Thursday, December 07, 2006

PCT - The evil within?

I attended the Cambridgeshire PCT Board meeting on the 6th December 2006, I found it very enlightening.

The PCT are the driving force behind the Hinchingbrooke Hospital review, yes more than the SHA. The PCT also have a huge mountain to climb and Hinchingbrooke are caught up in this, it appears that the 2 are supposed to be different issues but in effect they both are linked.

It is a shame that Hinchingbrooke is going to have to suffer because of the Government's obsession with changing the NHS around and also because the PCT is suffering a huge burden of debt.

It is a shame that Hinchingbrooke and the good people of Huntingdonshire are to be penalised due to financial mismanagement of the other former PCT's in the county of Cambridgeshire. Huntingdonshire PCT were financially sound and “in the black” but that was due to the fact they had a deal for healthcare with the superb Hinchingbrooke Hospital, unfortunately this deal has not passed over to the new PCT and this has had a huge impact on Hinchingbrooke Hospital as a whole. If the hospital had been paid at the full tariff for the episodes of treatment then it would be financially stable but still under threat from this year on from the new PCT.

I feel as a NHS patient, member of the public and an NHS shareholder that I have been let down badly, not by one but by many agencies.

It is time matters were put into perspective, transparency and full dialogue with the public made a major priority.

Naturally the public are protective of their health care and are reluctant to change especially as this new way forward for the NHS has not been “sold” properly.

I hate using buzz words and jargon but the PCT. SHA, Government and to some extent Hinchingbrooke are at fault here.

It has not been communicated properly to the public and the recent piece meal “Engagement events” were an utter sham, they need to be done again with proper road show type events.

As tax payers, users of the NHS and local residents we need to be ready to be motivated should a “tick box” consultation paper be issued, I have told the PCT that to use a “tick box” method is inappropriate in this circumstance and they should be having proper forums with real people. If they go ahead with this type of consultation then we will have to get on the streets again and ensure that no one completes and returns this kind of consultation paper at all.

Communication is a wonderful thing if it is done correctly, if the PCT had guided the public as to how healthcare is to be provided in the future and the reasons why as well as been able to have in place one or more working examples of the “new wave” of community based healthcare then that would have been more acceptable. The main communication issue is that the Interim Chief Executive has been banding about Care in the Community as his banner but in effect his arrogance has backfired on him. The public per sieve that Care in the community is when you are in a home or bed ridden in you own home, there has been much confusion as to the labels Care and Treatment in the community.

One issue with Treatment in the community is the risks involved and the lack of community provision, and with Patient choice who in their right mind will opt to have a minor procedure done at their G.P when they have traditionally and will feel safer, having that treatment at their local hospital.

At the meeting yesterday it was acknowledged that local patients do not use Private health providers as much as the PCT would like but then they probably won't even more under the Patient choice scheme.

The new 18 week referral to treatment was also raised yesterday and it is understood that in the first 2 years of the adoption of the 18 week scheme that “activity” will rise, yet in the Hinchingbrooke Hospital review activity is an area for which the PCT want to reduce, contradiction or what?

Another area of concern that has been highlighted is the cost of Prescription drugs and the use of generic drugs rather that brand names is being looked into, however it is well known that the drugs industry is a cartel and the Government should be taking this into account.

The PCT have a Turnaround plan and they are expecting a forecast of £33m overspend but it has been agreed by the SHA that a £17m is an agreeable overspend so in effect there have to be savings of £15m of which £6.9m of savings have been identified. There are 40 areas of work that have been identified by the SHA for possible savings and the PCT are looking to see what else they can do over and above what they are currently doing to save cash.

It was decided that there should be a strategic plan for the population of Cambridgeshire and they decided that they must get this across via public engagement, however they are not in practice and there is a great deal of work to do , they have to empathise, come down from the ivory towers, stop the jargon and tell the truth, be humble not arrogant.