Can we make a difference differently?

Can I just say (very loudly) how wonderful all those folk working in my GP practice are. I think the continuing sniping and complaints levelled at GPs and primary care colleagues is most unfair and uninformed. I want to acknowledge my respect and thanks to all those working in primary and community care, for all that they do each and every day. All through the pandemic, I never had a problem in accessing help whenever I needed it. Yes, sometimes that access was over the phone, and perhaps not always with my GP herself, but come on, she heads up a wonderful team of health and social care professionals.

Great teamworking is critical in effectively meeting the needs of individuals and the communities within which they live. Last Monday J went off to get her Covid booster and flu jab. I was slightly annoyed as I was originally going to get mine before her, but due to circumstances beyond my control, my appointment had been pushed back until the end of October. I was worried by the delay. Covid has not gone away. Although the numbers of cases are still very modest, 12,434 across the UK, this represents a 31% increase in the number of cases over the past week. A word I fail to say correctly, but can write, is ‘exponential’. The 31% rise is simply exponential, and it’s that thought which had given rise to my anxiety and unease.

Back to last Monday, my phone buzzed, and J, speaking from our GP practice, said, ‘get down here as they will do your booster and flu jab right now’. I didn’t need to be asked twice. Down I went and got my two jabs. J filmed it all and I was pleased to post the picture on social media. I am very thankful that I was able to get an early booster. I would recommend that all readers of this blog and all their families and friends follow suit as soon as it is possible to do so.

Now my GP practice is one of two located in our health centre. It is a fabulous place. We have a swimming pool, library, café, chemist, gym, a children’s playground and outside sports area. It’s the base for community health colleagues and houses a comprehensive multi-professional health team. It is clean, bright, airy and almost Scandinavian in design. Like many of the modern health buildings in the area it also has a beautiful glass sculpture design made by the wonderful John Ditchfield. If you are in the area his workshop and studio are definitely worth a visit.

Of course, not all health care environments are located in such modern buildings. Sadly, many hospitals and GP practices are to be found in old, expensive to run and often dilapidated buildings. Some are just downright dangerous. A report from NHS Digital, published last week, showed that it cost over £10 billion to improve these buildings and deal with every growing backlog of maintenance and repairs. When I describe some of these building as being dangerous, they really are. Nearly £2 billion of the £10 billion are for repairs which are reported as being ‘high risk’. These are situations where the need to repair or replace buildings and facilities is critical to avoid catastrophic failure, major disruption to clinical services and resolve safety issues that could cause serious injury or death.

Across England there are some 30 hospitals where the roofs are in danger of collapsing because the reinforced concrete they are made of is beginning to deteriorate and crumble. Some of these hospitals are now operating with steel props in place to hold up the roofs. Perhaps ironically, the West Suffolk hospital, which provides services in the parliamentary seat of the current Secretary of Health and Social Care, has a high-risk backlog maintenance bill of some £62 million. During 2020-2021 there were 10 safety incidents related to critical infrastructure risks at the hospital.

Mind you Cuppacoffee was conspicuous by her absence last week, perhaps she was having a sly cigar behind the DHSC bike sheds. In any event she needs to look at the amount of money currently allocated to deal with these concerns next year. Unless there is a change, the allocation for backlog maintenance is just £1.4 billion. This is just 14% of what is actually required. And I guess we can kiss goodbye to the 40 new hospitals promised by the previous Prime Minister. My own hospital, which is landlocked and has many buildings that are not fit for contemporary health care, did submit a bid for one of these new hospitals. The original estimate was that it would cost at least £500 million to build. Given the other financial pressures facing the government, I grow less confidence that we will get our new hospital any time soon.

However, whilst I think we will always need hospitals of some sort, possibly becoming more specialist, I do believe that we could do something different. Where I live, we have a lovely little hospital, the Blackpool Victoria Hospital. The name perhaps provides a clue as to the state of some of the buildings. The original hospital was opened in 1894, moving to its current location in 1933. Interestingly, its original location now has a state of the art urgent care centre, complete with another John Ditchfield glass art installation. I have been there as a patient, and the service and facilities are first class. Instead of building more large hospitals, perhaps we could build more of these types of urgent care centres. So much more health care could be provided in services such as these and my GPs health centre, and frankly, elsewhere in the community.

If the Covid pandemic gave us anything, it was the courage to do things differently, do things together and do things at pace. Maybe out of the political and economic turbulence we are once again facing, we can find that transformational vision and energy again to make a difference differently.