I will describe the manufactured changes in the service, note fragments of the chaos, the public mind and how we might turn the tide. There will be plenty of time for questions and for contributions from you. You know that OUR NHS is in the ICU and that many want it dead.

My background helps

Qualified 1964 St Mary's. Came to the old RD&E, just down Southernhay, in 1969. After 11 years of training I became a Consultant Orthopaedic and Trauma Surgeon at Torbay and the very good Princess Elizabeth Orthopaedic Hospital which the politicians bulldozed.

I have seen frequent and mostly harmful convulsions in the service arising from political dogma. Remind me to speak of a solution I have seen for 20 years. I have almost always spoken up; sadly that sets me apart from a large majority of doctors.

1988 was a good example. That most vicious leaderene was pushing for the 'Internal Market', a hospital dog eats hospital dog. Professor Enthoven, formerly of the Rand Corporation, had been flown over. I briefed myself and could see harm in at least 3 directions, but especially the cost of a swollen bureaucracy. All Torbay consultants turned up for a presentation by the unpleasant Regional General Manager, Ms Kathreen Hawkins. I stood and said – 'with the cost of administration now being 5%, is it not likely that it will double with these plans?'. '7% at the most'. I stood again and was told to SIT DOWN' by the surgeon chairman. That still hurts. No support from my fellows. The Internal Market, which was opposed by the BMA and colleges was rammed through. £1.3+ billion of administration costs were added to a budget of £30 billion – 5% to at least 10% in the first year. I was alone amongst the consultant staff at Torbay in fighting it. That set the pattern – of being alone in this most vital of things.

Read more: Address to Exeter Socialist Workers' Party: and NHS in Crisis – Fix it Now

A letter to Admiral Sir Richard Ibbotson, dated April 13th 2017

Admiral Sir Richard Ibbotson KBE, CB, DSC, DLChairman of the Board of the Torbay and South Devon NHS Trust

Dear Sir Richard,

I write to you in your position as Commander of HMS Torbay! I assume you have ultimate responsibility for the actions, both good and bad, that take place under you. Thus I bring to you a very disturbing facet of the new plan for 'care at home'.

I am confident in writing to you because I was trained very well in all specialisms at St Mary's Hospital, qualifying in 1964. I then spent 11 years training in surgery, the last 5 being in orthopaedic and trauma surgery. I was appointed to serve in this role at Torbay in 1975. Although my 77th birthday is tomorrow, I have continued to take the closest interest in our medical services and in my fellow man, both here and in the world.

My central concern (among many) is contained in the annexe below - “prevention of hospital admissions”. This duty, as stated, is unethical. Furthermore, it places a burden on a person who has not been asked to provide evidence of any relevant qualification. Any conscientious GP would always consider whether admission to hospital was necessary and many would have the great benefit of observing/treating some patients in the local Community Hospital. So the only words which have an ethical basis is 'the Assistant Practitioner/Intermediate Practitioner will bring any concern about the patient to the GP.' He or she will consider the need for hospitalisation. (The title of this 'practitioner' is nebulous and should be clearly defined.)

Read more: An example of the low standards of ethical principle and thought in OUR 'NHS'

Dear Nick and colleagues,

Now in my 76th year and unable to stand by whilst people suffer - as you know. In the attached letter, there are two links to important broadcasts. The second attachment is written by Dr Sarah Wollaston MP. We need quietness, thought and logic in our sacred calling, not thoughtless upheaval. Sacred in a philosophical sense.

For truth and with best wishes

Attachement One.

Attachement Two.

Formal titles -“INTO THE FUTURE Re-shaping community based health services”

'Driving quality, delivering value, improving services'

In fact – closing four Community Hospitals (CHs), including Ashburton/Buckfastleigh and substituting 'Care at Home'

The consultation extended from 1st of September 2016 to 23rd of November

21 December 2016

PREAMBLE

This briefing paper has been written in the event of the committee of the League of Friends of the Ashburton and Buckfastleigh Community Hospital (A&BL LoF) deciding that an application should be sought for a Judicial Review about elements of the consultation conducted by the South Devon and Torbay Clinical Commissioning Group (SD&T CCG)

I made detailed responses to the 'consultation' 21st November but 'interacted' with the CCG many times before. The document provides useful context and contains two, or possibly three elements which a barrister might consider justiciable. (1)

The SD&T CCG, like all others, was set up by the Health and Social Care Act of 1st April 2012. It was charged with commissioning medical services and, presumably, in pursuing efficiency, economy and safety in those services. The South Devon Care Trust, which had direct reponsibility for the Community Hospitals, launched the first consultation on the proposal to close CHs and substitute 'care at home' in the autumn of 2012. That ran into the sand. SD&T CCG has been consulting (wearing down) about these proposals throughout 2014 – 2016, with the formal period as noted above.

A large amount of material has been dispersed but traditional notices like posters have seldom been used. A large majority of the population does not know what the 'CCG' stands for or does. They would not be helped if they read, say, the Formal Governing Body meeting of April 2016 and its 263 pages.

Read more: INTO THE FUTURE: Re-shaping community based health services

The Clinical Commissioning Group (GPs who 'buy/commission services from the providers eg Torbay Hospital) have been directed by NHS England to close Community Hospitals.  In turn, more patients will be looked after in the home, about which there is a good deal of scepticism.  The pressure to get those listening members of the public to agree has been overbearing. 

There is no doubt, as this document says - 'Close the CHs - cripple the DGH.' Download the Document Here

Download the document attachements:

Attachment 2.

Attachment 3.

Attachment 4.

Attachment 5.

Attachment 6.

Attachment 7.

Head of Communications and Strategic Engagement SD&T CCG

Dear Mr Chalmers,

My letter to you is No 1, with attachments as listed.  

1.  Letter to Mr Ray Chalmers  Head of Communications and Strategic Engagement SD&T CCG (View as PDF)
2.  Stakeholder briefing  Aug 16 from SD&T CCG (View as PDF)
3.  Letter to Dr Diamond NDDH from 8 retired GPs and 3 retired surgeons.  NOT answered (View as PDF)
4.  Analysis of causes for 'delayed transfers' at NDDH in response to an FOI from me.  Very instructive. (View as PDF)
5.  FOI.  What consultation has taken place with all staff.   'The CCG has not yet started the formal consultation process on the future of community services. (View as PDF)
6.  Letter from me to the Public Affairs Committee.  It was taking evidence on 'delayed transfers' for the NAO.  There is additional information in that letter. (View as PDF)

I make no apologies for the length of my letter and the attachments.  We have been asked to consider complex and very important matters without all the facts.

for truth, justice and reason

David Halpin