Andy Crow learns about self injury
I had intended to attempt an objective explanation of the process of the West Cumberland Hospital takeover. I’m finding it very difficult. The process is complex and there are few certainties. Copeland MP, Jamie Reed voices a widely felt sense of frustration in his comments quoted by the Whitehaven News in their preview to the ‘Stakeholder Event’ held at Rheged on October 12th. To describe it as ‘a sterile public relations event’, however, gives scant credit to the energy expended by a lot of people intent on securing the best future from a situation not of their making. This event offered an opportunity to air fears and anxieties as seen from a wide variety of concerned perspectives.
I was very sceptical about the Foundation Trust model of healthcare provision when I first encountered it. It looked like a good way of breaking-up a leviathan NHS into bite-sized pieces, structured on a conventional business model: lean, mean and oven-ready for a private sector with a huge appetite for profitable tasty morsels financed by the public purse.
As I have become more familiar with our own Foundation Trust (as a member of its governors’ council)and the senior personnel that run it my cynicism has diminished. I see a team of determined and industrious enthusiasts. These people actually believe it is possible to run decent public sector health services despite the savage funding cuts being demanded. If front line services and jobs are protected it won’t be because of politicians’ words; it will be because this enthusiasm has made it happen.
CEO Stephen Dalton describes Cumbrian staff as ‘at least as good as any in the country’. If his perception is correct (why wouldn’t it be?) his vision for future health services in Cumbria lets that talent off the leash of centralised micro-management to provide a joined-up healthcare service fit for purpose in the twenty-first century. To allow that to happen Cumbria Partnership needs the backing of a Trust providing a range of world class specialist interventions and he sees that support coming from Newcastle. To a large extent that is simply a continuation of the way Cumbria has always looked to Newcastle to provide services that are not viable in a thinly populated county with scattered small urban centres. Put like that a partnership with ‘Newcastle in Cumbria’ is what we already have in all but name.
The alternative proposal for North Cumbria (Morecambe Bay trust had withdrawn its bid in the light of a pressing need to put its own house in order) is to be part of the Northumberland Healthcare Foundation Trust. Northumberland’s case is largely based on their demonstrable expertise in running ten hospitals across a large geographical area with similarities to Cumbria.
Either of these proposals has the potential to ensure the future of public sector acute hospital services in North Cumbria, but they are different. We can’t have both, so a choice has to be made and that choice is about accepting a vision of the future. The vision is vital to longterm success. It matters how the new management will integrate with GPs, with voluntary sector organisations, with local and county council services, with wider community health services, with staff, specialist clinicians and… and… and. Ninety representatives of groups of these Cumbrian stakeholders met to interrogate the presenters of these alternative visions, and seek to clarify what was being offered. How might it differ from what we are currently familiar with for good or ill. These questions and answers, should inform phase two of the process as the hospital board seeks to select a preferred bidder. One might wonder why the board which has fallen short on the job is considered best placed to appoint its successor, but that is the system we have and its decision will be heavily influenced by auditors Deloitte who will look at finances real and projected, and crawl over the figures that purport to measure clinical outcomes..
Jamie Reed’s assessment that talk of ‘vision and overviews is futile’ will be spot-on if those making the final decision have not taken notice of the Stakeholders’ signposts to where the elephant traps lie.