All,
In case anyone is in any doubt about the very real threat to our existing GP Surgeries I am releasing a copy of the letter I have just received from all Welwyn Hatfield GPs. From this you will clearly see that doctors fear that our existing network of 8 GP surgeries is indeed under threat.
Sunday 6th July 08
Dear Grant
We have met on several occasions before through the Local Medical Committee and I email you to update you on our latest position concerning the planned Darzi Centre on the QEII site. All the practices in Welhat continue to object to this imposition and have unanimously signed a mandate to this effect. On their behalf I have just written to the Secretary of State, Lord Darzi and the Strategic Health Authority.
I write on behalf of the GPs in the Welwyn and Hatfield Locality who have unanimously signed the mandate to ask that this issue be reconsidered and the directive overturned.
There have been really stringent financial restrictions in Hertfordshire for a number of years and the PCT are on record as saying that the building of two new Darzi Surgeries is not the way that they would wish to spend their money. They have said that they consider that there is no need for such centres in Hertfordshire but as they have been given this mandate by the government as ‘a must do’ they see this as the most pragmatic way of meeting the incredibly short timetable that has been imposed.
For the reasons I have set out in my document attached, the QEII Hospital site is not an appropriate place for siting a new Darzi GP led Health Centre. It is less than 600yards from two major teaching practices with below average list sizes covering 38,000 patients. It is destabilising, costly, confusing for patients, duplicating resources and leading to further congestion at the site and the Darzi GP led Health Centre will indeed have to be in a portacabin for at least 18months.This is an affluent area with many wards in the top fifth of affluent wards in the country and practices with below average list sizes, low disease indexes but lots of ‘worried well’, large group practices with good QQF scores and at present good cohesion and cooperation between all practices who are attempting to achieve the best outcomes for patients. As this is a commuter belt area, the majority of practice here already offer extended access (although the DNA rate for such appointments is of great concern and so seemingly this is not greatly valued by patients.) Even if a Darzi GP led Health Centre is a total failure we are told that it will have to be paid for during a 5-year contract. The funds could be used for essential services such as facilitating locality based commissioning if they were not used for this.
I have been contacted by many individual patients and by groups. This week I was contacted by a member of the Local Pharmacy Committee who have similar concerns about the destabilisation of community pharmacy in the neighbourhood. They too are asking to work with us to object to this imposition. I know that West Herts have very similar major concerns about the siting of the Darzi GP led Health Centre on the Hemel Hempstead Hospital Site. Indeed I have yet to hear any individual speak in favour of this directive, although I appreciate that the PCT are trying to present and implement the government's directive to the best of their ability.
One of the other issues of concern is the lack of democracy. Stakeholders including GPs and patients were not consulted before a decision was made to place the Darzi Surgery on the QEII Hospital Site, which we were told was the only option that was available and that it was not negotiable. There was additionally several weeks of delay in telling us about the decision after it had been made. All that appears to have been negotiable/ consulted upon, was what might be included in this Darzi surgery. We have listened to Lord Darzi telling us all (eg BBC news 8th May
http://news.bbc.co/1/hi/health/7390784.stm) that such GP led Health Centres would only be introduced where there was a need and that if we did not consider that this was what was occurring, then we could object though the County Council Scrutiny Committee. The Hertfordshire Scrutiny Committee was very sympathetic to the arguments against having a Darzi GP led Health Centres and have written to the Secretary of State raising their concerns. However, as the Acting Chair of the Scrutiny Committee said, he did not see any point in referring it back formally to the Secretary of State because all that was doing was asking the Secretary of State to reconsider his own directive. Clearly this lack of ability to have true scrutiny has been of get concern in this locality and we would value your comment on this issue.
The directive that Hertfordshire must have two new GP led surgeries has been successful in uniting health professionals and patients to object to the government’s health policies in a way that I have not previously seen in 26 years in general practice. This is an extremely clear example of where ‘one size does not fit all’.
I am therefore asking you, on behalf of the Practices in Welwyn Garden City and Hatfield, to write to the Secretary of State, concerning the inappropriateness of the plans for a Darzi Surgery on the QEII Hospital Site and adding your support to the other requests that the directive to have the new GP led surgery at the QEII site should be overturned Resources can then be better used to provide an increased service for patients.
However I should make it clear that in the event that there is a failure to overturn this decision then the GPs in this locality are unanimous in their support for a GP bid to try to prevent further extension of privatisation of the NHS.
We will look forward to hearing from you concerning this matter.
Dr Frances Cranfield
Partner in practice in Welwyn Garden City and lead for Welwyn Hatfield GPs concerning these objections.
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