Letter to Merton CCG regarding closure of Wilson

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13 February 2017

Wilsonhospital Siobhain has followed up her petition against the closure of the Wilson Hospital's GP Surgery and Walk-In centre with a letter to Merton CCG. 

You can sign her petition online here and download and print off a paper copy to get your friends and family to sign here! 


Dear Dr Murray,

Re: The future of the Wilson GP surgery and Walk-In Centre

Thank you for your letter of response. I completely oppose the closure of the Wilson Walk-In and GP surgery and the use of the funds released to develop a system where services to Mitcham & Morden will be reduced, and where residents will be forced to access emergency GP Services by calling NHS 111.

As you will be aware from our well-attended public meeting, residents completely oppose the closure of the Wilson’s GP and Walk-In Centre, where they can currently access health services twelve hours a day, seven days a week, 365 days a year – and they can do this by self-referral, allowing them accessible healthcare when they most need it.

Of course, I accept your apology for having misled residents about the planning application having been submitted. But now that you know that there was no such submission, and you are aware that the council would be extremely sympathetic to such an application, why is it that the CCG and NHS England cannot now work together to submit an application to continue these services at the Wilson?

Health inequalities

As I understand it, you now intend to close the Wilson’s services and spend the money released on two hubs, one in the ‘east’ of the borough and the other at the Nelson, that will be available between 6-8pm each evening, and on a Saturday morning - with the Mitcham Hub also being open on a Sunday. Once again, it seems that Mitcham & Morden is losing services in order to bolster services in Wimbledon.

Your reforms represent a reduction of service in my eyes – and that can only mean bad news for the residents of Mitcham & Morden. At our public meeting, you acknowledged that it was wrong for the local NHS service to have re-built the Nelson Health Centre rather than the Wilson. As such, all of the money was spent on an area with much lesser health needs than ‘East’ Merton (otherwise known as ‘Mitcham & Morden’) where the health inequalities are significantly greater.

In spite of that knowledge, you plan to further dilute access to GP and out-of-hours services in the areas that really need them most. Indeed, these services will now be diluted and spread across the borough, to areas with lesser health needs and demands.

Your plans represent a reduction in the quality of service to the people in my constituency. We are once again seeing important local health services taken away to give to those who already have the best health, the longest lives and the most money. And while I have no problem with more services for people in the west of the borough, I mind it very much when it is at the expense of my constituents, confirming an established pattern of spending by Merton CCG.

At what point does the area that is most genuinely in need get the health services that will reduce its health inequalities? Or is that no longer the ambition of our local health services?

Your letter states:

“As you can see from our proposals, rather than cuts, we are actually significantly increasing the investment in General Practice for the people of Merton and are prioritising east Merton for Sunday access.” But ‘East’ Merton already has Sunday access at the moment, via the Wilson Walk-In Centre – so, to be clear, you will not be providing anything additional to the residents of Mitcham & Morden.

I completely support the long-term redevelopment of the Wilson hospital site, but given the history of the local NHS regarding the redevelopment of the Nelson site and the closure of the Wilson GP surgery and Walk-In, sadly I have little confidence that Mitcham & Morden residents will be treated in a fair or even-handed way by the local NHS.

Provisions

Your letter states that the following will be provided:

“Two Primary Care Centres (“hubs”) open at least 6.30pm-8pm Monday to Friday, one in the east and one in the west of Merton, with both open 8am-8pm Sat, and one open on Sun 8am-8pm… …The scheme will provide more appointments in existing practices during the current Monday-Friday core hours (8am to 6.30pm) and also during ‘extended hours’ (6.30pm to 8pm) and Saturday mornings in some practices” I am concerned that your new plans will mean that all out-of-hours GP services will be available only by calling NHS 111. In all of the meetings I have ever had with Merton CCG’s officers, this fundamental shift in emergency out-of-hours services was never suggested.

However, the benefit of the current system is the fact that residents are able to turn up and have the confidence they will certainly be seen. Indeed, I think that the reason A&E usage is kept under control is because our residents are given the choice to access alternative out-of-hours services.

I would very much like to know how many staff there are working on these phone lines, and how well medically trained they are. How can you be sure that their service standards are acceptable, and how long is it reasonable to expect someone to have to wait for an answer to their call? Surely you must be concerned that if they do not receive an answer within a reasonable time, they will head to A&E?

Accessibility

The current service at the Wilson Hospital is easily accessible by both public transport and by car, with generous public parking, not replicated at either of the proposed hubs. These changes will make our health service far less accessible for some of our most dependent users, such as the elderly and families with young children.

In particular, Cricket Green Surgery’s parking provisions will not be enough to accommodate the increased need and pressure that will be placed on the surgery. In contrast to the Wilson, which has a generous car park, where people can drive right up to the front door, it is impossible to park at Cricket Green Surgery.

I would like to know, how many people have used the Wilson Walk-In Centre since February 2016 until now? How does this break down on a monthly, weekly and daily basis? And is there a specific pattern of need within the week, or during the day – in other words, what days and times are busiest?

Mitcham & Morden GP surgeries

As you will be aware, ‘east’ Merton currently has thirteen GP practices:

• The Rowans Surgery, Windermere Road

• Mitcham Medical Centre, Haslemere Avenue

• Cricket Green Medical Practice, Miles Road

• Ravensbury Park Medical Centre, Ravensbury Lane

• Bishopsford Road Surgery, Bishopsford Road

• Dr Ayub & Partners, High Street Colliers Wood

• Lavender Fields Surgery, Western Road

• Dr R Lall Mitcham Family Practice, Mortimer Road

• Figges Marsh Surgery, London Road

• Central Medical Centre, Central Road

• Tamworth House Medical Centre, Tamworth Lane

• Wide Way Medical Centre, Wide Way

• The Wilson, Cranmer Road

I understand that you intend to increase the number of all the appointments available at GP surgeries, and that they will now be open twelve hours a day, 8am-8pm, Monday to Friday, with some open on Saturday mornings.

As these changes are apparently meant to come into effect in less than eight weeks’ time, I would be grateful if you could inform me as to which of the above surgeries will be open on a Saturday morning? I am sure you will appreciate that this information will benefit those whose working lives mean that they are likely to need appointments on a Saturday.

I would also be grateful if you could let me know how many doctors and medical staff have been appointed to each medical practice in order to make these changes possible? I find this a particular concern, given the continued shortage of GPs in London, where half of the practices are short of a key member of staff, and nearly a third are missing at least on GP.

Could you also define exactly what you mean by the statement that GP surgeries ‘will be able to offer same day appointments to all those who need them’, and who it is that defines ‘need’?

Alternatives

I acknowledge the point that you have made regarding the fact that the Wilson Walk-In Centre does not have easy access to X-Ray and blood testing facilities. However, as you will recall, Mr Roger Norman raised these points at our public meeting, and explained readily available mobile facilities could be placed on the site to overcome this deficiency.

I see no reason why the GP and Walk-In services cannot continue to be provided on site, while the rest of the Wilson site is being re-developed as a state of the art health and well-being centre.

Future plans

The plans for the new centre specifically include a job centre and Citizens’ Advice Bureau, both of which are already provided in close access to the Wilson. Your plans will therefore either duplicate or replace what already exists in our area. Additionally, given the current circumstances with plans for a large number of closures of job centres in London and planned cuts to funding for advice services, it seems very unlikely to me that these services will be allowed to be duplicated.

While I fully support the provision of projects that increase aspiration and healthy living, the constant battle to find funds to keep similar services open leads me to question the prospects of obtaining funds to open new services on the Wilson site. As I said at our meeting, should you manage to do so, I will gladly buy you a drink.

Ongoing concerns

My two additional concerns relate to the absence of meaningful consultation and to GP registration.

Your letter talks of having two years of consultation and public engagement with the proposed changes. But as far as I am concerned, people can only meaningfully engage with a consultation when they understand absolutely what is being proposed and what the full range of consequences will be.

Therefore, I want to ask you, who exactly did you engage with, how frequently, and how did you frame these community conversations? Did you make it clear to residents that you were proposing to close the Wilson GP and Walk-In services? How do you know that residents understood the fact that the price of getting so-called ‘extended GP opening hours’ was going to be a huge reduction in other services they depend on?

Furthermore, of the approximately 5900 patients registered at the Wilson GP surgery, just 5300 are yet to register at an alternative GP practice. This is extremely concerning.

Residents continue to contact me with the difficulties they are experiencing in transferring. In particular, elderly residents are finding it hard to find surgeries that are conveniently accessible by public transport - and those in work are finding it impossible to register at surgeries that are open evenings or weekends.

It is obviously in the best interests of the residents of Mitcham & Morden to have direct access to seven-day a week, twelve-hours a day walk-in facility. Residents’ first priority is to keep easily accessible health services on the site.

I believe it to be the overwhelming view of my constituents that the Wilson GP surgery and Walk-In service should remain. I would therefore ask you to continue to keep it open.

With all best wishes,

Siobhain McDonagh MP


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