The Great Western Hospital and the “beds crisis”

You didn’t need a premonition in 1999 (“We warned this would happen says pensioner over beds crisis at GWH”, Swindon Advertiser) to know that the new hospital would be short of beds. Swindon TUC helped set up an NHS Defence Campaign which cut through the propaganda of the Trust management to show that the new hospital would only have 483 in-patient beds, as compared to 703 in the various hospitals at their disposal before GWH was built. (See an article I wrote in the Swindon Advertiser evening-advertiser-article )

The new hospital was opened in December 2002, and within one month it was in difficulties. The Advertiser on the 6th January 2003 declared “No room at the hospital”. The Trust wrote to GPs pleading with them not to admit emergency patients in the light of the “untenable” bed situation at the hospital. “Unfortunately every trolley, bed and bed space is in use currently. It is extremely difficult to find spaces to examine patients.”

Chief Executive Sonia Mills famously said, in response to one patient’s unfortunately long sojourn on a trolley:

Under normal circumstances we would not expect Mr Collins to be cared for on what is technically a trolley but which, in many respects, is similar to a bed.”

She also declared that the fact that the hospital was so full was an indication of its “efficiency”!

The GWH is one of the most cost effective in the country. It makes the most efficient use possible of its beds and services. Around 98% to 100% of its beds are occupied at any given time.”

Bed capacity “continues to be a problem”

The Trust found it necessary – here was the proof that they were wrong about the bed numbers – to take over an administration area to create a 32 bed ward, build a 60 bed intermediate care unit (which they had to plan for even before the new hospital was finished), and later in 2005 build a diagnostic and treatment centre with 128 beds. The Trust’s annual report for 2002/03 had to admit that bed capacity “continues to be a problem”.

Swindon TUC and the NHS Defence Campaign opposed the use of PFI which was an expensive Hire Purchase system. Originally the Trust was going to redevelop the Princess Margaret site for somewhere in the region of £45 million. The cost of the new hospital started off at £90 and then progressed up to £148 million. On top of the actual cost of building it the Trust had to pay the Hospital Company (originally set up by Tarmac) for the non-clinical services that they would provide. The Trust pays the private company a quarterly fee for the occupation of the hospital and a quarterly service fee for the services provided by the operator such as portering and catering. In 2003 the trust entered into a ‘variation’ of the original agreement for the construction of the Brunel Treatment Centre, resulting in increased ‘availability’ and service charges. The availability payment is increased annually based on “a combination of the annual increase in the RPI and a fixed percentage increase of 2.5%”.

Planning application

The planning application was pushed through the help of a little moral blackmail (See this newsletter dec-1997 ). Agree the application or we will lose the hospital was the message: PFI or nothing. In what was probably the highest response of any consultation in the town, 896 respondents opposed it to 373 in favour. Swindon TUC and the NHS Defence Campaign opposed it because it was a PFI scheme and because it would be built in the wrong place. We were told that acceptance of the application would not create a precedent for further development in the Coate area! Later Bath University wanted to build in the area. Their plan fell through, but as is well known the Tory administration changed the local plan to enable developers to build housing. Council Leader Rod Blu had said “No University, No housing”.

The current crisis is beyond the scope of this brief article. Suffice it to say that the GWH is struggling with the legacy of the PFI deal and the attempt of previous governments of all stripes to introduce competition and the methods of private busines into the NHS. GWH had a deficit in the last financial year of £9.744 million and the Care Quality Commission gave the Trust an overall rating of “Requires Improvement”. This, of course, is not exclusive to GWH. There is a growing funding crisis across the whole NHS as it struggles with the consequences of New Labour policy and Tory.

Martin Wicks

December 23rd 2016

 

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