The ‘other practice’ the PCT had in its sights was ‘Clement’s House’. This was the surgery that had been set up and run by successfully for many years by Dr Praful Patel.
The staff were friendly, accommodating and efficient which made them popular with the patients. Latterly Praful had been joined by Dr Souymo Gorai who took over the running of the practice when Praful retired. There had been a certain amount of friction during the transition period and, when Dr Gorai took over, it soon became clear that he was spreading himself too thin. As well as running the SWF practice there were mentions in the press (etc) of him having fingers in other pies. In particular he was doing a lot of ‘out of hours’ work – so, as well as being responsible for his own patients during ‘social hours’ he was looking after other GPs patients during ‘unsocial hours’ (i.e. nights and weekends). This is risky as tired doctors make mistakes … but, in his defence you could say that he was merely accepting the standards that had been generally adopted by generations of doctors.
The risks had been played down by the medical profession for many years. As I never tire of pointing out, when I worked for transplant pioneer, Prof Roy Calne at Addenbrooke’s I was on a ‘1 in 2’ – in other words, as well as ‘the day job’, I worked every 2nd night and weekend. This meant that, for ‘on-call weekends’, I started work on Friday morning and carried on until Monday evening. If you’d said to a patient towards the end of the shift “Your operation is about to be carried out by a team who have been on the go for over 72 hours” nobody would have batted an eyelash. On the other hand, there would have been a riot if a planeload of people had been told: “This is your pilot speaking. Welcome to your flight to New York. By the time we get there I and my crew will have been flying backwards and forwards across the Atlantic for around 80 hours without a break.”
You’ll remember that the Maldon and South Chelmsford PCT decided that it would be a good idea to open a 4th practice in the town centre (at a time when the population was well under 20,000) of the basis of a public consultation which showed that there were just 53 residents who thought that this was a good way of spending large amounts taxpayers’ money. This put a considerable strain on NHS resources so ways of offsetting this profligacy were always welcomed.
Dr Gorai’s problems were used as the initial excuse for focussing attention on Clement’s House as the ‘local NHS’ had a responsibility to ensure a safe and satisfactory service to patients. The fact that it had hitherto interpreted this as a duty to do everything in its power to ensure an unsafe and unsatisfactory service to patients in SWF was quietly forgotten. The surgery was therefore quietly set on a path to destruction. As ever, the local GPs would have been more than happy to look after the surgery during the transition period … but it was decided instead (behind closed doors, as ever) to pay a private company approx £3000 a month to do this job. As I say, the staff were very competent so the surgery pretty much ran itself – which would have meant we could have put any additional funds into patient care … but patient care was always very low on the list of priorities held by the ‘local NHS’ so the company was deemed to be the most deserving beneficiary. The premises (which had served the patients well throughout Dr Praful’s tenure) was inspected by the CQC and found to be altogether inadequate … so this was used as the ultimate reason for closing the practice.
Management, having made the decision, then repeatedly delayed letting the public know what was going on. Such was their incompetence, the patients only found out at the 11th hour … so they then had to queue round the block in order to attempt to register at the remaining practices before their practice shut its doors for good. Pulse newspaper carried the following story
“A practice has been closed and patients given just two weeks to find another GP, partly due to a critical CQC report into its premises. NHS England Essex Area Team announced that Clements House Surgery in South Woodham Ferrers will close on Monday 30 September, and apologised for the late notice given to patients.
An NHS England spokesperson confirmed that a CQC pre-inspection that had raised concerns about the building ‘partly’ informed the decision to close the surgery.
The closure comes after a following a public consultation into the future of service delivery there. As part of the consultation, most patients said they were satisfied with services at the current surgery but expressed the wish for a permanent GP to manage their care. Respondents to the consultation also raised concerns about the building.
NHS bosses have apologised for giving patients just two weeks to find another GP, but said that all had been informed.”
It went on in the same vein before concluding:
“Dr John Cormack, a GP at a nearby practice in South Woodham Ferrers, Mid Essex, said he would take on some of the patients from the closing practice.
He said: ‘It’s absolute chaos. In giving them in only a couple of weeks they’ve created a furore with patients queuing out the door, with patients trying to get on lists before the doors close.”
I conducted a ‘mini-survey’ of the Clements House patients who’d registered with me once the dust settled. The responses given differed from those received during the official survey. Although they were satisfied with the service they were getting (they would say that, wouldn’t they), the patients nearly all said that they were perfectly happy with their old practice, they liked the staff there, they liked the building and, if it hadn’t been closed, they’d still be patients of that practice.
John Cormack