As NHS Wiltshire disappears its Chairman criticises government’s methods & worries about new risks
Southgate House in Devizes is about to see the changing of Wiltshire’s ‘health guard’. It was the scene today (March 13) of the ever last board meeting of NHS Wiltshire (or Primary Care Trust) before it disappears to be replaced by the clinician-led Wiltshire Clinical Commissioning Group (CCG) which will also have its headquarters at Southgate House.
Tony Barron has been chairman of the PCT since it was set-up in 2006 – bringing together three smaller PCTs. He inherited from them a £63 million debt which has now been paid off and turned into a surplus which the CCG will inherit. And that’s something of which Tony Barron is very proud.
Speaking to Marlborough News Online before his final Board meeting, Tony Barron said he had so far had his final meetings with all but one of Wiltshire’s five MPs: “Even those who had been most outspoken in criticising the changes we brought in, said they were deeply appreciative of our management of the money and achieving the care targets.”
His meeting with the final Wiltshire MP will be on Friday.
Tony Barron is, however, very critical indeed of the way the coalition government’s restructuring has been handled: “It’s been an extremely painful process. Politicians denigrated PCT staff as bureaucrats and then turned round and said we can’t deliver this change without you. They said the PCTs and Strategic Health Authorities were useless, denigrating staff and then loading them with extra work.”
“It’s an awful way to carry on. Before in reorganisations, we’ve had a plan. This one, they threw everything up in the air and are still, today, making up the rules and regulations for what we have to do by 31 March.”
“It’s been an awful time for the board and staff – the whole process. This is not how you improve health care – it was inefficient, stressful and wasted resources.”
Tony Barron has prepared a two page ‘legacy’ statement which summarises the PCT’s achievements and top of the list is the innovative and award winning introduction of neighbourhood nursing teams initially run by the PCT but which are now part of the community health programme run for the PCT by Great Western Hospital:
“Government policy is now toward greater integration and bringing care more into the community – that’s what we did. And I’m proud to turn the lights out on 31 March with that job done.”
The PCT had plans to bring primary care and the neighbourhood teams into a closer working relationship: “I don’t feel I’m drifting off into the sunset with my plans incomplete because the GPs are picking up most of what we were going to do.”
Another policy from his list which is not so complete is the opening of Primary Care Centres – people in Devizes have not been able to agree where one should be, but two have opened and two more are underway. There will not be one in the Marlborough area: “A Primary Care Centre doesn’t work unless there’s a concentration of population.”
Many in Marlborough will remember the PCT for the closure of the Minor Injuries Unit (MIU) at Savernake Hospital which was, he stresses, a clinically agreed decision. Tony Barron points again to the £62 million debt and explains that the PCT were paying twice for care:
“A significant proportion of those going to the MIU were going for coughs, colds – general practice work. So we were paying at the MIU and paying the GPs’ surgeries too. But it was not just the money – in a small unit staff were losing their skills – if you do something once a month you start to get rusty. That’s what the staff were telling us – they were getting bored.”
Looking to the future what would top his personal ‘risk register’ as the CCG takes over three fifths of the PCT’s the commissioning work: “Money. They’ve inherited a surplus [expected to be £7.5 million] for their first year. As the money gets tighter and tighter the enthusiasm of the GPs is going to wane.”
“That’s not being insulting to GPs. Of course they have a medical ethic, but they are men and women running small businesses – in it for the profit – not like NHS staff who will just get on and do the job – that’s the wonderful thing about NHS staff.”
“The pressure on the GPs is going to be huge – working only one or perhaps two days a week on the commissioning. My fear is that with the pressure of a kind they are not used to mistakes will be made.”
After twenty-eight years in the NHS (and taking part in eleven reorganisations of various sorts), Tony Barron has a new job. He is the chairman of the Hampshire and Isle of Wight Pathology Consortium which will be a ‘hub and spoke’ operation concentrating expertise.
Like many of those who are leaving Southgate House in eighteen days’ time, he has already started his new job – part time of course. At least he has got his commute to work down to eight minutes: “Hardly enough to get the car warm – so I arrive cold!”
And Southgate House? The GPs wanted to promote a new image so it has been ‘brought up to a higher standard’ with a shiny new reception area and new carpeting: “Not our patch- and-mend NHS when we spent as much as possible on the patients and not on the buildings’ appearance. That’s their free choice – it’s their budget.”
NOTE: Marlborough News Online will soon be interviewing Dr Steve Rowlands, the Trowbridge GP who has been the PCT's Medical Director and now chairs the new Wiltshire CCG.