The influx of new GPs included Dr Anne Dyson and Dr Suzanne Everett who joined my practice in QE2 sq and Dr Ramesh Patel who joined ‘Old Dr Patel’s practice’ in Champions Way. Dr Jayant Patel joined Dr Ingold’s practice in Kingsway when Dr Joliffe was sadly forced to retire following a heart attack. This ensured the long term continuance of general practice in the area.
Most of the doctors who arrived at the time and subsequently had spouses who had a reasonable income. This was because the town had always lost out due to the arbitrary manner in which NHS funding was allocated … so the practices (and hence the GPs) received a smaller allocation than elsewhere. This persisted for most of the time I was in practice in SWF. For example, in 2016 Brickfields, Kingsway and Greenwood Surgeries jointly wrote a letter to Andrew Pike, Area Team Director complaining of a large reduction in funding. And in 2018 I wrote a (somewhat tongue-in-cheek) article which included the following:
“A short distance away is the Danbury Medical Centre which is awash with cash because their patients are deemed to be much less affluent than ours. A high proportion of those living in leafy Danbury and Little Baddow are experiencing major ‘austerity’ problems at present. In many households the cook has to double as the wet nurse, the gardeners have to run errands, the nanny has to undertake cleaning duties and the Butler has to act as chauffeur when he can be released from his household duties. There are even reports that some Little Baddow households are delaying ordering new Ferrari 812 Superfast Coupes until the climate is more favorable. Fortunately, though, the NHS recognises their plight and makes sure that, by way of compensation, they get a whopping chunk of the available budget for primary care.
“Here’s the surprise – despite being set up in a palatial new practice building (loosely based on the Taj Mahal) and being treated very favourably by the NHS, this practice fared badly in the recent survey. I wonder, therefore, if the current drive towards huge practices is misplaced. And is NHS England (which is encouraging this trend) shooting itself in the foot by publishing this data? Small practices are much more efficient in many ways – knowing the patients well means we can cut the crap and get straight down to business. Indeed, there was powerful evidence published this year that continuity of care improves health and longevity – something we take for granted in NHS single handed practices. The CQC says of Greenwood, for example, that: ‘Female and male life expectancy is above the local and national averages.’”
Thus was in line with the ‘pay more, get less’ ECC ethos that the residents of SWF were experiencing … so we were all in the same boat.
There was help in the early days, however, when it came to the funding of new GP premises. The NHS had set up a ‘Cost Rent Scheme‘ whereby GPs could take out loans to fund new premises and they were assured that the repayments would be covered. In other words, they rented out their premises to the NHS and were reimbursed accordingly. This was how the Brickfields and Greenwood Surgery buildings were funded.
To set the ball rolling I had to talk to the Essex County Council representative based in SWF. He told me that ECC had a ‘vision’ … a ‘health hub’ in the centre of the town. By this time the Town Centre Health Clinic and the Ambulance Station had been completed. The plan was to add two medical practices, a dental surgery, and a pharmacy to create a complex in which most of the ‘primary’ health needs of the residents could be accommodated. Residences for the elderly were built close to the hub so that patients living there could get to the town centre facilities under their own steam. This was conveniently ‘forgotten’ when the NHS closed all the town centre facilities – leaving these patients high and dry.
I wanted a freehold property but I was told that only leasehold was available for this purpose. That didn’t seem to be an insuperable problem as all the leaseholders in the town centre had been led to believe that they would be given first option when ECC sold off the leases. (Needless to say this didn’t happen.) I was offered a site and asked if had a builder in mind. I hadn’t so I was given the details of one who seemingly could take on a task of this magnitude. I contacted the builder and was then asked if I had approached an architect. I hadn’t so the task ended up being allotted to a contact who happened to be the Council’s contact I had spoken to in the first instance … which seemed rather a cosy arrangement. That said, the plans for the building looked OK to me (although the mandatory ‘SWF style’ wasn’t quite in line with the ‘box-like’ NHS template) but I soon lost confidence in the builder and had to commission an alternative company. There were a few of the usual hiccoughs encountered which delayed the opening … but eventually we had our new surgery and moved in.
Tune in for next week’s exciting instalment!
Dr John Cormack