They're closing our hospital...

Cyclefrance · 03-06-2007, 06:24 AM

Does it happen in the States?

We seem to be experinecing a love of the super-sized hospital by our current government, so much so that they are busy closing down our local hospital in Epsom. No one can really understand why.

Behind it is the myth that by going big they will make economies of scale, and so we have the prospect of our nearest hospital now being 30 to 40 minutes car/ambulance ride away, not near a train station and badly served by public transport.

Add to this that the proposed hospital is old, germ-ridden and requiring massive investment, while the Epsom hospital has been the subject of massive investment and boasts a brand new wing, then the whole thing seems even more screwball.

The new wing seems to be the outcome of a thing called a PFI, which stands for Private Finance Initiative (I think). A great idea from our government to see private industry involved in public sector projects. Private industry builds and then the customer (in this case the hospital) leases back on a long-term lease. The trouble is they all seem to overrun budget and the customer ends up with a lease/rental that is exorbitant. In the case of the new wing it's too expensive to use.

So there we have it. Nice new wing, which could be put to good use, but remains empty, and will continue to do so because the accounting method used says it's too expensive even to begin to contemplate using it. And as we have an asset that is losing so much money, it has to go!

Madness. A local benefactor even offered to buy the hospital for Pds75 million and was turned down. Instead it is being sold to a developer who will demolish the existing buildings (including the new wing - no doubt he will sell off any good bits!) and construct homes on the site - the owners of which will be short of local hospital facilities, naturally!

Sundae · 03-06-2007, 07:05 AM

I remember when they tried to close A&E at my parents' local hospital (Stoke Mandeville). They were proposing to make people drive to High Wycombe, 20 odd miles away - ridiculous. Everyone locally knew it was a slow road - narrow, winding and only 2 places to overtake safely - and yet they believed it wouldn't impact people's health?

Luckily for them it was re-thought, although Mum says now there are rumours that Wycombe A&E will close and patients be redirected to Mandeville....!

I honestly don't know how the NHS will ever pull out of this tailspin. My PCT is so poor in so many ways - and yet so much money is wasted imo. Because it's public money, every penny has to be questioned and justified and those processes themselves create countless departments full of people that in turn spend PCT money.

Some of the things we have to consider, record, store and protect against are frankly laughable and would never happen in the private sector. I am currently jumping through countless hoops just to allow my floor to be able to take part in Red Nose Day...

Shawnee123 · 03-06-2007, 08:00 AM

They did that to us here. They took the two neighboring town's 3 hospitals and converged them into the 1 that is about halfway between the towns.

Hardly anyone in the communities wanted the change. I remember bumper stickers that read "Save Our Hospital."

No matter!

Are services better now? I really don't know.

The hospital in the town I live in has been empty ever since. I think the other one (where I was born) has been used for low income housing or something.

glatt · 03-06-2007, 08:26 AM

And when the bird flu comes, there will be even fewer beds now. Yay!

Shawnee123 · 03-06-2007, 08:36 AM

The bird flu? I'm still waiting on sars, the swine flu, and killer bees. Man, plagues and pesitlence aren't anything like they used to be.

elSicomoro · 03-06-2007, 09:35 AM

St. Louis went through some hospital closings in the '80s and '90s...the "indigent care" ones owned by the City and County of St. Louis closed their doors, and a couple of others consolidated. But in the suburbs, there's been a boom. A new hospital is about to open in the southwestern suburbs, which will replace a smaller one nearby.

wolf · 03-06-2007, 10:34 AM

Over the last 15 years, we've had three hospital closures in my immediate area ... one Medical hospital, and two psychiatric (although one of the psych hospitals went from psych to drug rehab and back to psych before finally closing). This has not left us without services, however. As the medical hospital was in a town that had two other full service medical hospitals within a 3 mile radius. The psych units reduced the overall number of beds in our county, but we still have three standalone psych hospitals and four psych units within medical hospitals. Our access to medical care here may be atypical. For 795,000 residents (not counting folks over the county borders that would go to our county's facilities because of proximity) and a physical area of 487 sq mi (1262 sq km), there are three standalone psych hospitals, a state psych hospital, two drug & alcohol rehabs, and nine medical hospitals, one with a Class I Trauma Center ... a second Class I Trauma Center serving the Western parts of the county is expected to be built in the next 5 years or so.

There are at least 7 or 8 more hospitals in communities that border this county.

Cyclefrance · 03-06-2007, 11:34 AM

Quote:

Originally Posted by wolf

...For 795,000 residents...there are three standalone psych hospitals, a state psych hospital, two drug & alcohol rehabs...

I think I get the message, but it may not be the one you intended....

Back to the UK scene, it also appears that those areas that are predominantly Tory/Conservative or Liberal Democrat in terms of their electorate and ruling political constituency fair badly when it comes to closures compared with those areas that are Labour strongholds. So that's fair enough, isn't it....

wolf · 03-06-2007, 12:31 PM

Quote:

Originally Posted by Cyclefrance

I think I get the message, but it may not be the one you intended....

I do see exactly where you were going with this. You're not the first person to have mentioned it.

My bachelor's degree is in Geography and Planning. One of the first principles of urban planning is not "build it, and they will come" but rather "go see where they are going already and build it there."

DanaC · 03-06-2007, 06:15 PM

Quote:

Back to the UK scene, it also appears that those areas that are predominantly Tory/Conservative or Liberal Democrat in terms of their electorate and ruling political constituency fair badly when it comes to closures compared with those areas that are Labour strongholds. So that's fair enough, isn't it....

I suspect there's more parity than that between the parties, it is more likely to be affected by regional factors....of course regional factors also tend to dictate who ends up in control of local government, so that might parrallel the impact.

The problem tends to be in the manner in which PCTs and local councils engage with each other. Good partnership working can go a long way, but requires Councils and their directorates to be able to play a strong overarching role in providing the vision for their region's health care. What makes this difficult is the tendency to merge PCT's which takes them into multi-Council partnership, and which leads to a parcelling out of services between the two (or more) PCTs. So, now whilst Halifax would once have had its own A&E, Maternity and other facilities, some facilities have now moved to Huddersfield. It sucks. I hate it. We now face the possible loss of the maternity section which would move to Huddersfield.

The system is fllawed. The whole PCT system is flawed.

CzinZumerzet · 03-07-2007, 08:23 AM

Imagine a capital letter L as the rough shape of a town which has developed in the past twenty or so years. The right angled joint of the upright/baseline is the centre of the original Victorian town where the old town hospital was. It is now redeveloped as luxury housing. The upright is the growth of the new part of town, currently the largest single housing conurbation in Western Europe. And still growing. And finally the horizontal flat line representing the gigantic retail devopment outside of town and at the tip of the line is the site of the new hospital built in the early 1990's.

The 16 year old hospital is now much too small for the growing town but as it's built on a flood plain 1/4 mile from the beach....feel it coming...it can't be enlarged in any direction. And anyway the PCT is almost 11 million in the red, so now the children's ward is closed and maternity is going to follow, with potential users having to bus or drive to Bristol, 21 miles away. Think of that in a seaside resort town of young families, kids and pregnant mums. The colossal waste of resources over previous years couple with addled thinking and planning just reduces us to a state of despair but there is some small consolation. With MRSA and C.Dificile now featuring on 38% of death certificates who in their right mind wants to go into hospital for anything?!
My grandmother was a herbalist and I am researching some of her old treatments. Well you never know when they might be life saving in the face of the ghastly mess the NHS is in.

Cyclefrance · 03-22-2007, 10:27 AM

This probably didn't help matters and probably even pushed NHS management towards their closure decision...

Sundae · 03-22-2007, 11:08 AM

It's one of the many problems we see here.
I was recruited 3 years ago in one of the boom times. No sooner was the ink dry on my contract than there was a hiring freeze and the job got more unpleasant year by year as I took on the work of colleagues who left and weren't replaced..

Most of the staff I talk to feel undervalued, overworked and consequently don't do as good a job as they could (okay, I'm actually lazy, but then I'm a poor example as I'm leaving anyway).

Without adequate support staff, the remaining staff have trouble completing even basic tasks and more time and money is wasted. Example - no-one taking responsibility for ordering stationery supplies, so any meeting or mailout involves roaming round the building begging for stationery. Inadequte Reception staff so random people in the building roped in as substitutes - the official "face" of the PCT then becomes someone seething with resentment trying to get their own work done while providing cover.

I have no doubt that there will be another boom soon - the long term staff have seen it before. Just as wasteful although more work will get done for a while.

Interesting that the answer to the question of overspending on staff is to employ more staff. Experts of course. I dread to think how much of our money has gone into the pockets of experts over the years.

Cyclefrance · 03-23-2007, 06:29 AM

I agree Sundae - and that's what makes the whole debacle of closing hospitals so frustrating. When the 'experts' can't even run a staffing programme properly to ensure the logistics of hospital supplies are managed, how on earth can they be trusted (or even be competent) to reach the decision that a hospital can justifiably be closed. Alsolute madness!

03-06-2007, 06:24 AM	#1
Cyclefrance Pump my ride! Join Date: Aug 2005 Location: Deep countryside of Surrey , England Posts: 1,890	They're closing our hospital... Does it happen in the States? We seem to be experinecing a love of the super-sized hospital by our current government, so much so that they are busy closing down our local hospital in Epsom. No one can really understand why. Behind it is the myth that by going big they will make economies of scale, and so we have the prospect of our nearest hospital now being 30 to 40 minutes car/ambulance ride away, not near a train station and badly served by public transport. Add to this that the proposed hospital is old, germ-ridden and requiring massive investment, while the Epsom hospital has been the subject of massive investment and boasts a brand new wing, then the whole thing seems even more screwball. The new wing seems to be the outcome of a thing called a PFI, which stands for Private Finance Initiative (I think). A great idea from our government to see private industry involved in public sector projects. Private industry builds and then the customer (in this case the hospital) leases back on a long-term lease. The trouble is they all seem to overrun budget and the customer ends up with a lease/rental that is exorbitant. In the case of the new wing it's too expensive to use. So there we have it. Nice new wing, which could be put to good use, but remains empty, and will continue to do so because the accounting method used says it's too expensive even to begin to contemplate using it. And as we have an asset that is losing so much money, it has to go! Madness. A local benefactor even offered to buy the hospital for Pds75 million and was turned down. Instead it is being sold to a developer who will demolish the existing buildings (including the new wing - no doubt he will sell off any good bits!) and construct homes on the site - the owners of which will be short of local hospital facilities, naturally! __________________ Always sufficient hills - never sufficient gears Last edited by Cyclefrance; 03-06-2007 at 07:29 AM.

03-06-2007, 07:05 AM	#2
Sundae polaroid of perfection Join Date: Sep 2005 Location: West Yorkshire Posts: 24,185	I remember when they tried to close A&E at my parents' local hospital (Stoke Mandeville). They were proposing to make people drive to High Wycombe, 20 odd miles away - ridiculous. Everyone locally knew it was a slow road - narrow, winding and only 2 places to overtake safely - and yet they believed it wouldn't impact people's health? Luckily for them it was re-thought, although Mum says now there are rumours that Wycombe A&E will close and patients be redirected to Mandeville....! I honestly don't know how the NHS will ever pull out of this tailspin. My PCT is so poor in so many ways - and yet so much money is wasted imo. Because it's public money, every penny has to be questioned and justified and those processes themselves create countless departments full of people that in turn spend PCT money. Some of the things we have to consider, record, store and protect against are frankly laughable and would never happen in the private sector. I am currently jumping through countless hoops just to allow my floor to be able to take part in Red Nose Day... __________________ Life's hard you know, so strike a pose on a Cadillac

03-06-2007, 08:00 AM	#3
Shawnee123 Why, you're a regular Alfred E Einstein, ain't ya? Join Date: Jun 2006 Posts: 21,206	They did that to us here. They took the two neighboring town's 3 hospitals and converged them into the 1 that is about halfway between the towns. Hardly anyone in the communities wanted the change. I remember bumper stickers that read "Save Our Hospital." No matter! Are services better now? I really don't know. The hospital in the town I live in has been empty ever since. I think the other one (where I was born) has been used for low income housing or something. __________________ A word to the wise ain't necessary - it's the stupid ones who need the advice. --Bill Cosby

03-06-2007, 08:36 AM	#5
Shawnee123 Why, you're a regular Alfred E Einstein, ain't ya? Join Date: Jun 2006 Posts: 21,206	The bird flu? I'm still waiting on sars, the swine flu, and killer bees. Man, plagues and pesitlence aren't anything like they used to be. __________________ A word to the wise ain't necessary - it's the stupid ones who need the advice. --Bill Cosby

03-06-2007, 10:34 AM	#7
wolf lobber of scimitars Join Date: Jul 2001 Location: Phila Burbs Posts: 20,774	Over the last 15 years, we've had three hospital closures in my immediate area ... one Medical hospital, and two psychiatric (although one of the psych hospitals went from psych to drug rehab and back to psych before finally closing). This has not left us without services, however. As the medical hospital was in a town that had two other full service medical hospitals within a 3 mile radius. The psych units reduced the overall number of beds in our county, but we still have three standalone psych hospitals and four psych units within medical hospitals. Our access to medical care here may be atypical. For 795,000 residents (not counting folks over the county borders that would go to our county's facilities because of proximity) and a physical area of 487 sq mi (1262 sq km), there are three standalone psych hospitals, a state psych hospital, two drug & alcohol rehabs, and nine medical hospitals, one with a Class I Trauma Center ... a second Class I Trauma Center serving the Western parts of the county is expected to be built in the next 5 years or so. There are at least 7 or 8 more hospitals in communities that border this county. __________________ wolf eht htiw og "Conspiracies are the norm, not the exception." --G. Edward Griffin The Creature from Jekyll Island High Priestess of the Church of the Whale Penis

03-06-2007, 08:26 AM	#4
glatt ™ Join Date: Jul 2003 Location: Arlington, VA Posts: 27,717	And when the bird flu comes, there will be even fewer beds now. Yay!

03-06-2007, 09:35 AM	#6
elSicomoro Person who doesn't update the user title Join Date: Jan 2001 Posts: 12,486	St. Louis went through some hospital closings in the '80s and '90s...the "indigent care" ones owned by the City and County of St. Louis closed their doors, and a couple of others consolidated. But in the suburbs, there's been a boom. A new hospital is about to open in the southwestern suburbs, which will replace a smaller one nearby.

03-07-2007, 08:23 AM	#11
CzinZumerzet .....short for Caz Join Date: Jan 2004 Location: The West Coast of England Posts: 358	Imagine a capital letter L as the rough shape of a town which has developed in the past twenty or so years. The right angled joint of the upright/baseline is the centre of the original Victorian town where the old town hospital was. It is now redeveloped as luxury housing. The upright is the growth of the new part of town, currently the largest single housing conurbation in Western Europe. And still growing. And finally the horizontal flat line representing the gigantic retail devopment outside of town and at the tip of the line is the site of the new hospital built in the early 1990's. The 16 year old hospital is now much too small for the growing town but as it's built on a flood plain 1/4 mile from the beach....feel it coming...it can't be enlarged in any direction. And anyway the PCT is almost 11 million in the red, so now the children's ward is closed and maternity is going to follow, with potential users having to bus or drive to Bristol, 21 miles away. Think of that in a seaside resort town of young families, kids and pregnant mums. The colossal waste of resources over previous years couple with addled thinking and planning just reduces us to a state of despair but there is some small consolation. With MRSA and C.Dificile now featuring on 38% of death certificates who in their right mind wants to go into hospital for anything?! My grandmother was a herbalist and I am researching some of her old treatments. Well you never know when they might be life saving in the face of the ghastly mess the NHS is in. __________________ ..down by the zea zippin' zider

03-22-2007, 10:27 AM	#12
Cyclefrance Pump my ride! Join Date: Aug 2005 Location: Deep countryside of Surrey , England Posts: 1,890	This probably didn't help matters and probably even pushed NHS management towards their closure decision... __________________ Always sufficient hills - never sufficient gears

03-22-2007, 11:08 AM	#13
Sundae polaroid of perfection Join Date: Sep 2005 Location: West Yorkshire Posts: 24,185	It's one of the many problems we see here. I was recruited 3 years ago in one of the boom times. No sooner was the ink dry on my contract than there was a hiring freeze and the job got more unpleasant year by year as I took on the work of colleagues who left and weren't replaced.. Most of the staff I talk to feel undervalued, overworked and consequently don't do as good a job as they could (okay, I'm actually lazy, but then I'm a poor example as I'm leaving anyway). Without adequate support staff, the remaining staff have trouble completing even basic tasks and more time and money is wasted. Example - no-one taking responsibility for ordering stationery supplies, so any meeting or mailout involves roaming round the building begging for stationery. Inadequte Reception staff so random people in the building roped in as substitutes - the official "face" of the PCT then becomes someone seething with resentment trying to get their own work done while providing cover. I have no doubt that there will be another boom soon - the long term staff have seen it before. Just as wasteful although more work will get done for a while. Interesting that the answer to the question of overspending on staff is to employ more staff. Experts of course. I dread to think how much of our money has gone into the pockets of experts over the years. __________________ Life's hard you know, so strike a pose on a Cadillac

03-23-2007, 06:29 AM	#14
Cyclefrance Pump my ride! Join Date: Aug 2005 Location: Deep countryside of Surrey , England Posts: 1,890	I agree Sundae - and that's what makes the whole debacle of closing hospitals so frustrating. When the 'experts' can't even run a staffing programme properly to ensure the logistics of hospital supplies are managed, how on earth can they be trusted (or even be competent) to reach the decision that a hospital can justifiably be closed. Alsolute madness! __________________ Always sufficient hills - never sufficient gears

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