Fiona Wise, the Chief Executive of Ealing Hospital NHS Trust, announced at last night’s Ealing Local Strategic Partnership executive board meeting that she was moving on. Apparently she is going to North West London Hospitals NHS Trust.
Clearly she is a brave woman. Ealing is rated as providing good services with good use of resources whilst NWL is rated only as fair with weak use of resources.
Last night we had a full agenda covering:
We had almost a full panel last night except for Councillor Kumar who had a clash with an Ealing Homes board meeting.
It was a long meeting, lasting three hours, but we covered a lot of ground. For papers follow link.
David Williams from the PCT outlined the PCT’s property strategy. It is all about getting GPs to come together in bigger practices that have additional services. I was a bit concerned about their fixation on “landmark sites”. I am not that keen on gold-plated, architect designed palaces of health. Bigger and fit-for-purpose is fine with me. The talk was long and slightly controversial as we had two Hanger Hill ward councillors, cabinet members both, Barbara Yerolemou and Nigel Sumner, there to back up Twyford residents who were complaining about the lack of GPs surgeries in the north eastern corner of the borough, bordering Brent.
David Williams also presented on practice-based commissioning which is Tory GP fund holding Mark II, bigger and better. From the doctor attending it looks like it will allow GPs to innovate, save money and use the cash to do more. Great. Shame we have lost 9 years of improvement.
Brian Queen, who knows a lot about bid bonds (to find more information on the subject visit https://swiftbonds.com/performance-bond/) and currently runs housing in the borough, outlined how the key estates strategy is changing. Currently we have too many estates designated as “key estates”. If we are not careful we will lose our Decent Homes funding in the next government spending review. A more realistic strategy is to remove some of our 8 key estates from the list and spend the Decent Homes cash now.
Finally a report from Adult Social Services by Mary Umrigar gave some re-assurance that the service is continuing its journey from no star, rock-bottom it hit two years ago. Good news.
The title of this council committee is not very glamorous but its work is important. I am one of five Conservative members. There are four Labour members.
Last night we had a full agenda covering:
In attendance last night we had the chief executive of Ealing Hospital, the chairman of the PCT, a director of the WLMHT, the cabinet members for Children’s Services and Adult Services & Housing and the Chairman of Overview and Scrutiny Committee.
The work of this committee is pretty demanding as the issues are complex and highly political and the papers are very hard work. The Better Government for Older People paper last night was particularly jargon ridden and hard to digest.
The Tory chairman of this panel, Clifford Pile, is very capable and his Labour deputy, Jasbir Anand, made frequent and impressive contributions in the first two meetings. The Labour group really let themselves down last night though. All four members failed to turn up. Councillor Anand did manage to get Councillor Dhami to stand in for her but he felt unable to make any contribtuiton whatsoever to the main meeting. Two of the Labour members have failed to turn up for ANY of the first three meetings of the panel. The people of Ealing, and in particular the people of the Southall wards, who suffer the greatest health inequalities, are being badly let down by these councillors.
Scrutiny allows opposition councillors to make a real impact. It seems a shame that the Labour group can’t come up with four councillors who can make a contribution.
Both the Ealing Gazette and Ealing Times covered the “How clean is your hospital?” show with Kim and Aggie this Friday. I did not get a chance to see the show but some of the coverage makes you think.
I am not surprised that they found some big problems in such a large and complex building with so many staff. Even in a small building you can find some reall horrors lurking in corners. What really worried me was the systematic lack of hand hygiene.
Apparently it was revealed by secret cameras, placed in the hospital over one weekend, that 55 per cent of nurses and 93 per cent of doctors did not use hand gels when entering wards, something which is designed to reduce the spread of infection. I cannot believe the arrogance of these doctors who almost all refuse to observe this basic precaution. The nurses seem to be not much better. Until the leaders of this organisation get out on the wards and pull up the senior staff in front of their colleagues for hygiene breaches there will be no real improvement.
Fiona Wise, the chief executive of Ealing Hospital, give the impression of being complacent and out of touch. She said: “I think the hospital is broadly clean but there are areas that are not, due to a number of factors. It is impossible to achieve 100 per cent cleanliness 24-7, because people do abuse the hospital, but NHS cleaning standards are reached and are maintained rigorously.”
Mrs Wise went on to say: “I am not trying to defend the fact that more than half my staff don’t wash their hands. We are not perfect but it is very difficult to be perfect 24 hours a day.” Umm. I think that doctors ignoring hand washing almost entirely and half of nurses too is a bit beyond “not perfect”. It is deeply crap.
The hospital’s medical director, Dr Bill Lynn, said: “We have been criticised on TV before for cleanliness on our wards and have been making a massive effort to improve cleanliness throughout the hospital. An action plan has been put in place and many of the issues raised in the programme were already, or have since, been addressed.” Less action plans and more rapping senior doctors over the knuckles is required I think.
The Evening Standard today reprinted figures on TB. In 2004 Ealing was top of the table with 256 cases. Newham and Brent also had more than 200 cases. There were nine boroughs with 100-200 cases. So we can add TB to our list of complaints along with diabetes, heart disease and stroke.
Yesterday saw the publication by the NHS of a health profile for Ealing.
A number of health issues emerge:
I understand that the first two of these are driven in large part by our Asian population (around 25%) who are particularly susceptible to these conditions. See references on heart disease, stroke and diabetes. Much of this early death is preventable and needs to be a priority.
We clearly need more dentists!
Dentists who can reduce problems such as tooth decay, tooth erosion and a lot more. Such instances call for dental implants. So click this link https://www.maestrosmiles.com/dental-implants/ to gain more insights on the same. On the other hand Ealing seems to be good for teenage pregnancy, binge drinking, healthy eating, obese adults, cancer, mental health treatment and drug misuse treatment.
Life expectancy in Ealing seems to be bang on the national average. The overall figure hides a lot of differences between wards. Northolt Mandeville, North Greenford, Perivale, Hanger Hill, Southfield and Northfield have significantly higher life expectancy than the English average. Southall Broadway, Norwood Green, Lady Margaret, Dormers Wells, Elthorne and South Acton have significantly lower life expectancy. The liberal consensus is that deprivation (you are poor) leads to health inequalities. Yes, but in Northolt West End we have a most deprived ward that turns out to have marginally higher than average life expectancy.
Last night the Health and Social Care Panel, one of Ealing Council’s scrutiny panels, heard John Bercow, Tory MP for Buckingham tear into Andrew Wray the Chief Exec of the Royal Free Hampstead NHS Trust. Bercow was pretty full-on, calling Wray “arrogant, incompetent and insensitive”. It was a very parliamentary style of attack. The Princes Room of the Town Hall with its peeling paint and strip lights did not quite provide a setting as grand as Bercow’s rhetoric.
The serious point of the evening was the closure by the Royal Free Hampstead NHS Trust of the Nuffield Speech and Language Unit which is effectively a day hospital run by the trust. It is in effect a nursery school too, where a small number of children with profound speech and language problems get intense therapy three times a day.
Ealing PCT and our council officers, and others like them across London who represent the potential users of the unit, subscribe to the “national strategy” which is that specialist units are anathema. The Royal Free is in a bind as they have to take the risk of a shortfall in pupils which forces them to subsidise the few kids who are enrolled at the Nuffield specialist unit.
We heard heartfelt testimony from parents and staff and the reason that Bercow was weighing in was that he has a young son, Oliver, who is a potential candidate.
It was clear to the panel that the consultation on possible closure by the Royal Free has been badly handled and should stop. We would like to see the threat of closure lifted for a year to give the parents and supporters some time to promote the institution. When consultation restarts it needs to consider closure against the idea of re-marketing the whole Nuffield concept.
If the Nuffield is to swim against the tide of inclusion orthodoxy then everyone associated with it needs to band together to ensure that a flow of candidates comes forward. They should not expect some Trust comms department to do this for them. They need to get out and do it for themselves and other like them. We can only afford diversity within public services if the public take some ownership for themselves.
Today the BBC covered the financial performance of the NHS. The overall deficit is around £500 million. The Health Secretary, Patricia Hewitt, tries to minimise this figure by making statements like: “The NHS is now stabilising this financial problem while continuing to improve services for patients.” Unfortunately, the current Labour Government is seriously mis-managing the NHS and it is hurting our Borough.
Last night the Ealing councillors on the Health and Social Care Standing Panel had a briefing from Ealing Primary Care Trust (PCT), the people who fund all our GPs, dentists and pharmacies. Both the chairman and chief executive were there. Robert Creighton, the Chief Executive, covered the financial aspects of the talk. This year they were hoping to make £5 million available for new community care initiatives. As a result of the current financial crisis in the NHS Ealing PCT’s entire budget was top sliced by 3% and instead of having £5 million to spend on new activities they were looking at taking £6 million out of their current spending plans.
Robert gave the impression of knowing his stuff and in the last year the PCT performed well financially turning in a small surplus of £2.1 million (the equivalent of 0.5% of their £441 million annual spending).
So although our PCT is well run we will suffer this year from the national crisis.
The TaxPayers’ Alliance has today produced a useful survey of London’s health spending and the Strategic Health Authorities that oversee it (see their report titled Flatlining).
Since Labour came to power it has doubled health spending in London from about £6 billion in 1997/8 to £12 billion in 2005/6. To give a feel for the size of this number the Mayor is spending £3 billion in the current financial year. This would be great if we all thought that we were getting twice as much health care. The TaxPayers’ Alliance’s report points the blame for this lack of performance at the 5 Strategic Health Authorities (SHAs) that oversee this spending in London.
Ealing is covered by the North West London SHA and local Conservative politician Richard Barnes serves as a non-exec, hopefully protecting our interests. Like all these bits of the NHS they have their own website.
You can see their last annual report on the website too. This is typical of the breed (expensive, glossy, full colour, stuffed with lots of pictures) and as such it fails to tell you anything you might want to know. In the last year for which figures are available they spent £202 million of which £12 million was spent on themselves, ie their offices in the West End and £100K a year salaries for their executives. They list their activities but give no breakdown of how the £190 million they spend on these activities is broken down. We have no way on knowing if any of this spending is useful to us.
No need to worry though Pat Hewitt, our popular Secretary for Secretary of State for Health, is going to make these five bodies more responsive to the people of London by amalgamating them into one super SHA. So they will spend £1 billion out of the £12 billion that gets spent on health in London. They will spend it on target setting and giving the health professionals on the front line a hard time. When they have finished they will refuse to give us any information about how they have spent the cash. Great!
This morning the Telegraph reported that the highest-paid NHS chief executive was Sir Jonathan Michael, of Guy’s and St Thomas’s NHS Foundation Trust, whose salary rose by 11.5 per cent to £214,000.
Apparently a spokesman for Guy’s and St Thomas’s Trust said: “Sir Jonathan’s salary reflects the level of responsibility and expertise that his role demands”. I am not sure that his salary reflects his job security.
Across the board last year NHS Chief Execs got 10% and directors 7%. Currently Gordon Brown is trying to keep nurses rises down to 2%.
Phil Taylor 