I don’t think I have declared my bias. These are personal views and opinions. I live in Poole and I have family connections with Poole Hospital going back 48 years until the present and have seen many changes. I have experienced travelling to Royal Bournemouth Hospital by ambulance, car and by public transport, as a patient and taking friends for appointments. I support both hospitals equally and yes, I am biased because I have the utmost respect and regard for those who work and serve in the NHS and in the NHS as a public institution owned by the public. My biggest concern is the level of political interference and what that may hold for the future, but I am leaving that aside and looking at the reality of current proposals and potential changes for this end of Dorset.
I believe the NHS is woefully underfunded and if acute NHS services in particular are not considered financially viable then there is something drastically wrong with the system of payments. If it stays the same, a hospital that focuses on acute services will surely ‘fail’ and be placed in ‘special measures’ with all that entails, as currently is Barts in London, along with several others.
This logic means that which ever of our hospital takes on the acute role will be walking a financial tight rope as long as the current payment scheme is in operation.
Conversely, planned NHS services have the potential to be more profitable and therefore attractive to commercial interests who make their profits by choosing procedures and operations that are routine and easily replicated with larger volumes, ‘cherry picking’ if you like.
It follows that which ever hospital takes on the planned role should be profitable and therefore attractive to commercial interests.
For these reasons alone a merger would make sense for Poole and Bournemouth Hospitals. The other advantage is that it would enable the two trusts to work together to provide the best set of outcomes for patients based on their joint assessment of needs, provision and geography.
Even though NHS England and NHS Improvement say they would support such a move it currently would have to get passed the Competition and Markets Authority.
The ideological remit of the Competition and Markets Authority is totally inappropriate in public health care matters, having terms of reference based on commercial thinking to do with ‘customer choice’. It remains to be seen if it is referred and having said that I would not be surprised if the CCGs existing proposals would fall foul of the Authority also.
No doubt it is an evolving situation and one in which our two hospitals will seek to revise their merger proposals and present them in due course. What effect this will have on the CCG’s proposals and subsequent consultation remains to be seen.
©John Daniels
