A quick recap – I set up Healthcare 2000 in 1997 to carry on where the previous ‘patient power’ organisation (Medac) left off and we’d pushed for improvements over the years and written articles . We’d had some successes but I had to hand over the reins in 2004 when I reverted to being a single handed GP and had to work round the clock.
Dr Praful’s surgery was taken over by Dr Gorai when he retired and it was closed in 2013 by the PCT using the excuse that it wasn’t up to current standards – although the patients who completed a mini survey after the event said they were perfectly happy with the building and the staff. The haste with which it was closed attracted much criticism.
Dr Gorai had been ‘deposed’ in May 2012 and, as ever, the powers that be were keen that much needed funds should be diverted away from the SWF practices and so a fairly substantial ‘management fee’ was paid into the coffers of a company not based in SWF. There wasn’t much ‘management’ required as the staff had been running the practice pretty well for years.
The White Elephant known as The Practice (aka The New Surgery) was mercifully laid to rest in March 2017, after the contract that was awarded to a private company based in Amersham rather than to local practices (thereby diverting funds away from SWF) wasn’t renewed by NHS England. This brought savings although the NHS continued to haemorrhage funds due to the costly 20 year lease.
The patients from both surgeries were distributed amongst the remaining practices. This meant that the patients who had hitherto been distributed amongst five practices were now squeezed into three. Greenwood Surgery was particularly badly affected because we had previously hired rooms on the ground and first floors from the dentist and pharmacies next door (which gave us breathing space) but the old Maldon &S Chelmsford PCT refused to continue to pay for them so we subsequently had to make do with just the original building. This meant that, when the rooms were all fully occupied, patients were seen on the staircases, in corridors, in the little room behind reception where the old paper notes were kept, and sometimes in the kitchen (but never in the loo!)
In between all the ‘admin’ type work we did we, of course, had to keep up to date with the clinical side. This wouldn’t have been possible without the considerable help of our wonderful band of nurses. That said, we still had to come in at weekends in order to clear the backlog and , like all clinicians who’ve been around for years, we let off steam by having “things aren’t like they were – we were so marvelous but now everything’s gone to the dogs – bah, humbug” conversations. I’m sure we weren’t nearly as wonderful as we thought we were … and I’m equally sure that those just starting their careers will have conversations identical to ours in the years to come. Here’s a recording of two of us moaning (amongst other things) about the fact that SWF’s wonderful district nursing team was taken out of its SWF base by management and subsequently destroyed – leaving us to communicate indirectly (via faxes and emails sent to a call centre) with nurses we and our patients didn’t know. What a rum do, aye?
As briefly mentioned previously the head honcho at the Central Essex Community Services had been round the practices trying to sell us the idea of a lovely new building with a hint of all sorts of additional services being made available to SWF … something we’d been hankering after for years.
This was particularly attractive to Kingsway Surgery because Dr Susan Mathew was still practicing in the house in Kingsway that had been Dr Ingold’s practice – so it was far from ideal for use as a surgery. The new building would be very close to the Kingsway surgery so the move would involve minimal disruption for the patients.
Moving from Greenwood Surgery in Tylers Ride and Brickfields in Brickfields Road would mean more disruption for patients, particularly the elderly patients whose residences were grouped around the town centre ‘health hub’. It wasn’t made clear what the exact plans were but one thing we could be sure of was that nobody would be daft enough to close the Health Clinic as this was needed to continue to provide accessible healthcare to the elderly, those with mobility issues and those living furthest away from the CVMC who didn’t have transport during normal surgery hours (perhaps because the breadwinner had to use the car for work.) This assumption turned out to have been incredibly naive given that the one lesson we’d learned time and again over the years was that there was no limit to the daftness of the decision makers.
The GPs became involved in a long series of meetings with all those involved with the project – the NHS personnel, the developers and all the various interested parties involved with a project of this sort. It quickly became clear that, whilst the PCTs had not had what it takes to instigate and complete a project of any size (for example, a replacement for St Peter’s Hospital in Maldon) the developer did have this capacity. At every meeting we gave our opinions – and sometimes we were listened to and sometimes we weren’t.
One glaring omission: despite frequent prompting to set up a bay for the breast screening unit to replace the one that was part and parcel of the health clinic – a bay that would double for mobile diagnostic facilities such as MRIs and CTs (of the sort frequently used by Broomfield Hospital) – this was ignored. I had a patient involved in running a firm which rented these trucks out so we knew it could be done at reasonable cost – all that was needed was the gumption to push it through. Patients such as the late, great Alan Brunning also put their views forward.
With the benefit of hindsight the GPs could have done with additional input given that we were squeezing in all this in addition to the day job. I felt we were somewhat at sea with regard to some of the practicalities. For example it became clear that the building wasn’t going to be adequately future proofed given the developments at Hayes Farm and North of the Burnham Rd (etc). We asked about the possibility of a third floor given that the building would have a lift and were told that this would not be affordable but, because it would have a steel frame, it would be relatively easy to ‘bolt’ on extensions when the need arose. I doubt if that will turn out to be the case – and I imagine those with more experience of buildings of this sort wouldn’t have fallen for this ruse.
Dr John Cormack