Whitehaven News column – 12th March 2015

Once and for all
After a sustained period of disinterest from government health ministers, last week I wrote to NHS Chief Executive Simon Stevens calling for an investigation into the health service in Cumbria so that – once and for all –we can understand the difficulties facing our local health service and develop a plan to solve the problems we are presented with.
The Cumbrian health economy is experiencing the most prolonged period of intense pressure it has ever faced. Many working within it believe that it is on the verge of collapse.  Over recent years in particular, the system within the county as a whole has moved from one crisis to another. Inevitably this compromises patient care. I have repeatedly raised these issues with the Department of Health over a number of years. The time to act is long overdue and the publication last week of the report into the failings of University Hospitals Morecambe Bay Trust by Dr Bill Kirkup CBE now makes action unavoidable.
Those people working within the Cumbrian health economy who work tirelessly to provide high quality patient care in increasingly difficult circumstances deserve our unequivocal support. Despite these pressures, it is the efforts of these people – above and beyond what they are paid for or which should ordinarily be expected – who are preventing systemic collapse from taking place.
Cumbria is England’s second largest county. The population of the county – less than 500,000 people – is disparate. The terrain is difficult and the infrastructure inadequate. The county is home to startling social and economic inequalities and is served by two acute hospital trusts. These inequalities typically manifest themselves in health outcomes. North Cumbria University Hospitals Trust provides services at the Cumberland Infirmary (Carlisle) and the West Cumberland Hospital (Whitehaven) and the University Hospitals of Morecambe Bay provides services at the Furness General (Barrow-in –Furness) and at the Westmorland General (Kendal). These four DGHs serve Cumbria’s major centres of population. All are in ‘special measures’ and have been for some time. In addition to this, Primary Care across Cumbria is also subject to growing difficulties and there is a clear crisis with regard to the recruitment of General Practitioners.
The issues in relation to our hospitals – raised by Professor Sir Bruce Keogh and others – are clear:
-Staff recruitment and retention
-Locum expenditure 
-Maintenance of clinical standards whilst retaining accessibility to services
 Primary care is also under incredible pressure.  The most recent GP Patient Survey shows that over 60,000 people in Cumbria had to wait more than a week to see a GP the last time they tried. This is likely to be a conservative figure.
None of these issues are new, but progress has stalled in recent years and the situation is worsening.  Only by understanding the interconnected issues relating to the local health economy as a whole – rather than treating individual manifestations of failure – will Cumbria’s health services become sustainable for the long term. This is particularly relevant given the likely influx of thousands of people into the area in the near future due to the construction of three new nuclear reactors, new submarine building programmes and other investments that are larger than the Olympics in scale.

Good news: this week Simon Stevens responded and he will shortly visit the county to see first hand for himself the problems that we face. Progress at last. As for the strategy for ‘growing our own’ medics. Watch this space.
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