Letter to the Editor: There is no justification for moving both Lydney surgeries into an unsuitable old shop. Both are in good condition, well designed, and with plenty of space.
They were planned to house a full Primary Care Team. Such vital teams were largely axed by the Labour Party and by Primary Care Trusts (managers) in a cost-cutting exercise.
That has greatly diminished the enjoyment and attraction of general practice, leading to the current serious shortage of GPs.
Contrary to what has been claimed, both surgeries have excellent training rooms.
The reason for moving out of the present surgeries is for financial gain. Former partners in my practice negotiated a loan and then invested heavily out of their income to buy the Severnbank site, build and then equip the surgery.
No recompense was sought when leaving, as we all felt our investment was for the future benefit of the practice, and our patients.
We never envisaged that it might be sold off for someone else to profit.
The current partners at Severnbank did not consult patients or previous partners about the proposed move.
Having been both ill, and then deliberately gagged, I was unable to intervene sooner.
There was a public meeting about Lydney Health Centre, but not about Severnbank.
All but one of the regular doctors at Lydney Health Centre are now salaried employees of the Foundation Trust, and will have to go where told.
That practice was under threat after several retirements, but is now back up to five doctors.
All 76 Gloucestershire practices formed a limited company: G Doc.
The Health Centres were handed over to G Doc and then to the partnerships.
Already Lydney has lost its busy main post office from the old Co-op in the town centre to a small inconvenient replacement in a “Co-op food” shop on the outskirts.
For the elderly, disabled, and non-drivers it is disastrous.
The old Co-op was built on soft ground. The site was very extensively piled, and adding essential windows will be difficult because many piles run up through the cavity walls.
Coleford Health Centre was similarly handed over to partners. It is also an excellent building in a prime central site, and will be valuable real estate. Brunston surgery is also in central Coleford. Brunston and its branch surgery in Lydbrook will be owned by the doctors, and also valuable.
The new surgeries in Lydney and Coleford together will cost the NHS £10 million.
That will probably be “corporate” (private) money when the buildings will never be owned by the NHS or practices.
There will be a very long lease at extortionate rates, and money will be syphoned off from the NHS budget.
I doubt the chosen site for a new super-surgery in Coleford has much to do with convenience for Lydbrook patients. It is more likely to do with dispensing. Practices can dispense to patients living outside a radius of 1.6 kilometres from a pharmacy.
With a new out-of-town surgery fewer eligible patients will then travel into Coleford to a pharmacy.
Brunston would not want any of its Lydbrook patients, all eligible for dispensing, to switch to pharmacy dispensing if the new combined surgery was in the town centre.
Many practices now rely on dispensing profit, boosted by a dispensing fee for each prescription.
As a result, patients are not usually now given more than a one-month supply. Doctors cannot treat pharmacies any differently, so they also benefit, and currently survive in spite of “deregulation”.
Deregulation enabled supermarket giants to poach pharmacy profits and sell many medicines off-the-shelf where no professional advice is available.
If a new surgery is built where planned, more of the Coleford patients eligible for “practice dispensing” will then request it.
The community pharmacies will struggle and might close.
It is difficult to see any doctor quickly now. Pharmacies are readily available including Saturdays.
Effective 24-hour general practice, and a first-class 24-hour ambulance service are both vital for public confidence. We now have neither.
Out of hours GPs and ambulances have been contracted out. Last year I myself had to wait 14 hours for an “emergency” ambulance. Such contracting out is called “commissioning” where limited companies employ underpaid “agency” staff of all kinds for the NHS.
Those employees are treated poorly, not receiving benefits like NHS pensions, holiday pay, sickness pay etc.
Because of “commissioning” there is little incentive for the NHS or Review Bodies to pay genuine staff fairly. They are falling behind, and that is the root cause of most of the current NHS problems – staff shortages, strikes, horrific waiting lists, and yet more privatisation.
Unless “commissioning” ends it will ultimately kill off the NHS.
Lydney and Dilke Memorial Hospitals are well supported by local people and should stay as they are.
Their use could easily be extended again to relieve pressures on Gloucester Royal Hospital (GRH).
There is a good operating theatre, lift, and empty maternity ward upstairs in Lydney Hospital. It could easily be brought back into use for routine surgery. Lydney Hospital’s site will be valuable for development, Dilke not so much so, because it sits in protected forest, near to the crematorium. There is also a “toad migration track” through the site.
The minor injury units are vital, especially in Lydney. Both sites will be earmarked by developers.
Commissioning agencies are now moving into “corporate” funding and building development.
If Lydney Hospital shuts then it will add pressure to the struggling ambulance service, GRH Accident and Emergency, and GRH beds.
The journey to central Cinderford from the south is difficult, with many hazards on Forest roads. The A48 is much easier. This has not been properly thought through.
The new small Cinderford Hospital under construction could be adapted to replace Colliers Court, an old community mental health unit, now mainly offices.
Rooms could be provided for consultant supervised psychiatric assessments, training junior psychiatrists, group mental health sessions, and to replace the offices from Colliers Court, which could then be sold off.
Dilke Hospital is excellent and should be preserved. I have recently myself been a patient there. The nurses in both community hospitals are very good, but the medical staffing has been cut back severely since my day.
Good management could change so many things. I was a senior national medical politician through my posts with the BMA, and I was also a Forest member on Gloucestershire Local Medical Committee, representing all GPs in the county, since 1977, and chairman for 10 years.
I care deeply about the Forest. I was a town councillor in Lydney for eight years.
Lydney Hospital greatly increased the scope of my work, and was a major reason why I chose to come to Lydney. It matters to all local people.
Dr Peter Fellows, Lydney