Did Tony keep his NHS promise?

IN the 1997 Labour manifesto, a fresh-faced Tony Blair pledged to “save the NHS”.

Today, health reporter HAZEL BYFORD looks back at the good, the bad and the ugly of the last decade of the health service in Suffolk, and asks whether indeed it has been saved.

OUR national health service has always been a vote winner - and loser.

When Tony Blair pledged ten years ago to cut waiting times and invest in improving services and slashing bureaucracy, voters supported him at the polls.

But here in Suffolk a decade on, all is not rosy. Now people are judging Blair on MRSA rates, childhood obesity figures and the financial burden crushing services in the county - issues which a decade ago were not reality but something nightmares were made of.

And according to a YouGov survey for the Daily Telegraph, only one in ten said they counted health reforms among Blair's top three achievements.

Of course it is not all bad news. Waiting times are in fact on the way down and new services are available, such as the cancer information centre at Ipswich Hospital which opened in 2004.

Mike Freestone, a former GP at Ipswich's Barrack Lane surgery and a member of the British Medical Association, has witnessed the good and bad within the past decade.

He said: “One of the biggest differences for GPs and frontline services is the reduction of home visits.

“It was easy for patients to get a home visit from their GP ten years ago, but now patients are more mobile and GPs are less mobile.

“In the 70s I did three, four or five visits in an hour but with the present traffic conditions it can take an hour or more just to make a single visit nowadays.

“Waiting lists were an issue ten years ago and still are, as are the big killers such as heart attacks and cancers.

“Overcrowding was also an issue but not so much as it is now as beds have been reduced over the decade.

“Towards the end of my career, from 2000 onwards, the main pressure was trying to keep up with government targets.

“GPs are now a lot more tied to computers than they were ten years ago.

“What we were asked to record and how we were asked to record it kept changing, and anytime I was not with a patient, I was at the computer.

“Obviously there will be benefits from the work put in like this, but we won't see them for years.”

Today, you can't talk about health services in the county without mentioning infection rates.

Just last week Ipswich Hospital was named as 31st in a list of 166 hospitals country-wide for the number of Clostridium difficile cases it had in over 65s in 2006.

The hospital also hit the headlines for the wrong reasons in 2005 when Luke Day died of MRSA aged just 36 months old.

Money is being invested in reducing hospital-acquired infection rates, with the target at Ipswich Hospital and Bury St Edmunds' West Suffolk Hospital being to reduce cases to zero.

Other national headlines Suffolk cannot escape are obesity (which has doubled in children in the past decade and is a priority at the Suffolk Primary Care Trust), and privatisation - which most recently raised its head when it was revealed many GP surgeries could go private because of changes to their contracts.

Troubled finances and ugly historic debts means the county now dedicates much time to balancing books - which has sadly seen cuts.

Services including the Hayward Day Hospital and mental health clubhouses Bridge House, in Ipswich, and Old Fox House, in Stowmarket, have been closed.

The Pines, an occupational therapy centre for people with mental health problems, and The Hollies, a garden centre providing employment for mental health patients, have also been lost and The Bartlet convalescent and rehabilitation unit in Felixstowe is set to close, despite fierce ongoing campaigning to keep it open.

And earlier this month we reported how Ipswich's Hospital's Orford Ward for the elderly is the latest ward to close as part of a scheme where 71 beds, 357 jobs and four operating theatres are set to be lost.

Dr Freestone, a GP from 1971 to 2005, said: “Blair dismantled district health authorities and replaced them with primary care groups, which became primary care trusts, but then didn't give them enough time, and put too much pressure on them to change and move forward too quickly.

“We've ended up with what is essentially district health authorities again. The government were too busy managing the changes they took their eyes off the actual services.”

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What changes in the NHS have affected you since 1997? Do you think the NHS is in a better state today than it was a decade ago? Write to Your Letters, Evening Star, 30 Lower Brook Street, Ipswich, IP4 1AN, or e-mail eveningstarletters@eveningstar.co.uk

It was in 1998 NHS Direct service began as a trial service. The nurse-staffed 24-hour health helpline was extended in 2000 and had 5.5million users by 2001. It was conceived as a first stop for advice for all cases which are not emergencies.

ORTHAPAEDIC matron Jan Wright can tell you all about the last ten years at Ipswich Hospital - in fact, she can tell you about the last 30 years.

Mrs Wright trained as a nurse at the Heath Road hospital in 1976 and has worked there since.

She said the main differences between her work now and back in 1997 are patients' attitudes and the emphasis on infection control and finance.

She said: “People are now more aware of what they can expect from the NHS and behave more like customers.

“It's not a bad thing as years ago people gave themselves over and did what they were told without question, now people ask questions, as they would in any other part of life.

“Infection control is now a constant concern for everyone and the financial restrictions play a far higher profile role.

“The finance side of things can be frustrating and I'd like the whole process of patient care to be more seamless.

“Of course we have always been aware of finances, but ten years ago it was all about expenditure, now it's about balancing income with expenditure.”

Mrs Wright, of Bishop's Hill, Ipswich, became an orthopaedic nurse specialist when her children grew up, and she was one of the team who started the service at the hospital in the mid 1990s.

She then became a senior nurse in orthopaedics and spent three years as a service manager. In the restructuring last year, she went back into a nursing role as a matron.

She said: “The pace of work has increased. We have made great in roads, particularly in orthopaedics, in getting waiting lists down. But while that's a very good thing, it means people have to work much faster.

“We also work with patients with higher complexities now. Ten years ago there were lots of convalescing patients but now they are discharged in a more timely way, with community services carrying on the care.”

IT is just under a decade ago The Evening Star launched its Ambulance Watch campaign.

In the mid 1990s public faith in the service was at its lowest ebb but the trust has transformed and in the last assessment by the Healthcare Commission, was rated as “good” on quality of services.

In 1995/96 there were 79,046 999 calls to the service and ten years later there were 179,959 - as patients' attitudes changed and they became prepared to call 999 for more minor injuries.

That's not to say there is not still public criticism of the service.

In August 2005, Ipswich man David Halley-Frame, an asthmatic, died after waiting more than half an hour for an ambulance to reach him in the town centre.

And on Friday the Star revealed how Karen Haynes feared her son Ricardo Wells was going to die in Ipswich when police were forced to take him to hospital. An ambulance did not reach him in time after he severed an artery in his arm.

WHEN Aneurin Bevan founded the NHS in 1948, he envisaged a service offering free care and treatment for everyone.

Many things have changed since then, but the debate over whether the NHS can remain free at the point of delivery rages on.

Trade unions may argue that Tony Blair's direction of travel for the NHS is eroding many of its founding principles. But Mr Blair would point to huge progress in the NHS in the last decade and, despite criticism, there have been some undeniable benefits for patients.

A tour of Mr Blair's NHS legacy must acknowledge the fact that waiting times have been cut dramatically under Labour.

When the party came to power in 1997, some patients waited months on end for an appointment, let alone actual treatment.

Now, waiting times have come down dramatically and, if Labour's ambitious targets for the end of 2008 can be met, they will highlight a true success.

By then, no patient is expected to wait more than 18 weeks from referral to the start of treatment, whether they are an in-patient or an out-patient.

The total waiting list has also fallen by a quarter in the last six years - a reduction of 260,000 people.

Other markers of success can be found in the fall in death rates from serious diseases like heart disease and cancer.

Between 1996 and 2004, there was a 16per cent drop in cancer deaths and the government is on track to meet its 2010 target for heart disease early.

Data is expected to show that the aim of ensuring 40pc of coronary heart disease sufferers do not die prematurely was actually met in 2005/06.

However, many NHS workers considering Blair's legacy will find it hard not to point out the negatives.

Despite record levels of investment (by 2008, funding of the NHS will have tripled since Labour came to power), many have been left questioning whether the money has been well spent.

Millions of pounds have gone on hiring management consultants and “turnaround teams”' for failing trusts, with £22m spent on such teams in the last year or so alone.

Then there's the miscalculation over salaries which has led to a pay bill more than £600m higher than expected.

The impact of deficits across the NHS has also hit the workforce hard - with the Royal College of Nursing (RCN) pointing to more than 22,300 NHS posts lost in the past 18 months.

Mr Blair himself has rejected this claim, saying just 303 clinical posts have gone.