Peter Moore: Moving cardiac unit will put lives at risk

We cannot risk the lives of the people of Torbay by moving our excellent acute cardiac unit to Exeter.

Why did such a mad and dangerous proposal ever see the light of day?  Listening to the presentation to council’s adult social care scrutiny board at the Riviera Centre last week I can see their misguided logic.

The new NHS plan is to appoint an integrated care board to oversee the health service for each geographical area covering populations from about 500,000 to three million. In a city it makes sense for hospitals to work together and offer different services but falls apart in rural areas.

This idea has worked well for my old medical school. It was founded as a monastery 900 years ago in the City of London. I have no doubt that it was a great place to have a monastery caring for the sick at the time of Herny 1st but today there aren’t that many poor and needy in the square mile of the city.

As a result many departments such as A & E and maternity have closed while they have built a large new unit specialising in state-of-the-art treatment for heart disease. This makes sense as the Royal London Hospital is two and a half miles away and Homerton Hospital under five miles away. 

Many people in the cities do not realise the problems of rural counties. Talking to a colleague at a medical school reunion I explained that I was now a GP in Torquay.  She commented, “you must see quite a lot of so and so. He’s just down the road in Truro.”

I was tempted to suggest that she must see a lot of the people in Portsmouth which is slightly closer to London but with much better transport links. They even have a direct railway line which never gets washed away.

Back in the 1980s we faced another problem. In those halcyon days GPs could get a grant towards post graduate courses. Unfortunately some colleagues abused the system by using the money to visit friends and family at the other end of the country.

They still had to attend the approved course but had subsidised travel and could stay with family. The government tightened up by only allowing the money if the course was less than one hundred miles from their surgery. The only GPs who complained were Devon and Cornwall and an area of Scotland. 

In the 1980s our nearest teaching hospital was Bristol which I could just reach as my surgery was in north Torquay. Doctors in Plymouth could reach Exeter but for Cornish doctors the only opinions were Truro or Plymouth. When we brought this up the government and NHS management had no idea that some doctors are nowhere near numerous hospitals. 

When fundholding was introduced in the 1990s we were told that we could shop around to get the best deal for our patients. Torbay Hospital was in the middle of my practice area.

I could not tell a single mum from Hele or an elderly person in Shiphay that I could get a great deal in Barnstaple. They had no transport. Shopping around did not work for my patients. 

Most civil servants and politicians, like my colleagues at the reunion, are based in cities. Wes Streeting, the Health Minister, was brought up in Stepney, went to Westminster City School and is now MP for Ilford North.

The most senior civil servant, Samantha Jones, the Permanent Secretary at the Department of Health was a nurse at Great Ormond Street Hospital before being appointed as chief executive at Epson. It is not surprising that neither understand the problems of rural areas.

Surely it is the role of Torbay NHS leaders to speak truth to power. So far the nearest we have had to an apology for the disastrous proposal to move our acute coronary services is the confession that the announcement could have been handled differently. They do not seem to understand that it is the idea that is wrong and dangerous not the presentation. 

We were told that we are not in competition with other hospitals but must work together but where does competition end and capitulation begin? True leadership means fighting your corner to represent your people not trying to impose changes against their interests because you are told to by others up the line. 

No one needed to be an expert on non-verbal communication to assess the mood of the people in Torbay at the recent meeting. Why aren’t our local NHS leaders joining the rest of us to bang the table and shout. It is their role to ensure levelling up not levelling down.