Salisbury Walk-In Health Centre in Avon Approach scored highest among local Salisbury Surgeries

Salisbury Walk-In Health Centre in Avon Approach scored highest among local Salisbury surgeries in a national survey and yet it is due to close. So what was the purpose of the survey??

NHS forced to close walk-in health centres because they are ‘too popular’ (The Bureau of Investigative Journalism, June 2011)

First Chair of new Wiltshire Clinical Commissioning Group is a senior GP from a Virgin Care ‘Partner’ Surgery

The first chair of the new Wiltshire Clinical Commissioning Group (CCG) is a medical director from the old NHS PCT and a senior GP from a Virgin Care ‘Partner’ Surgery

Trowbridge GP Stephen Rowlands has been a senior partner at the Bradford Road surgery for 27 years and served as the medical director of Wiltshire’s Primary Care Trust for the past year.  “I am very keen to support the transition from PCT to clinical commissioning as smoothly as possible,” the doctor said. (‘This is Bath’, Monday 7th May 2012)

This looks reassuring – hopefully a GP led CCG will avoid the worst excesses of the governments top down NHS “reforms” to be seen elsewhere in the country.

But just one word of caution, Dr Rowland’s Bradford Road Surgery, is  a Virgin Care ‘Partner’. When Richard Branson took over ‘Assura‘ he inevitably gained access to hundreds of GPs who were joining CCGs across the country as part of the government’s reform programme.  There are already fifteen surgeries in Wiltshire that are Virgin Care ‘Partners’ so there is a possibility that there are more Virgin Care ‘Partners’ in the Wiltshire CCG.  Is this a good thing?? What does being a Virgin Care ‘Partner’ mean?? Is there a potential for a conflict of interest?? Who knows??  However, it does look like Virgin Care have got off to a good start in Wiltshire.

‘This is Bath’, Monday 7th May 2012

‘Virgin Care’ partners in Wiltshire

Conflict of interest fears in NHS shakeup plans

Is Virgin Care set to take control of NHS services in Andy Burnham’s own constituency?

‘Virgin Care’ partners in Wiltshire

I just came across this web site (Virgin Care Wiltshire) (UPDATE: This link is no longer working, probably due to this) which lists the 15 GP surgeries in Wiltshire that are already in partnership with Richard Branson’s Virgin Care.  This came as a surprise to me – I was not aware that Virgin Care already had such a foothold in Wiltshire.  Is this a good thing? It would be good to hear from someone who knows whats going on.  Virgin Care has partnerships with 350 health Centres nationally.

In addition, Virgin Care has secured about a billion pounds of NHS business as it has been handed responsibility for running, “and I am not making this up”,  Surrey Sexual Health, Brighton/West Sussex Sexual Health & Milton Keynes Sexual Health. These parts of our NHS are now in the control of Virgin Care.

Nationally, Virgin Care have been invited to help with a rewrite of the NHS constitution.

Here is a list of Virgin Care partnership members in Wiltshire:

1. Adcroft Surgery

2. All Saints Medical Practice

3. The Avenue Surgery

4. Bradford-on-Avon Health Centre

5. Bradford Road Medical Centre

6. Giffords Surgery

7. Jubilee Field Surgery

8. The Lansdowne Surgery

9. Lovemead Group Practice

10. Market Lavington Surgery

11. St James Surgery

12. The Southbroom Surgery

13. Spa Medical Centre

14. Westbury Group Practice

15. Widbrook Medical Practice

Virgin Care Wiltshire  (UPDATE: This link is no longer working, probably due to this)


News from Neighbouring counties

NHS Somerset are selling off (“liberating”) their Podiatric Services (20th April 2012) to “any qualified provider” AQP. Does this mean Podiatric services will no longer be free of charge?? Does anyone know? Was anyone asked their opinion? (Quote: “There will be a local tariff for podiatry services and there is likely to be a national tariff for nail surgery”.)

A relief care service run by a Swindon charity is being transferred to a private provider (April 2012): Due to cuts in funding, a service, currently run by a charity and which supports about 65 ‘clients’, is to be transferred to ‘Bluebird Care’ a private company by the end of June:

Devon NHS children’s services set for privatisation (April 2012): Core children’s health services in Devon may be about to be privatised in a move that critics have warned is a foretaste of the breaking up of the NHS that will take place when the government’s health and social care bill becomes law.

The kinds of things we need to look out for in Salisbury

Here are some lessons from the “Coastal West Sussex Clinical Commissioning Group”.  Apart from commissioning Virgin Care to deliver Sexual Health Services in what looks like opaque circumstances here is a news item which demonstrates that there is a real risk that the Health and Social Care Reform Bill will allow for NHS patients to be charged for treatments that were, or still are, free under the NHS while at the same time tax payers/NHS money will be used to subsidise private patients.   In other words this looks like yet another example of transfer of funds from the 99% to the 1%.

This and the many other potential conflicts of interest could destroy the GP – patient relationship which is currently the jewel in the crown of the NHS.

“GP surgery’s private sessions could break BMA ethics guidance”  West Sussex County Times, Monday 20 February 2012:

Virgin Care to deliver Sexual Health Services in what looks like opaque circumstances

Salisbury NHS Watch: News

In case you didn’t know, Clinical Commissioning Groups (CCGs) are taking over from the old PCTs (Primary Care Trusts). Our local CCG is the “Sarum NHS Alliance”.  However it seems that the Sarum NHS Alliance is merging with other Wiltshire CCGs to form one county wide CCG.

The news report linked below indicates that the merger is due to the work loads involved and to the need to avoid a “post code lottery”.  This last point is interesting because it is exactly what the previous , chief executive of Salisbury NHS Foundation Trust, Matthew Kershaw, admitted the reforms could lead to.

In an article from last year (see link below). Kershaw discussed the risk that neighbouring CCGs could offer different levels of service, refuse to provide certain treatments or allow longer waiting lists for more expensive treatments.  Conversely he warned of the possibility of CCGs merging together to provide a more uniform service in an area but that this would undermine and prevent the competition that the Government is aiming for.  Interesting issues – see link below for more details.

The new CCG will operate in shadow form and work closely with NHS Wiltshire this year before it takes over the reins in April 2013.

So What are Clinical Commissioning Groups?

Clinical Commissioning Groups are groups of GPs that will, from April 2013, be responsible for designing local health services In England. They will do this by commissioning or buying health and care services. (There is also the NHSCB and the four SHAs but more of those in a future post).  Apparently, aboard of 5 GPs and 2 non GPs was formed last April to run a Clinical Commissioning Group based around Salisbury Hospital, called Sarum NHS Alliance. It consists of 27 practices and approximately 150,000 patients.

This all sounds great – who better to control our health service than dedicated well known and trusted local GPs.  Unfortunately it might not turn out like that in the long run – the kind of GP who is dedicate to his/her patients and the community is unlikely to enjoy the management and committee work of a CCG.  Evidence is already appearing which indicates that CCGs are likely to end up consisting disproportionately of GPs who own stakes in non-NHS providers and could use their decision-making power to simply commission their own companies to offer services.  Here is an example. I stress that I have no reason to believe that any of this is true for our local CCGs and am sure that those that have got involved have done so for the best of reasons – to ensure that they can adapt and guide  the reforms for the benefit of their local communities. However, we all need to be vigilant to ensure that we spot the conflicts of interest that could develop in the long term.

A Salisbury GP has resigned as chair of Sarum NHS Alliance commissioning group. The Doctor, who was previously heavily involved in practice-based commissioning, said ‘The CCG role was becoming too much. I had to make a choice and in the end my priority was my patients’:

NHS reforms ‘risk’ creating a postcode lottery:

Three Wiltshire CCGs (including Sarum NHS Alliance) to merge:

Half of GPs on clinical commissioning groups have financial links with private providers:

What happens in Surrey today could happen in Salisbury tomorrow

“The people of Surrey did not vote for their NHS to be gutted and served on a silver platter to Virgin Care, but that’s what they got”:  Healthy competition in the NHS is a sick joke (Daily Telegraph)

So this is what David Cameron meant when he promised that the NHS would not be privatised. He clearly uses a disingenuous definition of privatise.

The people of Surrey were not consulted, there was no democratic process. Surely we need to be more proactive in Salisbury?

Letters to Salisbury Journal

This is a copy of  a letter that I wrote to The Salisbury Journal letters page (Postbag) and which appeared on Thursday 22nd March 2012.  Link

Having been the recipient of excellent healthcare from my Salisbury GP service and Salisbury District Hospital, I am compelled to write about my concern that we, the patients and taxpayers, seem to be doing little to prevent the destruction of our NHS.

According to independent and objective international comparisons, the NHS is one of the most cost effective and successful health care systems on the planet. This is despite political interference and chronic underfunding for most of its existence.

Yes, there are defects, as there are with all other systems, and we should be ashamed that we have not fought harder for these to be fixed.

But the government reforms, not mentioned in any manifesto, and with no democratic mandate, will result in an NHS run by companies who will make decisions which prioritise their shareholders’ interests and will channel huge sums of tax payers’ money into their profits and CEOs’ bonuses.

Some of these companies already have a dubious track record. Their contracts and finances are subject to confidentiality and they are immune to the Freedom of Information Act.

We cannot trust any of the political parties.

The Labour Party, when in power, introduced privatisation by stealth and the present Tory/Lib Dems want to turbocharge this and enshrine it in law to prevent any reversal. If we want to retain a National Health Service we will have to fight for it ourselves.

If we care about the NHS we need to pay attention and get involved – it will soon be too late and there will be no going back – our children and grandchildren will not forgive us if we do not fight the self-interest and ideology which threatens our NHS.


The Postbag editor clearly wanted to liven things up and so gave my letter the headline:  “Political parties cannot be trusted with our NHS”.  I do not think this fairly reflected the thrust of my letter but nevertheless it did prompt Steve Fear from the Labour party to write in response.  This is a link to his letter. I have not pasted it hear in case the Journal has the copyright.

In the following week there was a response from John Wigglesworth. Link here.

As I do not believe either of these responses addressed the focus of my original letter, I followed it up with another letter to the Journal – this was published on Thursday 19th April with another letter from Steve Fear. Here is the link to Steve’s message. I have posted my letter, in full, below (the Journal’s version was significantly edited).

Letter to Salisbury Journal Post Bag (published 19th April)

My recent letter to Postbag (21st March 2012) regarding the demise of the NHS has generated a couple of responses but both were of a party political nature.  They did not address the focus of my letter which was that the passing of the Health and Social Care Bill effectively means the end of the NHS as we have known it and that health care in the future will be subject to huge conflicts of interest with inadequate safeguards.

At the local level, a senior GP has resigned as chair of Sarum NHS Alliance Clinical Commissioning Group (CCG) due to the adverse impact on his professional and personal life and the care he felt he could provide his patients.

In case you didn’t know, CCGs are taking over from the old PCTs (Primary Care Trusts), does this mean that people are being made redundant from the PCTs, at great expense, only to be reemployed by the new CCGs?

I note that at least one experienced local GP is giving up one day a week in her surgery because of her membership of Sarum NHS Alliance. How many more GPs are being taken away from contact with their patients?

It now seems that our local Sarum NHS Alliance is going to amalgamate with the rest of Wiltshire to form a county wide CCG.  Will this be good or bad for Salisbury?

What happens if our local GPs decide that they didn’t enter medicine to become managers of multi million pound budgets and they decide to hand over the CCG to management consultants with service delivery run by Virgin Health Care or the health care equivalent of A4E?

I don’t know the answers to any of these questions.  It would be great if someone who does could write a letter to Postbag giving us an update.

The reform bill gives a legal basis for charging and providing fewer health services this could mean a large number of private beds in our hospital and, as seems likely, GPs telling their patients that they will have to pay for services currently provided free through the NHS.

Please don’t think I am making this up – check for your self, these changes are already happening in other parts of the country.  If we care about this we need to pay attention to what is happening locally and be prepared to fight for the retention of a comprehensive, integrated health care system that serves the whole community.

Colin Lawson

Salisbury NHS Watch

On March 27th 2012 the Health and Social Care Bill became law and at a stroke brought to an end sixty years of the NHS. What the future holds I do not know but what is clear is that it will not be a universal, comprehensive integrated health service available to the whole community as we have now.  It will be a system in which huge conflicts of interest, mixed with huge sums of tax payers money, will offer individuals and international corporations unrivalled temptations to make huge sums of money at our expense.

This has happened on our watch, our children and grandchildren will not forgive us.  With a few notable and commendable exceptions the media, political parties, health care professionals and us the patients and taxpayers have all stood back and allowed this to happen with a virtually non existent level of public debate.  And to top all this the “reform” of the NHS was on no parties agenda – there is no democratic mandate whatsoever for the biggest change in health care since the formation of the NHS.   When David Cameron said the NHS was safe in his hands and that the NHS would not be privatised he was simply not telling the truth – we have been taken as fools.

I have started this branch of my blog as a place to document and log the development in Health Care in my home City of Salisbury in the vain hope that it may serve as some use in the fight to ensure that we can avoid the worst excesses of what could happen to health and social care in England over the next few decades.

Salisbury NHS Watch – more …