Memorandum submitted by Liz Haggard (PCT
2)
I was for eight years chief executive of a community
health services trust which provided services for a population
of half a million people. Our staff included district nurses,
health visitors, chiropodists, occupational therapists, speech
therapists, pain specialists, learning disability specialists
and Macmillan nurses who provided services in home and community
for older people with health problems, people with long term physical
and mental health needs, patients discharged from acute hospitals,
people who wished to die at home, children at risk, children with
health problems and physical and learning disabilities. Our patients
were people with multiple problems, many of them finding it difficult
to manage life financially and practically, many of them from
ethnic minorities. They depended on our services being reliable
and knew that we worked alongside their general practitioner so
that our staff knew their doctors. Patients knew they could contact
us because we worked with their general practice.
It is extraordinary to suggest that "contestability"
and staff employed by a range of separate organisations would
bring these patients any advantages which would outweigh those
that come from staff employed to work as members of the primary
care team. Primary Care Trusts are large enough to provide staff
who cover patients at home 24 hours a day, seven days a week;
large enough to provide varieties of work, flexibility and opportunities
for development for staff, large enough to manage staff so that
someone is accountable if a nurse fails to visit or a mistake
is made, centralised enough to be contactable and to set up and
run good systems with acute services, and yet local because the
staff they employ work with general practices.
The current consultation has not given the public
the one choice which survey after survey shows is the one they
prefer. The results are clear. The public say: continue with the
model of general practice we have and trust, which includes the
services provided by the staff like district nurses and health
visitors who work with our doctors; make improvements in general
practice—we like the better premises, the improved access
and the longer consultation times, but we don't want radical changes
in this vital part of the health service. Listen to what we say
and read the surveys please—they tell you that we trust
our general practice and we want to keep it pretty much the way
it is. Of course if you ask us questions like, "Would you
like more information" we are likely to say yes, but you
cannot assume that in any way that means you will have our support
in dismantling our general practice services.
Liz Haggard
28 October 2005
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