County Councillor Karen Constantine: Fighting for our NHS

Cllr Karen Constantine

While Brexit may be a headline grabber and Court proceedings over election expenses may be a side show, real concerns over the health and wellbeing of Thanet’s population never go away. At this moment we need all the might we can muster to fight for our threatened health services.

Our NHS is as vital as it is special.

Prime Minister Theresa May and NHS England chief executive, Simon Stevens finally launched their much-trailed 10-year NHS plan recently. This has caused much consternation. A very respected NHS commentator  and former GP, Dr. Kailash Chand, says: “The 10-year NHS plan is in reality a policy statement to solve a political – not practical – problem. As I have argued before, the total £20.5 billion funding will barely make up for eight years of austerity that have crippled the NHS and social care and undermined public health. This extra cash is too little to prevent patients having to wait even longer for both GP and hospital care. NHS spending growth is set to be at an all-time low. The risks of longer waiting times, the clogging up of primary care services, cancelled operations, instability in primary and secondary care, and sinking staff morale will continue. The gap between policy rhetoric and supply has never been starker.”

Labour Shadow Health Minister Jonathon Ashworth MP has stated that the Tories are now actually cutting NHS settlement by £2 billion.

The NHS is vital to us all. From the cradle to the grave, we all rely on our NHS for good health, treatment when ill, and sometimes life saving and life enhancing procedures. We have also come along way in recent years recognising that physical and mental health are equally important. The NHS provides treatment in both areas.

Our NHS is rated as the best in the world and has been funded by us all, including our parents, grandparents and in some cases our great grandparents. Almost everyone of working age has made a financial contribution to the NHS over the last 70 years. It is ‘ours’, it belongs to us all as our jointly owned asset.

The devil as always is in the detail. 

I think it’s time for some plain talking about the NHS. Undoubtedly there are really significant challenges. As a society we are living longer and using NHS services more, especially as we age. It’s also true that medical advances, the type we could only dream about 20 years ago, are expensive to implement. It’s also blindingly obvious that early prevention is better (and much more cost effective) than later treatment. It makes no clinical or economic sense not to fully adopt prevention, promote greater health literacy, and to ensure treatment is provided at the earliest opportunity. In the 5th richest nation in the world, we appear to be doing the opposite. At a huge cost to the general population.

Stroke unit decision

Take for instance the current discussion about where to site the HASU, the Hyper Acute Stroke Unit. The current proposal is to close the stroke unit in Margate’s QEQM Hospital and to open a HASU at the William Harvey Hospital in Ashford.

A HASU is the right clinical decision. Specialist treatment for strokes, leading to improved outcomes is what we want. However it is completely wrong to provide this utterly vital service so far away. It also flies in the face of medical evidence. Research I have been shown by health service professionals suggests individuals should receive treatment at a HASU within 20 minutes. This crucial timing is referred to as ‘door to needle’ time. The NHS is trying to tell us that it’s up to 120 minutes.

In December 2017, at a public meeting I organised about the NHS with the local commissions, I forced our local MP, Craig Mackinlay to admit that he agreed that the stroke service should be moved to Ashford. Since then he has changed his mind. Has he woken up to Thanet’s actual health needs or is he thinking of votes during the next general election? That may be closer than some think.

As the next most senior politician representing Ramsgate, I have written to Craig Mackinlay twice in recent weeks requesting him to join with me in calling for a halt to the decision to move our stroke unit. I have had no response.

So I use this column to say once again – Craig, please let’s work together to stop this travesty happening!

12 Comments

  1. With the down grading of hospitals and slashing doctors surgery’s plus proposed bus cuts to be announced this week and universal credits causing economic misery to the sick and low paid workers the tories have declared WAR on Thanet. Shame on them

  2. Dr. Kailash Chand is also Honorary Vice President of the British Medical Association, ex deputy chair of BMA council, and ex chair of an NHS trust – so he knows what he’s talking about. The NHS Long Term Plan has been praised by the top layer of NHS management, but numerous other professionals and professional bodies have pointed out that:
    – the plan isn’t costed
    – that the promises made in the plan can’t be delivered with the spending promised
    – that the spending promised only just repays what was effectively cut from NHS spending since 2012
    – that prevention is a focus, and yet public health budgets have been cut by a quarter
    – that the workforce crisis is omitted from this plan despite being the biggest threat to the NHS at the current time
    – that the back door that was opened up by the ‘five year forward view’ to private firms remains very much open
    – That the forced rollout of a new structure involving ICSs* risks allowing third sector and private firms to be involved in the commissioning of NHS treatment.

    Dr Chris Moulton, Vice Chair of the Royal College of Emergency Medicine said this: “We fear that there are incompatibilities with expectation and reality; particularly when considering the gap between what is being promised and what is being provided. As others have rightly pointed out, the viability of this plan will not only be conditional on tackling workforce shortages – and ensuring that those staff that we have do not leave the NHS – but also on adequate funding for both public health and social care.”

    *ICS = Integrated Care Systems: they will make health decisions at regional level, there will be approximately 40 in the country. In Thanet, this would probably mean NHS decisions being made at county level rather than at Thanet level, with the likelihood that private firms could have a seat at the table where decisions are made about how funds are spent, what should be offered, what should be discontinued, what should be means-tested, and so on.

    • It depends who you ask of course. The King’s Fund commented on the Ten Year NHS Plan thus: “This is an ambitious plan that includes a number of commitments which – if delivered – will improve the lives of many people. NHS leaders should be applauded for focusing on improving services outside hospitals and moving towards more joined-up, preventative and personalised care for patients” (The King’s Fund, 7 January 2019). And the CE of NHS Providers and Deputy CE of Rethink Mental Illness have both made positive, public soundings. Jim Bob From Broadstairs.

  3. STROKE: The final decision about the stroke units in Kent, including the closure of the stroke unit at QEQM will be made in coming weeks.
    A ‘final decision’ meeting will take place at County Hall in Maidstone, where a vote will be held, and 20 GPs across Thanet, 2 from each region, will vote for or against the plan.
    Here’s what you can do to help us stop the plan to relocate emergency stroke care to Ashford:
    1. Write to your MPs and Kent County Councillors. Ask MPs to raise this in parliament and to do all they can to stop the plan. Ask councillors to persuade their colleagues on the Health Scrutiny committee to ‘refer the plan back to the health secretary’, which means that the plan effectively gets rejected at a local level and sent back to government for review.
    2. Join the protests: 17th Jan at Dashwood Surgery in Ramsgate, 10.30am; January 25th 9am outside County Hall in Maidstone; Friday March 1st at 9.30am, County Hall in Maidstone.
    3. It might be necessary some time this year to mount a legal challenge to stop the closure at QEQM. In that event, we will need to raise funds from the local community. So get your thinking caps on about ways to raise money and send them to saveournhskent@gmail.com

  4. Life expectancy isn’t rising and many senior medics are really angry that the elderly are used in a political campaign. They are not the problem as most are living independently and in good health until the last where their needs escalate. The issue is with the Tory government bringing in Stevens who is deliberately running down our NHS to set it up as per his USA model. Eg privatisation. Watch THE GREAT NHS HEIST in you tube and follow SAVE OUR NHS in KENT

  5. Our MP’s here in Thanet are a waste of time. What have they done to help stop the decline in health here, or anything else for that matter? Roger Gale only sticks in mind for representing his business friends after the former airfield. Craig Mackinlay for following in Roger’s footsteps and reiterating what Roger says. I’m sure there must be something, but I am unable to name one good thing either of them have done for Thanet. If we cannot rely on them to stand up to these NHS managers when needed then it’s time for a change at the next election. Karen Constantine at least has our health at heart and is fighting for what is right, and we all need to get with her to fight for the Stroke service staying at QEQM or lose it altogether. Karen has acted more positively for Thanet since she has come on the scene than the pair of them in all their years.

  6. Whenever the Tories defend their cuts to NHS funding(for example closing the Stroke Unit at QEQM) they seem to forget that they promised that £350 million per week would soon become available because of Brexit! But they never take this alleged windfall into account when making future plans. You would think that they would announce a new HASU for Margate (and everywhere else!), paid for out of that Brexit dividend. But they don’t, because they know that no such amount of cash will become available.While many of us are waving Union Jacks and voting for Brexit, the Tories are quietly wrecking our Public Sevices. Very patriotic of them!!

  7. Just a clarification… The term ‘door to needle time’ is used in this article, and it’s worth pointing out that that term is used by stroke clinicians to refer to the time between reaching hospital and being treated – ie the ‘door’ referred to is the hospital door, not a patient’s front door. It doesn’t include travel time, it’s a measure of in-hospital treatment time.

    • mean the time from the initial call to the ambulance to actually getting to Ashford for treatment. My apologies ‘call to needle time’ would have been a better description than door to needle time.

      Here is the link.

      4.4. Travel times and stroke to needle times: general points
      R8. Ajourneytimetothestrokehospitalofwithin60minutesisagreedasappropriate. However in order to achieve the desired maximum call to needle time of 120 minutes, the time taken for ambulance response, on site assessment and departure, and for in-hospital assessment, scanning and initiation of thrombolysis (door to needle) must be minimised.

      https://kentandmedway.nhs.uk/wp-content/uploads/2018/01/Appendix-E-Final-SECS-review-.pdf

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