Health chief takes the hot seat

GAIL RICHARDS - making a point

THE Chronicle is putting Oldham’s leading figures in the hot seat, giving local people the chance to ask questions that really matter to them.

This time NHS Oldham chief executive Gail Richards answers your points.

Gail today joined a national team developing how GPs take control of health spending, handing the local reins to Shauna Dixon, former executive director of clinical leadership.

Marina Berry posed the questions on behalf of readers.


Q If you had a choice between cancelling operations and balancing the books, which would you choose?
A WE don’t have a choice about balancing the books — this is a legal duty.

Where we do have a choice is in looking at every single thing we pay for and making sure we get the very best value for money.

It is certainly true that in some cases we can save money by doing things more productively, more efficiently and by following the very latest medical guidelines — and still provide the services patients want.

For example, we will save more than £500,000 by stopping the overnight drop-in facility at the Urgent Care Centre.

Just four people a night use it on average for a range of minor conditions — which is not a good use of taxpayers’ money.



Q HAS NHS Oldham failed? If not, why is it being abolished?
A NHS Oldham has had a good reputation for performance, both in terms of patient care and financial management since it was formed in 2002.

It has been successful in helping to increase life expectancy in Oldham as our latest annual public health report shows.

For several years, the primary care trust, along with others across the country, has been moving towards a role where it only commissions services and doesn’t provide them.

The new health White Paper is accelerating the process to ensure that doctors and health professionals take a lead in commissioning services from organisations which provide health services such as Pennine Care, Pennine Acute Hospitals NHS Trust, The Christie and so on. When primary care trusts are abolished by 2013, responsibility for the money used to buy health services will be moved closer to GPs, and some of the bureaucracy and reporting will be reduced.

We will get the benefit of more GPs and clinical staff, along with patients, deciding what services are needed where.

Change was already happening. In Oldham we already had practice-based commissioners, and a number of the leaders already work almost as part of the primary care trust.


Q How did the primary care trust (PCT) find itself £10m overspent? When did you first know the PCT was going to be in the red and who is responsible for this?
A WE are not £10m overspent. We are at risk of an overspend at the end of this year, but we have a financial recovery plan in place which should help us to manage to so we can break even.

This is dependent on us making considerable savings over the next five months, and more next year.

There are several reasons why this has come about. We have invested in health in Oldham over the years and it is beginning to pay off — people are healthier than they used to be.

People are being seen and treated more quickly and in many different ways. People have a wide range of choice about where and how they are treated.

However new treatments and services are expensive, and demand for these NHS services is also increasing every year.

Ultimately wherever people are seen in the NHS system the PCTs pick up the bill.

Finances were very tight last year and we were left with very little reserves but we did manage to balance the books.

We also know that from 2011 there will be much less money ‘in the pot’ as the period of unprecedented growth the NHS has seen in recent years comes to an end.

So, we are in a position where we have to reduce costs safely to balance our books but this is not happening quickly enough, and at the same time our bills are going up each month — beyond what we predicted and beyond what we have the money for.

This is why we have a financial recovery plan in place.


Q When GPs take over commissioning, how will we know they are acting in our best interests instead of their profits?
A GP Consortia will be statutory NHS bodies and will be held to account like every other NHS organisation and be bound by all NHS rules around finance.




Q DO you think that having clinics for specific illnesses in one place, forcing people to inconveniently travel long distances to other hospitals, really does save money? I believe you should be able to attend your local hospital for appropriate treatment for whatever illness you have.

A The reason clinics are in one place is so that patients receive the very best care.

If every service is offered everywhere it means that experts in a given speciality are often unable to see enough people to make sure that their skills and knowledge are kept right up to date.

One example is cancer care. If you need specialist care for cancer in our region you will often go to The Christie Hospital.

Because this is the focal point for cancer care it means the very best cancer doctors want to be there, which in turn means the patients get the best care.


Q When will Saddleworth get a new health centre, like in other parts of Oldham?
A Uppermill Health Centre is very cramped, and as opportunities came up we looked to see if we could make developments under LIFT (a scheme to replace and update local health centres).

Specific opportunities explored just weren’t value for money, and we are still continuing to look for different ways of seeing more patients.

It is as important in Saddleworth as elsewhere to meet the needs of everyone and ensure a consistently high quality of care from NHS services.

While there is a good level of health care provision in Saddleworth across its local communities, we know there are some pressures on the health facilities and we would like to do more.

We are continuing to look at solutions for improving health in Saddleworth.




Q WHY does the NHS extend free treatment and perform operations to correct botched operations performed abroad and paid for privately, often for cosmetic purposes ?
AThe NHS does not turn people away who need urgent treatment for potentially serious problems.



Q Why is there no concerted effort to stem the rapid growth in diagnosed cases of TB in our area with free vaccinations for all who may be affected rather than just those returning from parts of SE Asia ?

A Although TB can affect anybody, the majority of new cases occur in people from risk groups, such as those with family associations in countries with high levels of TB, and people whose immunity to infection has been impaired.

Rates of TB in other groups have fallen to very low levels over the past 15 years.

TB is a difficult disease to catch because it requires prolonged exposure to an infected person.

The BCG vaccination programme was changed to reflect this, following advice from the Joint Committee on Vaccination and Immunisation, and is now given only to people in at-risk groups

It is also offered to babies who are more likely than the general population to come into contact with someone with TB.

Other at risk groups include health workers and people who have recently arrived from countries with high levels of TB.


The above is an edited selection of the questions put to Gail Richards. For the full Q+A, see tonight’s Oldham Chronicle or subscribe to the E-Chron - click the button.
TOMORROW: More questions for gail Richards — Is it true that people over 65 are given less care than younger people?