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Notes from the field of public involvement

Wednesday, 11 January 2006

A Shropshire bellwether perhaps

Anyone half-interested in public involvement in health issues should be aware of what could be brewing in Shropshire. The BBC has reported that thousands of people have taken to the streets of Bridgnorth to protest against the possible closure of a community hospital and there were similar demonstrations in Whitchurch and Ludlow where two other community hospitals are under threat.

What is prompting this literal outpouring of people onto the streets in Shropshire market towns? The local health economy in Shropshire and Staffordshire SHA is £55m in debt and the situation seems to be deteriorating. The local NHS sees closing community hospitals as a key way to save money. Clearly the public doesn't agree.

Will the Shropshire public's literal demonstration of its loyalty to community hospitals make a difference to the prospects for restoring the local health economy? The simple answer is that it has to make a difference, even if it is not the preferred solution of the politicians and bureaucrats. If the community hospitals are not cut, then what else will be or can be eliminated or reformed to produce recurring savings? The answer may be "nothing". And, the big unknown, whatever alternatives are possible, are they worse than or better than cutting community hospitals in terms of their impact on the ends of the local health economy which must be the health and well-being of local people themselves? If the only alternative seems to be for the government to put in more money and for the resulting level of financial health to be sustained over the long term, then the situation is insoluble and the NHS end game is underway. These are the questions that the local community not just in Shropshire needs to be educated about and involved in as owners of the local health economy before it is too late.

We are about to see the White Paper on care outside of (mainly acute) hospitals. In that context, what will Shropshire's manifestation of patient and public involvement in deciding the local NHS’s future amount to? Ministers would do well to take note of a likely political bellwether. Parliamentary seats have been lost on less before. Think about Kidderminster’s independent anti-closure campaigner Dr Richard Taylor’s capture of Wyre Forest in neighbouring Worcestershire from Labour in 2001 and his re-election in 2005 with many local councilors riding the coat-tails of his Independent Health Concern party. Shropshire could give a new twist to what a "patient-led NHS" can actually mean and the route may lead off the ministerial road map.

Andrew Craig | Send feedback