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In Praise of the Heart of Birmingham Health Trust
By Andy | November 17, 2007
Woke up this morning to a very misleading piece on the Today programme that featured a new initiative by the Heart of Birmingham Health Trust. The Trust’s new development programme for GPs was portrayed as ‘franchising’ - which always raised the subliminal image of Macdonalds.
The BMA (British Medical Association) were right in there criticising the policy in what I thought was - at least - a very disingenuous series of comments.
This is an innovative policy which is attempting to deal with the reality of providing first class health care in one of the most difficult, diverse and disadvantaged communities in Britain.
The Heart of Birmingham Trust covers inner city Birmingham - it doesn’t have many posh bits in its boundaries. For a decade now the city has been worried about GP services in the Trust’s area.
Many of the GPs here work in small, often single, practitioner settings. Many of them are getting old and will be retiring over the next five years or so. The Trust needs to bring in a new generation of GPs. The problem is that young GPs don’t want to work in these isolated settings. They want to work in multi-discipline teams with all of the backup that you’d expect in a middle class suburb.
After a decade spent exploring all kinds of incentives the health Service has simply had to acknowledge that GPs were not going to set up shop here as they would four or five miles ago in the leafy suburbs.
The strategy has been to directly employ GPs more than most Trusts and, now, to look at consolidating existing provision in new, state of the art facilities. But you have to have the staff. You have get them to work in the area in the first place. Despite some achievements it is still difficult to get people to work in these neighbourhoods. This new scheme is another development designed simply to ensure that GP coverage not only continues - but improves - over the next decade or so.
In the coverage the Trust invoked the customer culture of Tescos and Asda, perhaps, not the best choice. But both of these stores work in poorer areas, invest significantly in staff and stores. This is what it was all about - ensuring that the poorest members of our communities have access to the same quality of health care as the rest of us.
The BMA should be ashamed of themselves this morning. The suspicion lingers that many of their members do not want to work in difficult inner city neighbourhoods - work is harder, and more challenging here.
The Today report was also not penetrative enough. They interviewed a local GP who worked on his own. He painted a rosy picture of a small practice, with warm, fireside chats. People like his style, I’m sure they do. But just how old was he? And who replaces him when he goes?
Our NHS is so important. But we have to recognise when - and where - it is failing. Developing good services in difficult locations demands innovation. The Heart of Birmingham Trust should be commended for their experimentation. And, of course, there can be no experimentation without risk. But our poorer communities deserve just as good health care as the rest of us - maybe better.
May 25th, 2008 at 11:00 am
Andy,
I live in ladywood and chair the patints network here and agree wholeheartedly with your comments. (The newly opened Summerfield Health Centre is well- worth a visit.) We have been served well by a group of single-handed gps over the years but their time is coming to an end and there is no guarantee they will be replaced in thier practices
May 26th, 2008 at 9:52 am
Thanks for that Chris. You’re lucky to live in an area where the PCT really thinks, cares and plans for these things. This is one Trust where the appointment of the Chairman has been an extremely positive one.