You should have been there on Wednesday at the Dorset open C.C.G. meeting; no, really, you should have. With protestors from all over the county we had just enough to fill the available seating and an overflow room but the long awaited angry pitchfork-wielding mob is still holding out on us. The whole rigmarole resulted from an off the cuff remark at an earlier open meeting last summer when one of our number asked to see the costing. The following day it was announced the decision was to be deferred until now. Evidently they hadn’t bothered to do the costing, since the decision had already been taken and they think we’re a bunch of fucking yokels. They’ve since spent £2.9 million on a ‘review’.
The suits staged a piece of choreographed P.R. bullshit, commencing with a presentation involving some silly diagrams projected on a side wall that fewer than half of us could see, accompanied by 30 minutes (it seemed longer) of that meaningless management drivel they all spout – what the actual fuck is a “pivotal provider”? We were subjected to a patronising lecture about how they were going to encourage us all to give up smoking and take more exercise, as if all our health conditions were our own fault. There’s going to be an ‘engagement road show’ (like Radio One?)
Hidden amongst the overarching visions, stakeholder engagements and enabling workstreams were a few gems. They face challenges in recruiting staff – why do you think that is? Having pissed off every other health worker the government is currently at war with its future consultants and that isn’t going to end well.
The threat to children’s services we have been staving off for so long remains, there is a recommendation to amalgamate these facilities with Yeovil hospital, which as a heckler pointed out, is in Somerset! Yeovil are not keen.
There is talk of care in the community or the home. The meaning of this will be familiar to anyone with experience of personal care. The council, or in this case the health service, pays a provider through the nose for half-hour care slots by agency staff on poverty wages. The half hour includes travel time so you only get twenty minutes, about ten of which are spent filling in paperwork.
Incredibly, the review has determined that aggregate travel times from Bournemouth to Poole, and vice-versa, are equivalent. This was challenged from the floor and we were dismissively told some folk had gone out with GPS and things.
The yokels were not impressed. It was pointed out that Poole hospital is a ten minute walk from the railway station whereas R.B.H. is a 40 minute bus ride from the Bournemouth one – when the bus actually shows up. R.B.H. sits in a traffic bottleneck that is virtually impassable for a couple of hours a day. Six streams of traffic converge on a single-lane roundabout then the eastbound traffic goes over a bridge that “was built for a horse and cart”. Even with a blue light on, the ambulance has to queue for traffic lights like everyone else, because there simply isn’t any room to make way. We recall a flooding incident that backed the whole thing up for an hour and a half.
I’ll spell it out for them: if I had an accident at Bournemouth rail station I would go to Poole hospital. The material accompanying the presentation even more extravagantly claimed that:
“… access to primary care and community services … would be possible by car within 8 minutes for 90% of the population … with just 25 [as opposed to 135 at present] well placed primary care locations”.
That’s pure fantasy. Tell you what, I defy any of them to drive into R.B.H. from Cooper Dean roundabout, park their car, and walk to hospital reception in 8 minutes.
There were many references to financial sustainability and overspending. We are told the N.H.S. has a huge funding gap, now we all know why this is, and it’s got nothing to do with obesity or the ageing population. Private Finance Initiatives (PFIs) allow moneylenders to ‘own’ things other people require to live – such as roads, hospitals and schools – which, like everything else, are simply the products of our labour and ingenuity. With up-front privatisation thoroughly discredited, successive governments have handed the infrastructure over to cash-rich corporations who expect us to lease it back from them over decades at a huge premium. The advantage to the politician is that the transfer of public assets to the private sector is temporarily invisible, as is the magnitude of the debt. So it’s a sort of payday loan, by the time the payments become crippling the politician is long gone, having moved on and with luck, landed a job with one of these glorified pawnbrokers. When the state was forced to bail out the financial institutions after the crash it found itself paying for public assets it no longer owned. Servicing these loans is now given priority over providing services; vampire-like, they are sucking the life out of the N.H.S. The agenda of the government is to shut down and amalgamate as many non-P.F.I. hospitals as possible, nevertheless, the U.K. still spends a smaller portion of its G.D.P. on healthcare than Germany, France or the U.S.A.
Capitalists have a problem; every so often they run out of things to steal. A couple of hundred years ago they stole our land and forced us into waged labour. Every day bosses, bankers and landlords rob us of the fruits of that labour, leaving us only the barest means of subsistence. But as technology makes things easier and simpler to produce, labour gets less and less profitable, or even necessary. Even with us all consuming flat out, there isn’t much to do and most of us are simply an inconvenience to them, especially when we’re too sick, old or young to be adding value to their capital. All that’s left to pillage are things like education and healthcare, which are not commodities but social duties. How can any social grouping possibly “overspend” on the health and wellbeing of the very people who create its wealth?
Following some unconvincing questions from the panel, and a vigorous rebuttal from the floor, a farcical voting ritual unanimously endorsed their decision to concentrate A & E in Bournemouth and reduce Poole to a basic outpatients. This will do for the kid with the saucepan on his head and the rugby player with the singed arsehole, but nothing life-threatening. Here’s a consultant’s view We are told Dorchester is safe, and frankly we don’t believe a word. In 2014, a patients’ survey declared D.C.H. Emergency department as the best in the country. It would have looked a bit odd if they’d tried to shut it then so they went for the path lab instead, then when that was foiled decided to sneak up on it by squeezing out paediatrics and maternity.
A note to newspaper and T.V. editors: we are not “concerned”, we know what they are up to and we are fucking livid.
We hope for a larger and rowdier protest at the next one, bring your mates, and a pitchfork.
How PFI is crippling the NHS