One of my early forays into blog writing was just over a year ago when I wrote about the need for a fit for purpose health centre, specifically a permanent one, and this remains the case, in my ward (St. Lukes, Southend). I was hopeful that long before now things would have moved on for the better given the overwhelming need for better primary health care services in the ward but sadly, despite trying to interest the right people and receiving all sorts of assurances, that is not the case. Yet again the glaring health inequalities that exist in this country have been overlooked by our decision makers. While we were given to understand a decision was imminent, yet again we were disappointed. Refer to that blog for the position then (as I saw it), what had happened previous to then and what I felt needed to happen next, along with my hope and commitment to support moves to bring about a permanent health centre and better primary care services for the residents that live in a part of town that is not otherwise well served in health matters.

The NHS is a huge subject and with the General Election only five weeks away there are signs this will be a major election issue as the various political parties seek to attract support. I have already argued in an earlier blog that the NHS is in crisis and have also registered my interest around one key aspect of health – mental health, and that too often the services that are needed do not exist e.g. in my homelessness and mental health posting. It is not my intention to side with any party in particular on the matter and this is because I have yet to be convinced by any. While there is the big issue of lack of resources along with a lack of funds due to the present austerity paradigm we are in, an even bigger one is a lack of good leadership evidenced by the fact that no action has been taken regarding the St. Lukes Health Centre. There is also the complex one that health is far more than making people medically better and given that peoples’ holistic needs, e.g. social care, is not being taken care of, this adds extra burden onto health services.

When I wrote my earlier blog regarding the St. Lukes health provision, I did so trying to be balanced and even handed yet still managing to upset some. As chair of the local residents association (see under Cluny Residents Association) I sensed those locals who had given the matter much thought favoured taking over a building that was once used as a care home, situated next door to the temporary portacabin that currently hosts the health centre, although an alternative solution was extending the St. Lukes Centre, linked to the local parish church of St. Lukes, to accommodate GP and associated services. As I later reflected and argued, what was/is needed was/is a business case considering the pros and cons of either solution, including the big issue of cost, and acting accordingly. Regrettably, this has not happened despite pressing the relevant authorities for such and little progress has been made since.

While the temporary portacabin based service is by most accounts a good one and very popular, it lacks the capacity to meet all the various demands and is severely overstretched and there is a long waiting list. Also, many of the additional services associated with a typical modern GP practice are not available because of the lack of space in the building. For some like myself, this is not a big issue and along with my family I can go elsewhere (and I do) but that is because I have transport. For many, including some of Southend’s most vulnerable residents, there are few alternatives. They are reliant on public transport that is not always available when needed.

The problem when arguing for a solution to a clear, dare I say it almost desperate, need, is the facts can easily become blurred and misapplied. Somehow all our high hopes disappear down a mysterious black hole only to materialize again when someone shouts loud enough or there is a development. This has been happening for over ten years and countless people have suffered as a result and not merely those who have felt they had been banging their head against a brick wall or in human terms fools and villains and a broken system. It is true the solution we have now is far better than the more dire GP surgery that earlier existed in Cluny Square, for example with the extended opening hours and better facilities, but falls far short of what is provided in other areas of the town where the catchment area health needs are arguably less.

Part of the clouding has arisen because there is a lack of understanding of what is involved (not helped when so many changes) and vision. But there are in my view a number of issues that often get mixed together in the pot when different considerations apply to each, which I will place in five sections based upon my rather simplistic assessment:

1. Doctors surgery (in much the same way as our parents and grand-parents would have recognised it)
2. Things that typically go on in modern GP practices e.g. nurse led services, various clinics, minor surgery, ECG, blood tests
3. Mental health services, typically psychotherapy and social interventions
4. Drop in service (linked to the doctors surgery)
5. Things to do with health promotion

I get the impression that different sections of the NHS are supposedly responsible for each of the above (and sometimes these fail to communicate) and in the last case not all these services fall under the NHS anyway despite evidence that these considerably help reduce later doctor interventions.

I see no logical reason why all these services have to be in the same building (although that might be nice). Already, the St. Lukes Centre is providing services to do with health promotion, nurse led and mental health, and that has been one of the bright spots regarding developments in the past year. The same applies regarding the St. Lukes hub situated in the Cluny parade of shops (here I declare an interest and will be blogging later on what goes on). A week ago I attended an open evening at the St. Lukes Centre and came away inspired and impressed. I agree with the chap who wrote about that occasion on his blog under the rightly provocative title: “Glimpsing the Kingdom of God”, and it should be added that most of what goes on serves / satisfies those of all faiths and none. Regarding the drop in service, it is nice that it is in St. Lukes ward. My dealings with vulnerable people leads me to believe such a service is needed as well as helping reduce hospital admissions. However, there is no reason this service has to be in St. Lukes and if there is to be just one such service in the town it should be situated in the town centre.

All of the above leads me to my conclusion … we need a centre (or more than one – ideally community led and talking to one another) and we need it now. Not to have one after all these years of trying is more than unsatisfactory. It is tempting to name names regarding contribution, positive or otherwise, in the drawn out convoluted saga that has led up to the present situation, but this is not the time or the place. What is important is that personalities and egos are set aside and those with an interest in these matters work together toward a solution that best serves the St. Lukes residents, especially those who are most vulnerable, and just maybe it requires doing something outlandishly crazy – after all and to date the best efforts of well meaning people with good ideas have not landed the prize!