Dr Phil Hammond, broadcaster and GP returner in Bristol

NHS reconfiguration must be based on patient benefits

Have you ever been to a party conference? I don’t belong to a political party and the thought of all that mass happy clapping and ovation turns me cold. Isn’t that how fascism started? However, this year a charity called the Health Foundation asked me to chair a debate on reconfiguration at the Labour knees up in Bournemouth.

Reconfiguration interests me, mainly because I am not sure what to think. If I had a major head injury, I wouldn’t mind travelling, preferably quickly, to a specialist centre with lots of experts and jig saws and machines that go ping, but I can’t see the logic in shutting down services for common emergencies (asthma attacks, swallowed marbles, stuck babies). I think there is a limit to how much erstwhile hospital work a GP with a special interest can do.

So I agreed. The debate was staged in something called the ‘Health Hotel’, a concept that has been doing the rounds at all the party conferences for a few years now. The aim is to gather all the important health debates in one place, and the Liberal Democrats and Tories apparently give it a prime location and plenty of support.

Labour, as you might expect, doesn’t want too much dissention or too many awkward questions, so we were tucked away at the back of the hotel. The audience needed Sat Nav to find our function room, and most of them didn’t. It was an intimate gathering.

And our health minister let us down. Ben Bradshaw pulled out because he had something more exciting to go to, so all-purpose GP MP Howard Stoate stood in. Joining him was Bernard Ribeiro, President of the Royal College of Surgeons, and Bob Noble, a communications officer for the fire service until the onset of Alzheimer’s disease.

It was a surprisingly lively debate, brilliantly chaired, with some searching questions from members of the socialist medical association. Bernard said the evidence for centralisation of complex surgery had been there for 10 years but politicians had been too cowardly to act. Howard agreed, and spoke of the wastage and needless duplication that goes on in hospital. Bob spoke of the frustration and insecurity of not knowing which local services were going to be merged or axed and why, and his wife, Marylyn, explained how hard it is to dash across town to a more distant hospital to look for your husband who has gone wandering.

It was a great example of how the NHS doesn’t involve the people who rely on it. People in boxes in Whitehall make decisions that aren’t properly thought through or explained, the press then misreports and sensationalises them, managers try to implement them (or face the sack), and the bullying and confusion gets passed down the line. As Bernard put it, ‘all reconfiguration should be based on sound evidence of patient benefit.’

Alas, in a politically run system, evidence gets watered down with ideology, spin, and the need to get a result by the time of the party conference. After 10 years of Labour, we have wasted a vast sum of money and a golden opportunity to reform the NHS. Things can only get better. G

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