On a dreary night in November 2015, I attended an extraordinary meeting of the patient participation group at my local surgery, Slaithwaite Health Centre. The meeting had been called by the GP partners and their message was stark.
For 18 months, they had been trying to challenge a proposed 44% cut to our practice budget. They had written letters (including solicitors’ letters) made phone calls, sent emails to NHS England North West. All to no avail.
The cut - a result of changes to PMS contracts - would take place over three years and the effect on our popular and highly-regarded surgery would be devastating. We would be left with the equivalent of 1.8 doctors and 0.8 of a nurse serving a patient population of 5,000, in a semi-rural area, seven miles from the local hospital.
Challenging the cuts
Within less than a year, the partners informed us, the practice would be unsafe and they would be forced to resign. There were two alternatives. We could accept the cut, or we could challenge it together. We chose the latter course.
The problem with a surgery campaign is that the people who care most are likely to be the regulars - older people, people with long-term conditions and young families. We needed to be inventive and we wanted to have fun. Our first event was a coffee morning where we ‘knitted our own GPs’ (real GPs being in increasingly short supply); we held a ‘patient parade’, hobbling through the town, dressed-up in bandages and sporting a variety of garish ‘wounds’, and our most creative member designed a series of wickedly funny mugs.
We might be a small town in an obscure West Yorkshire valley, but we managed to make quite a fuss. We starred on News at 10 and Radio 5 Live (who broadcast all morning from our surgery). We were a constant presence in the local newspaper and on local social media. We were a thorn in the side of our (now ex) MP who suggested we leave local decision-making to the experts - they’re bound to have a plan and of course they’ll have done the requisite risk assessments (they didn’t and they hadn’t).
And all the time, an exceptionally brave patient, supported by the legal firm Leigh Day, was preparing the grounds for a judicial review in the event that the cut was pushed through.
Like several members of the steering group, I’ve been involved in campaigns to defend local services before. But this was an eye-opener. For me, the issue could never be about the fairness or otherwise of PMS contracts. It was, and is, how could a vital local service be expected to survive a 44% cut? Who was going to take responsibility for the consequences? And most of all, how could it even be proposed without involving the community?
Six weeks ago our GP partners reached a compromise with the local CCG. The cut has been more than halved, no jobs will be lost and the partners believe that the surgery is safe for the moment.
We held a celebration – tea, cake and speeches in our public hall. We were happy and proud. But we know that we have been lucky. The Colne Valley is a strong community, with a long tradition of self-reliance. We have fantastic GPs who were prepared to ‘go public’ and take the consequences.
And we know what has happened elsewhere. In Chelmsford and Brighton and Hove, surgeries facing cuts of 30% have closed, leaving thousands of patients scrabbling to join neighbouring lists.
Something needs to change to stop patients across the country being put in our position. There is a statutory responsibility to consult enshrined in the 2012 Health and Social Care Act and people making decisions about local health services need to reacquaint themselves with that legislation. The ‘cut now, consult later (but only if you have to)’ approach is no way to treat either the providers of vital local healthcare or the many thousands of people who rely on them.
- Fiona Russell is a patient at the Slaithwaite Health Centre and a member of the Slawit Health Centre SOS campaign to save the practice