Selfsufficientish.com

... centralisation:

The Great Consolidation

What more can the government shut down? Oh yes, doctors’ surgeries.

By George Monbiot. Published in the Guardian 29th April 2008.

Everything is getting bigger and further away. Hospitals, post offices, schools and prisons are being “rationalisedâ€

Ina I am with you on Centralisation, but...

I acted for a private company who developed Scotland's first Public Private Partnership Healthcentre - known as a Primary Care Centre in todays lingo. Now we may have been lucky, but my client was very keen to get it right with it being the first. I chaired numerous meetings in what was an ageing NHS building which housed 2 GP practices. A third practice rented their own accommodation and this was badly maintained and without getting myself into trouble, broke nearly every rule in the book. The nearest Pharmacy closed down a few years before.

All three practices now occupy a purpose built, energy efficient building with excellent parking facilities and public transport links. The NHS building was no where near a bus stop and had lots of steps back and front and noteven enough parking for the staff, let alone patients.

In addition to the 3 practices, a dental surgery is also under the same roof, but equally importantly is the NHS Community Services - this saves people traveling miles to the nearest Hospital for Podiatry, Post/Anti Natal/Speech Therapy/Minor Ops to name only a few. The building is open in the evening and hosts slimming classes, stop smoking classes etc.

There is also a national Pharmacist (the one that closed down moved into the building) and central circulation spaces where local artists and the camera club exhibit their work.

The different organisations work individually but the likes of the minor ops suite and other common parts of the building with unique but expensive kit in them are shared by all. There are also common staff facilities which helps the different organisations in the building share ideas. Most of them were in different buildings previously.

The running costs for the building are less than the previous building before and they were well managed (by me!!) rather than taking away time from the Practice Managers who can now focus on their job of running the practices. An on site Caretaker was the only additional cost, but this was trialled initially and all building users found the chap utterly invaluable. He had previously been made redundant by the NHS from an identical post elsewhere in a cost cutting excercise.

It was a good news story all round. The old NHS building was converted into much needed housing in the town and the privately rented unit is now a shop.

The basic idea is good, but the politicised version is usually a non-starter. For instance, all Senior Citizens in North Notts. have free bus passes. After government-approved rationalisation, no more than 50% of North Notts. villages lie on a bus route. Who's kidding whom?