A room with a view: or the privatisation of healthcare in Broken Barnet - Mrs Angry writes to Mike Freer, MP

When the Royal Free Hospital was Free

Amidst the excitement of yesterday's Cabinet reshuffle, and the rather alarming news that Jeremy Hunt has taken over from Andrew Lansley as health secretary, Mrs Angry was thinking about the state of healthcare here in Broken Barnet, already in a state of chaos as a result of government policy and looking ready to become a whole lot worse very quickly. She decided to write to her MP, Mr Mike Freer, who has already blocked her on twitter after daring to challenge his support for the healthcare 'reforms' and the refusal to publish the risk register which might inform us of what we really are letting ourselves in for.

Dear Mr Freer,

I would like to draw your attention to the following report regarding the Royal Free Hospital:

NHS patients 'made to wait' as radiographers are told to set time aside for private treatment

which is published here in the Camden New Journal: as you will see, it seems that radiographers are being told to exclusively reserve one hour a day for private patients, who will receive prioritised access to resources,while NHS patients wait for their turn, as the Royal Free embarks on a programme of opening new private clinics in our NHS hospital.

If you are unaware of the history of the Royal Free Hospital, perhaps you might gather from the clue in the name that it was founded not for the benefit of those who can afford to pay for health care, and enjoy, as they are offered, ' “amazing views of Hampstead Heath or London landmarks”, as well as satellite TV, a remote control, telephone, nurse call facilities and a daily newspaper' ... but in order to provide treatment for those without means. The incorporation of such ideals into a National Health Service has continued, until now, as the right of all of us. No longer, it seems.

former health secretary Lansley receives a less than warm welcome at the Royal Free

In the last year, unfortunately, I have had direct experience of the increasing difficulty of residents of this borough in receiving prompt access to assessment and treatment at our local hospitals at Barnet and the Royal Free.

Earlier in the year I was informed, for example, to my absolute disbelief, that I would have to wait at least a month for an emergency scan, as even high priority scans were being routinely 'rationed'.

I only managed to receive an appointment, at the Royal Free, after weeks of extreme discomfort and anxiety, and a visit to A&E, after my GP here in Finchley went to enormous lengths to bypass the regulations which your government has introduced restricting access to such basic tests.

If this sort of delay is being increased due to private patients being given privileged access to NHS facilities, and receiving care before the long, long queue of NHS patients has been accommodated, I hope that you will agree that this is a totally unacceptable situation.

During the past year a close family member has developed a life changing illness, the diagnosis and treatment of which has been continually delayed, with distressing consequences. Throughout this period we have had to struggle to obtain referrals, and the appropriate tests and treatments, due again to the new bureaucratic regulations which ensure that only patients suspected of terminal illness can be 'fast tracked' to see a local consultant, and seemingly obstruct easy acess to so many tests and assessments as a result of budgetary implications. Only this week, a crucial and complicated procedure at the Royal Free, delayed while the medical team were obliged to apply for special budget funding approval, was cancelled at the last moment, due, we were told, to 'staffing shortage'.

The Catch 22 situation which has been created by such policy makes it impossible to see quite how a GP is supposed to guess how seriously ill a patient is before they have undergone the tests required, and one which places an intolerable burden of responsibility on them.

Recently an elderly family friend died in Barnet General, directly as a result of a prolonged delay in waiting to have the assessment and treatment that would have saved her life: there must be many other cases in which people are dying, or suffering needlessly as a consequence of the rationing of healthcare, and it seems clear this situation is going to worsen as the new 'reforms' are introduced.

Whenever I visit my GPs they are clearly under immense pressure, torn between their professional duty to their patients, and frustrated by the diminishing accessability of proper healthcare in this borough for residents without the means to bypass the NHS system and use private healthcare as an alternative to a failing NHS structure.

They feel betrayed by local Tory politicians who refuse to talk to local practitioners and listen to the huge concerns they have about the impact of government policy on healthcare, and what they see as a direct assault on the NHS.

Yesterday we learnt that responsibility for the NHS 'reforms' has been passed to someone who is reported to have expressed his disdain for our national health system, and considers it to be not as most people would see it, the mark of a society that is dedicated to the support of those with needs, but an anachronism, a white elephant: something to destroy, and rebuild, and break into pieces, to give away to the same sort of private sector companies who are circling this borough, waiting for the commercial opportunities offered by the One Barnet outsourcing madness that is the result of your 'easycouncil' concept'.

I believe that the privatisation of our local council services is an issue which is of immense concern to the residents of this borough, and I know that the destruction and partial privatisation of the health service is a thought which horrifies everyone.

In this area, the effects of change are already having an impact on people's lives, and effectively in this borough now you have a two tier system of healthcare: fast access to care if you are wealthy, or have private cover, and an increasingly more distant chance of speedy treatment if you are without the means to pay.

You are on record as supporting the government's position on the NHS 'reforms', and agreeing that the risk register should not be published. I would suggest to you, Mr Freer, that such a position is completely out of touch with the feelings of almost every resident in your constituency.

Those of us who depend on the NHS, and value the huge contribution to social progress that it has given us see it as something precious, something to be protected, as part of our heritage, and part of what makes us proud of being British.

I wish I could be sure that you agree that the vulnerability of our health service to exploitation by the private sector is something to abhor, something to resist at all costs but I rather think you will hold a different view. I would suggest to you, however, that your own electoral vulnerability might indicate that a misplaced loyalty to government policy on this particular issue would be a grave mistake, and it might be time to see you putting the well being of residents and patients in this area before the interests of your own political agenda.

Yours sincerely,

Mrs Angry

Update:

To his credit, Mr Freer replied straight away, as follows:

Dear Mrs Angry

Thank you for your email which I have read with interest.

I do not share your analysis and will reiterate that I use the NHS as do my family. As for putting my residents first I would also point out to you that I intervened with the Treasury to lobby that the funds for the new Finchley Memorial Hospital did not fall foul of the spending review.

This government is increasing spending on the NHS, unlike the Labour Party who were committed to cutting the NHS budget.

I do not receive the Camden New Journal and so I can not comment on the accuracy of the report. I would ask you to look at some of those hospitals that have high levels of private income, they use it to enhance and expand NHS services. This of course has now been enshrined in the new Health and Social Care Act. The last Labour Government allowed hospitals to earn private income (indeed they positively embraced private provision farming out many procedures to private hospitals) without any legal provision to ensure the monies earned were used for NHS provision.

Mike Freer
Conservative Member of Parliament for Finchley and Golders Green

Mrs Angry has replied:

Dear Mr Freer

Thank you for your prompt reply.

The level of funding is not the issue here: it is the impact of the introduction of private enterprise into the NHS, and the destabilising effect on the fair provision of healthcare to NHS patients. The question is will government policy improve access to care, or increase delays? The example of the Royal Free using already pressured NHS resources for private patients is in my view a scandalous development and one which as MP for this constituency I hope you will investigate.

As to the Labour policy of relieving the burden on waiting lists by using private hospitals - I personally have no objection to this, as it seems a pragmatic response to a problem. Unfortunately, as I discovered myself, such an option is no longer available to NHS patients, whose interests under a Conservative government clearly come second to the need to open up another market for private enterprise.

Yours sincerely

Mrs Angry

A Tale of Two Barnet Hospitals

In recent posts about Charles Dickens' connections with this borough, reference has been made to the old Barnet workhouse, built in the early 1830s, which some think may have been the inspiration for scenes from 'Oliver Twist'. This building was demolished, without warning, and in the face of opposition from local residents by the hospital developers a few years ago, supposedly in order to provide much needed extra parking areas.

Unfortunately yesterday morning I had occasion to see for myself that all these years later, (and despite the continual complaints from patients and visitors about the cost and chronic shortage of parking at Barnet General) the workhouse site is still derelict, still fenced off with temporary (or rather, no: long term interim?)- barricades, so old now that some of the sections are themselves disintegrating, or being held up with lengths of rope staked in the ground.

I suppose the land is more valuable as a potential source of development, rather than a car park, and will, like so many other former public building sites in the borough, be flogged off as soon as they think they can get away with it.

Peering through the fence, now, you find an ugly wasteland of self sown weeds, rough patches of grass, a opportunistic collective of ash trees squatting amongst the remaining bricks and discarded fixtures of the old workhouse. It occurred to me that it all presented a fitting metaphor for so many of the things that are wrong with Broken Barnet, and wrong within a wider context too. The destruction of our social history, and heritage, the use of land for profit, rather than the benefit of the community - and the new reality of lessons forgotten from our social history coming back to haunt us now, nearly two centuries after the workhouse was built.

I spent too long looking at the demolished building, because I didn't really want to leave and enter the hospital, where a close family friend of many years, a dear friend, was dying in the intensive care ward. I didn't want to face up to what I knew was going to be a very difficult experience, and a reminder of my last visits to the hospital, when my own parents died there. I didn't want to face up either to the terrible truth that this death was one which, we learnt yesterday, if things had been done differently, would not have been inevitable.

The stark truth is now, in this borough, if not everywhere, if you are seriously unwell, and do not have private healthcare, your life may well be put at risk by the delays that exist in giving you access to the proper assessment and treatment you may need.

I have had some experience of this new reality, in the last few months, myself. Luckily my case is not so important, but it has been a worrying and educational experience.

Last winter, in need of an urgent scan for a problem, I was told that I would have to wait four weeks for an appointment. Complaints by me and my GP made no difference. My GP eventually sent me to A&E, where I sat for three hours, watching the staff only just coping with a constant influx of patients, and wondering how on earth the service will be able to accommodate more demand when they shut A&E at Chase Farm hospital - (in complete contradiction to the specific pre election promises by David Cameron, incidentally). Eventually I was seen, had it confirmed I had a problem, but was told my GP should not have sent me, and they refused to do a scan. They were 'rationing' the availability of scans.

After kicking up more fuss, I managed to get an appointment at the Royal Free within three weeks, and was then told to wait four months to see a consultant to discuss my problem. Seeing a consultant turned out to be a farcical five minute experience, with the consultant not even bothering to sit down, resulting in an assurance that it would all be better in a few months, a referral to a pain clinic, and a list of unanswered questions. Of course, I could have paid to see the same man, in a local private hospital, in a long appointment, five months ago, and in retrospect, I realise that is what I should have done. But why should I have to?

Any appointment with my local GPs at the moment is inevitably accompanied by apologies from the doctor who will be fighting to contain his or her fury over what is happening both nationally and locally with the NHS. They explain that now, in Barnet, unless you are clearly very seriously ill, or have a trivial complaint that can be addressed locally, you cannot be referred for treatment through the 'fast track' system, whatever the effects of your condition on your life and well being.

Of course the problem with this brilliant policy is that it depends on the ability of your GP to guess how ill you might be, as the Catch 22 system does not allow for any proper assessment of condition within a timeframe that would be appropriate, if you do have something that needs immediate attention, but which is not immediately apparent.

My friend died yesterday afternoon, shortly after I saw her. Her death, ironically, was from a complication similar to the problem they thought I might have. It should have been properly assessed and treated weeks ago, and she would no doubt now be recovering.

I was told to be aware of this complication, in the months I waited to see a consultant - in her case, because she was elderly (although very active and healthy for her age) she was simply kept waiting in line to be seen, and taken into hospital far too late, which turned out to be a fatal error. How many other fatal errors are happening, we must ask? And how much worse will it get, once the coalition government's assault on the NHS is in full swing? And here is a new, and rather chilling factor: once the responsibilty for healthcare is devolved to the local authority?

In my friend's lifetime, she had seen the creation of the Welfare state, and the NHS, and was of the generation that has made the biggest contribution to these institutions through income tax. And at the end of her life, she was betrayed by the politicians who are trashing these great institutions, and forcing healthcare providers to ration the treatment and support that they are supposed to make accessible to all.

The tale of two Barnets is not just about council services, social care, housing and education: there is a growing, yawning gulf opening up in this borough between the standard of health care for those with means, and those without. It is quite fitting, perhaps that the old workhouse lies in ruins bang in front of the shiny new Barnet General: the workhouse system of support for those in need, caught in poverty and ill health, was replaced by the new promises of the Welfare state. For all our lives we have depended on this support, and expected access to healthcare as our right. It is now becoming increasingly difficult to excercise that right. It's a short walk from the workhouse to the hospital, but it's getting further and further away for most of us.

If you live in Barnet, you must become aware of the new reality of the way in which healthcare is working now, and how much worse it is set to become. If you are not afraid of this new reality, you should be. And you should be lobbying your political representatives, and telling them you do not want to see the Welfare State you've paid for all your lives destroyed for the purposes of political ideology and the profitability of private enterprise.

There is an election coming up - they are local London elections, but healthcare is now a local issue. Don't vote Tory because you think Boris Johnson is a good laugh: if you do, the laugh is on you - give the Tories a bloody nose, and let them sit in A&E for eternity, waiting to get it fixed.