistently said that this location was not served by public transport. As it wasn’t, we’re now left with trying to get funding for other sources. We’ve tried INTU as part of the Broadmarsh redevelopment work but failed and have also approached the various City Centre car parks which are also on route – again with no response. We have also sought advertising revenue from EON (as the bus is electric) but this expired after one year.
I should also note that by September 2016, we’ll be extending the Centrelink service to Queens Dr P&R via the train station, as a temporary cost-saving arrangement pending various changes to Broadmarsh bus station and charging facilities. Citylink 1 will be rationalised accordingly to give us cost savings.
Citylink 2 currently runs every 15 mins and does an anticlockwise loop of the City Centre linking Victoria area, Market Sq and Broadmarsh, returning via Canal St. Passengers can alight at the end of Canal St or on Pennyfoot St for the Island Site. They will have to return from the other side of the Drop In Centre on Manvers St . You are right that we’re looking to see if we can redirect this through the Island Site (Citylink) but this is currently in exploration stage only.”
Chris’ answer Chris acknowledges that the public bus provision for the Urgent Care Service seems to have fallen between gaps in funding streams but he will follow this up. He also agrees that consultations do not seem to take into account the responses that they receive.
3. From John Hackett
The question In what ways is Labour policy being developed to counter the current Tory policy of creeping privatisation of the NHS?
Chris’ answer Currently the Conservatives are in a majority which means the opposition has little leverage. Chris agrees with the aim of improving 7 day access to healthcare but feels the Junior Doctor negotiating has not been done well. The formalised contract review every three years or so means that alternative providers tend to be favoured in the process. Whilst NHS budgets have not been cut, they have not grown in line with demand. Whilst he acknowledges that the Conservatives say they have no agenda to privatise the NHS, this is patently creeping in and will be difficult to reverse. In addition the regular bailing out of Trusts over winter crisis gives no incentive to those Trusts who are trying to manage their budgets effectively. The possibility* that Sherwood Forest Trust may be amalgamated with the Nottingham University Hospital Trust will make a very large Trust and could overstretch the hitherto well run NUH.*Confirmed the following Monday (15/2/16)
4. Shelagh Clarke
The question What worries you most about the Conservatives running the NHS without any effective opposition from Labour? I worry most about the privatisation by stealth that is happening.
Chris’ answer Chris thinks that the main possibility for change in the current political environment could come when the main contenders to succeed David Cameron start setting out their stalls and jockeying for position.
5. Jane Bramley
The question NHS will be affected by the Transatlantic Trade and Investment Partnership.
Although the National Health Service has already been privatised to a large extend with countless contracts given out to private providers, the passing of the TTIP legislation will enable much more privatisation without any hope of getting privatised services returned to the NHS
Don’t you think that you as our MP you should do more campaigning about TTIP to bring it to the attention of constituents as well as speaking out in parliament. TTIP discussions are taking place in complete secrecy. It is never aired on TV and I think there is a danger of it getting in ‘under the radar.’
Chris’ answer The concern is compounded by the complication of when there are disputes involving US companies, would this be settled in Courts here or in the US? Also there are concerns that US practice is to push patients to have maximum treatment even when it may not be in their best interest – because the treatments are a revenue stream for them. TTIP is raised in parliament from time to time but Chris will add it to his list of things to follow up.
6. Dave Groom
The question The combined resources of the present government and the media are hell bent on discrediting all aspects of the NHS, whittling away the public's trust, with the intention of bringing about its demise as a free publicly provided, publicly funded service. What innovative plans might Labour be considering to combat the worsening crises created by under-funding. How will labour restore this much loved service to one in which everyone can feel safe.
Chris’ answer There needs a plan to decide what sort of NHS we want to service society. The trend is more people living longer and having longer retirement. We have to decide spending priorities. We could find other sources of revenue: tackle waste, streamline and flatten hierarchies. Labour created the NHS and will not let it go.
7. Amanda Roberts
The question What will labour be able to do to impact the training and provision of healthcare professionals of the future? We know there is a shortage of GPs and many surgeries are at breaking point. We know that there are around 200 vacant posts for dermatologists around the country and the impact this has had on adult dermatology provision in Nottingham and we have read about the plans to force nurses to pay for their own tuition fees.
Chris’ answer Chris is part of a just-set-up All Party East Midlands Group of MP's at Westminster that is going to address a number of issues specific to the East Midlands. One of the issues is recruitment and retention of doctors and especially GP's. He was clear that the East Midlands lags behind on a number of criteria: infrastructure spending, lottery grants etc.
Questions for which time ran out:
From Rose Thompson:
a) My second question is about the Cancer Screening service.
The very informative NHS Cancer Screening Service website was decommissioned at the end of Sept. (Sept 30th). The service has to be evidence based led and cost effective. Currently 9 out of every 10 breast lumps detected by NHS screening services (primarily mammography) are not cancer and over diagnosis of breast cancer in some slow growing cancers that may not have developed is an issue. The recommendation is that only high risk groups affected by specific types of cancer should be screened. For example people with a family history or specific groups disproportionately affected by a specific type of cancer.
New diagnostic tests and tests to see who is most at risk of developing fast growing tumours that require treatment are under development and will no doubt change the face of cancer screening radically.
However as they are not yet in place why has the NHS Cancer Screening Service based in Sheffield had such a radical overhaul. Including replacing years of useful patient information with a few pages on other websites. (NHS Choices). Years of research and evidence useful to health profession students also gone.
b) Does Chris know what the future of the NHS Cancer Screening service is?????
From Ian Hewitt
'The evidence from the early stages of the DEVOMANC (http://www.kingsfund.org.uk/blog/2015/03/devo-manc-health-social-care-wellbeing-greater-manchester) process is that the local NHS services are being heavily compromised and the privatisation agenda is being accelerated without democratic oversight or any apparent restraint. How can we ensure that North Midlands Devolution does not follow in the same tracks?'
Ingrid Reid
My main concern is increasing privatisation, lack of staff (increased use of agency nurses, overall decrease in funding for the NHS in relation to GDP (Britain being now behind more or less every European country) .What are Labour's views and plans on all this????
From Pauline Sault
What reassurance can Chris give that future elected governments will not be prevented from taking back into public ownership health services that have been privatised when the Transatlantic Trade and Investment Partnership (TTIP) is agreed between the EU and USA? The investor-state dispute settlement (ISDS) included in TTIP will enable private companies that provide health (and other public services) to sue any future elected government for loss of profits if legislation is introduced that allows the government to take privatised services back into public ownership.
Spending on health services in the UK is significantly lower than in other western European countries. Over 80% of hospital trusts will seriously overspend their budgets in this financial year. For many of them PFI debts constitute a significant proportion of their debts. How would Chris fund adequate and sustainable health services in the future?