Finsbury Health Centre will be open for Open House weekend

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Finsbury Health Centre will be open for both days of Open House this weekend, 21-22 September 10am – 4pm. There will be a small exhibition of the Cullen cartoons (see one of them above) and other historical material in the lobby, and the rest of the building will be accessible via tours. The tour will go around most of the building except for clinical space and administrative offices, and will include the boiler room, where during the recent upgrade of the boiler the original was kept in place, along with other historic fittings. Volunteers from both the campaign and FHC Preservation Trust will have further information about the building, the new Trust, postcards of Abram Games’ poster ‘Your Britain – Fight for it Now!’ featuring FHC (50p) and copies of Alec Forshaw’s ’20th Century Islington’ (£10) on sale. This will be the first time in many years that FHC has been open for this popular event.

The new landlords, NHS Property Services, are very proud of the building (which makes a big change!) and are opening FHC along with their newest health centre in the Olympic Village for the occasion. Do take the chance to see more of the building than usual or just stop by and say hello!

The FHC Preservation Trust is also organising a party in celebration of the 75th anniversary of the opening of FHC in 1938. This will be the evening of Monday, 21 October: more details to follow.

Finsbury Health Centre update

There will be information about the Finsbury Health Centre Preservation Trust (which has recently received charitable status) and postcards of Abram Games beautiful 1942 poster ‘Your Britain – fight for it Now” available at the Amwell Street Fete this Sunday, 30 June, 12-5pm at the stall in front of Amwell Books, 53 Amwell St. Do come along to support your community and our work to get FHC finally refurbished.
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Finsbury Health Centre will be part of the Open House Weekend for the first time in about 8 years 21 & 22 September. If you would like to be involved in helping that weekend, get in touch via savefhc(at)yahoo.co.uk.
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Although FHC is now owned by NHS Property Services Ltd. (NHS PropCo – sole shareholder, Jeremy Hunt) so far the estates team set up by the old PCT cluster has simply been transferred over, and they have been a vast improvement on previous officers. FHC Preservation Trust is currently negotiating to set up some kind of formal relationship so that we can get on with raising the money needed to refurbish and modernise the building, and to develop relationships with both the Islington CCG and Whittington Health who run services from FHC, so that the refurb meets the needs of both staff and patients. To say that decision-making about NHS services has become a complete muddle is to put it (very) mildly. The diagram below from the King’s Fund’s report ‘Leading health care in London‘ gives a good idea of the mess, click to enlarge:
leading-health-care-london-figure-one
Other local issues:
There is a consultation open about a planning brief for the whole of the New River Head site, in the wake of the recent attempt to turn the Pump House into flats. This contraveined an earlier agreement to turn the building into a heritage centre. There is an exhibition about the brief on Thursday June 27 6-9pm & Saturday June 29 11am-2pm at Finsbury Town Hall, and the consultation http://www.islington.gov.uk/services/planning/plan_brief_major/pol_planbrief/Pages/New-River-Head.aspx closes on 8 July.
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The Mount Pleasant site plans are still not out yet, but a very large development of over 400 flats seems to be on the cards. If you would like to keep abreast of what’s going on, send your name/email to Edward Denison edenison13(at)gmail.com
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There was the march, and another consultation, now the wait – Clerkenwell Fire Station, the oldest in Europe, and third busiest in London is threatened with closure along with 11 other mainly central London stations under the cuts plans supported by the Mayor a few months ago. It seems obvious from the map of the planned closures that the main metric used was not call-out times but property prices. One important thing all but left out of the discussion of the fire cuts is the fact that a large proportion of call-outs now deal with traffic accidents (also time-critical). You can still write to Boris Johnson to express your disapproval at mayor@london.gov.uk. After having counter-manded two Fire Authority decisions against the cuts he is due to make a final decision sometime in July.

Finsbury Health Centre Preservation Trust Launch Fri 14 Dec

The  Finsbury Health Centre Preservation Trust is being launched on Friday, 14 December 7.00-10pm in the Reception area of Finsbury Health Centre – with live music, food, drink and a few (short!) speeches, for staff and patients at Finsbury Health Centre and supporters of the SaveFHC campaign.
The FHCPT will be working to raise money for and oversee a complete restoration and modernisation of the building, to ensure that Finsbury Health Centre remains at the heart of our  community, doing what it was designed for.
We will also be celebrating the hard work by staff looking after patients at Finsbury Health Centre, the recent repairs by the NHS, and the many supporters of our campaign who fought for the building to remain open. The 14th also happens to be Lubetkin’s birthday!
While we live in a dangerous time for the NHS, coming together in celebration now may also help us protect this most popular of British post-war achievements – largely inspired by Finsbury Health Centre and others like it in Wales and Peckham.
Many thanks to Whittington Health and the North Central London NHS for making this celebration possible. It will be a great opportunity to meet the people involved with forming FHCPT and your neighbours, and to see this difficult year out in style. As the building’s architect Lubetkin famously said, ‘Nothing’s too good for ordinary people’!

The good, the bad, and the ugly for Finsbury Health Centre

It was an interesting evening at Islington Council’s Health Scrutiny Committee tonight. Not only was physio at FHC discussed, but GP services and performance monitoring, safeguarding of vulnerable adults, news from across the North Central London Cluster and a report from Islington Link were all on the agenda.

In the midst of the current chaos, it was good to see there are still some managers left who are still trying to run health services as a public service.

First up, the good news for FHC: Whittington Health is, as of next Monday, not only moving Physiotherapy services up to the ground floor, but restoring it to a full 5-day service, covered by not just two actual physiotherapists but three. Beverley Senior, who manages physiotherapy for WH, said that they are working to shorten the currently common three-month wait for appointments there down to no more than a month, depending how serious the problem being addressed is. Bravo to Whittington Health for recognising the demand for physio in the south of Islington and doing something about it.

Next, the bad: All NHS property not held by a hospital trust and which has multiple providers of services will pass, with the formal demise of PCTs in April 2013, to a new entity called ‘NHS Property Services’. This will include Finsbury Health Centre.

Now this is where it gets ugly: NHS Property Services (NHS PropCo is a although UK government ‘owned’ it is a private registered company one share holder: the Secretary of State for Health. Part of its remit is to make a profit. Although it is not allowed to sell anything for a year, who knows what will happen after that. Local councils will apparently be excluded from rescuing any NHS properties from the clutches of private developers, but there may be scope under the Localism Bill for local groups to do so. But no one really knows yet.

What is clear, however – the government is planning a huge theft of public property from tax-payers and communities, and it is time to get busy finding out what’s really going on before it happens. The committee will be looking more closely at NHS PropCo at its next meeting in December.

Health services in Finsbury under reform: It’s all good!

There was an interesting meeting over at the Finsbury Ward Partnership last week, where the topic under discussion was how local health services will be affected by the reforms approved by the government earlier this year. The meeting drew a range of local residents, voluntary organisations and doctors keen to hear what the local Clinical Commissioning Group (CCG) has been up to and what other delights might be in store for our health services. About 35 people attended.

A woman from Public Health set the stage, and we were told we were very lucky to have a whole group of people employed to examine this. Can it possibly be true that most other localities refrain from collecting public health statistics? Gathering information and disseminating it under the new regime will now be fully the responsibility of local councils, no longer shared with the NHS.

She ran through the differences in life expectancy in different parts of the borough, and the main diseases killing people. Heart disease, cancer and COPD top the list, with diabetes also common, and particularly so in the Clerkenwell part of Finsbury, where men have the shortest life expectancy in the whole of Islington, despite being slightly less ‘deprived’ according to census stats. These were very much presented as ‘lifestyle’ choices the poor make. The numbers of people with mental health issues is also on the rise, with Islington shown to be a leader in this category. The audience pointed out several other possible factors, like lack of open space, lack of greengrocers, and possibly even a GP to help keep track of their health. (More about this later.)

Cllr Janet Burgess (Executive member of the Cabinet for Health and Adult Social Care) then talked about the new Health and Wellbeing Board, which will be stocked with Cllrs, GPs and other health professionals, reps from HealthWatch, which locally will be the reconstitution of the current patients’ rep body Link. Its purpose is to scrutinise the decisions of the CCG, and if an unresolvable dispute arises it can appeal to the National Commissioning Board (not the Secretary fo State for Health as in the past).

Next was what we were all waiting for: an explanation of how the local Clinical Commissioning Group will work. The CCG, working of course in close consultation with absolutely everyone, will commission (that is, buy in) all heath services except those which they don’t. This includes the GPs themselves, prison health services – and something the presenter left out, maternity and early childhood services. There will be only one in Islington, so it will be essentially a neo-PCT, with less control over fewer services. We were shown a fairly simple chart showing the hierarchy of the NHS before the reforms and a much more complicated chart (even after fairly gross simplification) showing 7 tiers replacing the three which existed before, and nearly twice as many CCGs replacing the PCTs around the country. So much for simplifying bureaucratic structure.

The CCG will be buying in services from the hospitals and community service providers, and the speaker, a GP at City Road Practice who is Vice-Chair, emphised that the tenders would weighted for quality and experience (thus favouring those formed out of former NHS services) ‘as much as’ price. Veteran health campaigner Wendy Savage queried the claim that services would have to put out to competitive tender at all, in the wake of the judgement in Stroud last spring. In general there was much support for the use of legacy NHS services over for-profit private companies.

Former Bunhill councillor Joseph Trotter and others raised questions throughout the evening about the lack of GP coverage in his area, which is served by only one GP practice, where the Clerkenwell side of Finsbury has three. A GP from that practice noted the rather alarming fact that they are signing up 20-30 new patients a day. The new CCG, however, will not be commissioning GP services – the national NHS Commissioning Board will do this. This rather essential body is, however, still ‘in the process’ of formation, with a structure which can still only be guessed at.

For the last 20 minutes another member of the CCG gave a rather confusing talk about ‘integrated care’ – basically getting the different agencies talking to each other better and co-ordinate things between them so that the whole burden is not on the patient. No one could doubt this would be a Good Thing, and in fact it has been a stated goal of both the NHS and the Council for some years now, with seemingly little progress to judge from the stories which came from the audience. When asked how this programme was going to square the circle of competitive tendering vs co-operation between services, the speaker gave a rather technical answer involving targets and point scores. Hopefully the CCG will take their lead from the Stroud case and ignore the tendering process altogether. If nothing else it would save a lot of time for our already over-burdened doctors.

No doubt we’re lucky that the local CCG seems more concerned with patient care than with promoting the hollow concept of ‘choice’. We need to hold them to it. If you’re concerned about health services in your area, join your practice’s Patient Participation Group, and/or get in touch with Islington Link, which represents patients throughout Islington. If you want to keep track of how the changes are affecting the NHS – and action you can take about them – there’s London Health Emergency and nationally Keep Our NHS Public.

By popular acclaim the next Finsbury Ward Partnership meeting will be about housing.

Yes, Miranda, new buildings are soo much more reliable and cheap to maintain, especially when multiple owners are involved…

While feeling no end of sympathy for the patients and staff affected, it was hard not to indulge in a tinge of Schadenfreude on hearing news that the new Holloway Community Health Centre on Hornsey St is closed due to ‘flooding’. This is where Islington PCT first proposed in 2008 to locate all of the non-GP community services available at Finsbury Health Centre. Now it seems quite fortunate that didn’t happen, despite the at the time ‘self-evident’ truth, to the PCT, that new buildings are ‘much more reliable and easy to maintain.’ People are just naturally resistant to change, they said. You poor benighted dears, they implied, you just don’t understand the demands of 21st century health care.

Refurbish a well-made old building and you’ll be able to deal with problems more efficiently, we said, and community health services, particularly those used by children and the elderly, need to be spread better throughout the borough for good access. We didn’t think of: what if that one building fails entirely?

Practically guaranteeing that what probably started out as a mole-hill would turn into this mountain, the new health centre is saddled with multiple ownership of the building in which it sits. While the flats above it are owned by Newlon Housing Association, the HCHC is owned by a LIFTco, one of the public/private entities charged with building and managing new community health buildings under the Labour government. Queue squabbling over who’s responsible for repairs affecting both, natch. Nothing can be done to fix the problem until there’s an agreement about who pays.

This has become a big headache for Whittington Health, the NHS trust which manages the community health services at HCHC and Finsbury, and the North Central London NHS, who, as the representatives of the rump of five neighbouring PCTs is responsible for dealing with the buildings like FHC which the NHS still owns outright. It seems that while both landlords deny any responsibility for the flood there’s little room for negotiation. How either can rest easy with these denials in the face of such huge public inconvenience, it is difficult to say. Neither is displaying any duty-of-care towards the people in the buildings they are contracted to manage.

Apologies for yet another ‘I told you so’ moment, but SaveFHC campaign was also highly critical of the LIFTco model. PFI deals like a LIFTco leave the NHS not only responsible for spiralling costs. We also pointed out that LIFTco’s interest in maintaining the buildings they own would be minimal, under their 30-year hand-back agreements, whatever else was said in the contracts.

Although how a LIFTco could be worse than the local NHS on building maintenance, we also couldn’t quite imagine. Until now.

Meanwhile broken appointments stack up, pain goes unrelieved, conditions undiagnosed and untreated. At this writing I don’t know if FHC is picking up the slack. At least NCL’s current estates managers are trained surveyors who actually understand and like buildings. This is a very welcome change, albeit in the twilight of its existence. I can only wish they and Whittington Health luck in sorting this abysmal situation out. As much as it is hard for us in Finsbury to get up to Hornsey St, many living in that area will find it difficult to get down here.

PS: Very oddly, despite the development of some 300 new flats rising above the Holloway Community Health Centre, and a further 1500 planned or under construction in the wider area, it was not deemed necessary to include space for a new GP practice in the new health centre. While it was still under construction the foreman told me that this was the main question on new residents’ minds. Too bad the new CCG can’t deal with that…

FHC services and building to be discussed 24 May

Islington Council’s Health Scrutiny Committee will be hearing an update on the Finsbury Health Centre from North Central London NHS at their meeting on Thursday, 24 May in the Town Hall on Upper Street, 7.30 pm. The Michael Palin Stammering Centre has moved next door, freeing up space in FHC. While blood testing has been a welcome addition, services like physiotherapy and sexual health which were due to move upstairs to the more accessible ground floor still have not done so. It seems that while windows on the south side were painted, they weren’t made weatherproof, a frustrating sitution for staff who had been looking forward to finally having computer access up there! There are also continuing problems getting physio appointments at FHC due to understaffing. Philip Allwyn and Martin Machray, respectively Chief Operating Officer and Communications Officer at North Central London NHS (the cluster of five borough PCTs which replaced the local trusts) will be appearing. The meeting is open to the public, so do come along to ask questions and make your views heard.

Enough of all this ‘death’ talk

Ok, so now the health reform bill is through. Bar the unlikely success of a bid to get the Queen not to sign it, this bloated piece of legislation, written the kind of complicated yet vague language meant to ensure the reader loses the will to live, festering with amendments and over the most concerted opposition by doctors ever.

A lot of us wrote letters to MPs, Lords, signed various petitions (the biggest one ended up being 38Degrees), went on pickets, marches, organised meetings, held street ‘auctions’ of health services. But not enough, and when there were what should have been enough doing all these things, it was too late to turn this particular part of the saga from away from a bad ending.

But really…let’s make sure this ‘saga’ continues. Now that the doctors have agreed about what they don’t want, can we hear from them and public health experts, about what they do? One reason opposition to this bill took so long to pick up steam was that really, almost everyone who had anything to do with PCTs directly were fed up with them. Although our campaign had a lot of support among people working at Finsbury Health Centre, there was great fear of speaking out – and indeed when people did they were severely spoken to afterwards. Lanlsey’s bill will not change this culture, and if anything will make it worse.

We can already see what happens where our brave new healthcare market has already let profit-driven companies run things: Southern Cross, and lately the closure of whole GP practice in Camden have caused untold chaos and worry for patients.

There are still things to do to preserve the scraps of what’s left, outlined by Richard Blogger writing for False Economy which involve getting involved in the structures formed by the bill. More ideas from Andrew Craig here. There is an opportunity to find out more about how to do this Wednesday at the Islington Link Fair, 4-8pm at The Resource Centre, Holloway Road, N7 6PA where the main existing group for patient participation will be talking about the issues facing patients. (Unfortunately their website is down, phone 020 7832 5813 for more information.) There are also already moves underway to push for a ‘Restore the NHS’ bill, and get NHS candidates to elected to parliament and local councils…

We also need to be thinking about what kind of NHS we want restored. The PCTs (now in clusters) are opaque and unaccountable to the public they are supposed to serve. Given the history of FHC, which was commissioned by a local health committee under the guidance of a Medical Officer for Health (a doctor responsible for researching and advocating for public health) I’ve never understood why the old PCT/trust functions could not be done by elected councillors in a decision-making health committee. When we started this campaign that’s how most people thought things ran already.

So please, no more talk of death, there is still plenty left to fight for.

All out for demos and rallies 7 March

More Lords a leaping over the NHS

Yet more amendments to the Health and Social Care Bill are being discussed in the Lords today and tomorrow. Now, not only care can be privatised, but even patient representation, as outlined by Lord Toby Harris here.

There are several events planned tomorrow:
A human chain around St Thomas’s Hospital – 12-2pm
Lobby your MP in Parliament 1-5pm – just fill in a slip and ask to see your MP about your concerns
Join the Doctors’ Educational march from BMA headquarters at 5.15pm to
TUC rally at Westminster Central Methodist Hall, 6-8pm

Two major GP supporters of the bill announced in the Guardian they’ve (finally) figured out that in fact the National Commissioning Board and Monitor will have more power than the Clinical Commissioning Groups over health spending. Number 10 even did the dirty on Lansley over the weekend, complaining via the Times about his lack of diplomacy in dealing with criticism of the bill and even hinting that he should be shot!

There is still time to write to a Lord (a list is here, and another here) and remind him or her – preferably on paper and posted but if not, online – that this bill destroys the last vestiges of the NHS as a unified public service, which will increasingly not be free at the point of delivery – whether that’s in up front charges or fear of them driving people to buy extra (private) health insurance. And send a copy to your MP while you’re at it.

There is also a 10 Downing St petition to simply ‘Drop the Bill’ which has nearly 170,000 signatures but has been so far ruled out for debate. You can sign it here, would be great to get it to 200,000 and force the government to reconsider.

Keep Our NHS Public has been working overtime on this issue, please donate via their website. Without a cohesive NHS, Finsbury Health Centre’s position as a public health centre will be in danger, whatever the planning regs now say – and really I’d rather be raising funds for a full refurbishment and update of FHC than fighting a takeover by BUPA or some such.

Next meeting: Monday 13 February 7.30 at St Clements Kings Square EC1

At our next meeting we’ll be having an update on moves towards establishing a building preservation trust, and planning a public event to celebrate both the continued use of Finsbury Health Centre as an NHS heath centre and the new Finsbury Health Centre Preservation Trust.

BDonline has recently published an article about FHC’s future being ‘secure’ when in fact it feels far from it unless the Health Reform Bill is dropped. The Bill in its original form said nothing about NHS property, and September’s directive to devolve ownership to providers using over 50% of the building has apparently been resisted by the potential Foundation Trusts and GP surgeries affected. We have been trying to arrange a tour of the building in the wake of the emergency works for months, but are being told that ‘they are not quite finished yet’.

Where’s the bill now?

In the meantime, Lansley’s NHS reform bill is still in the Lords. Most of the healthcare professionals’ colleges have come out against it, with the glaring exception of the Royal College of Surgeons. 38Degrees has just published this Yougov survey of NHS staff, who are overwhelmingly opposed.

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