A Workers reader recounts what it is like to be part of the NHS's new style of communicating with the public...
No such thing as a free lunch
WORKERS, APR 2007 ISSUE
After participating in a Mori survey about NHS services in London, I was a bit surprised to receive a phone call asking me to participate in an all-day all-expenses-paid forum on the same subject, lunch and refreshments included. Having already expressed my views, I was puzzled. The caller explained that the purpose was to further discuss what the future of health services in London should be. It seemed wise to check what they were up to! Maybe I could find out why they were proposing to close or downgrade the local hospital.
Opinion leaders
The NHS has employed a company called Opinion Leaders to conduct these events, of which there were two, at the end of February for north London and early March for south of the Thames.
It was rather sloppily organised. The promised letter with details of the event never arrived. We arrived at 9, about a hundred of us, and stood in a smoky hotel lobby for an hour while the organisers got the room ready. A large number of people had not been allocated tables, but eventually we were seated, about ten to a table.
Finally the forum got under way, well over an hour late. It opened rather innocently, with an introduction about the need for change in the NHS to improve Londoners' health, followed by open-ended questions about our positive and negative experiences of the NHS.
But it soon became apparent that the "facilitator" on each table was there not just to chair the discussion but to persuade us, quite nicely, to fill in some blanks on his computer screen.
Participants wished to be very specific about improvements needed to health care, such as hygiene in hospitals, better communication between members of the health team, and between them and patients, better training of NHS staff, better conditions of work, etc. Plenty of us were glad to get a lot off our chests, not worry too much about what the facilitator said, and then go off and have a lovely lunch at the expense of the NHS.
After lunch the Opinion Leaders really got down to business. Opinion leaders turned out to be a fairly good description of it. We were to be not so much consulted as led, by Professor Ara Darzi, who clearly has a plan. Due to progress in medical treatments, he reckons we now need structural change in the NHS: local community hospitals and health centres containing both GPs and specialists, and a few specialist centres for specific conditions requiring urgent treatment (like strokes and heart attacks).
Brave new world
Fair enough, perhaps – he's the expert. But then the crux of his argument: our present hospitals won't do; we must start afresh! So we were given a glimpse of a brave new world through a video showing a brand-new health centre in Tooting and a brand-new community hospital in Park Royal, with inspiring architecture.
Plenty of us liked the look of these swish new buildings, but wondered where the money would come from? Who would own them and where would they be fitted into our neighbourhoods? Then one elderly lady said, "Of course you can have a fine building but still wait too long to get an appointment. And a fine building soon gets dirty if not cleaned properly." Someone else then observed, "The new PFI hospital in Romford already has 3 wards closed due to MRSA."
Not for discussion
These points were not up for discussion. Our table raised the question: "Wouldn't it be better to clean up and remodel what we have, to make it serve the new functions?" No, the old buildings just weren't good enough, according to Professor Darzi.
One cheeky fellow wondered if Professor Darzi was working for an architect or developer, as well as the NHS. How much had he paid for that Hermes belt he was wearing!
None of this, of course, will show up in the "consultation" report. We had to vote on a number of carefully framed questions. We were required to say in each case whether we agreed the proposed changes would bring improvement. And, while opinion was very divided, more people were prepared to agree. Many of us went away feeling we had simply been used, to "prove" there was public support for the destruction of our hospitals. We were sold a pig in a poke.
And there is no such thing as a free lunch.