[1 of 4] We Don't Deserve It - Rural Health Services in a cold economic climate [Jane Farmer]


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The future for rural health services is the topic for the first in the new series of free public lectures at UHI, the prospective University of the Highlands and Islands.

Professor Jane Farmer, UHI co-director of the Inverness-based Centre for Rural Health, is joined at the lectern next week by two of her researchers, Amy Nimegeer and Artur Steinerowski. The centre has carried out two years of concentrated research with rural communities in the region about their health services.

Amy has been working on a project looking at ways to involve communities in planning services, while Artur is looking at the role of social enterprises in community sustainability and working on the centre’s O4O (Older for Older) scheme. In collaboration with local people, the O4O team is devising initiatives to enable elderly people to live happily and healthily in remote and rural areas.

Professor Farmer said: "Our research has shown what rural communities want from health services and how that might be provided. We also speak about the changes required from managers, professions and community members themselves - and how everyone may have to think and act in much more radical ways to have services provided in the future."

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[1 of 4] We Don't Deserve It - Rural Health Services in a cold economic climate [Jane Farmer]

  1. 1. We don’t deserve it… rural health services in a cold economic climate…. Jane Farmer Amy Nimegeer Artur Steinerowski Centre for Rural Health www.abdn.ac.uk/crh
  2. 2. Rural communities & service change <ul><li>“ We have rights to health services just like everyone else…” </li></ul>Conflict – sometimes, not always…. “ Who needs to move most? Communities or NHS managers?” – as the man said Let’s take this discussion to a completely different place
  3. 3. 60 years of the NHS <ul><li>People live 10 years longer than 1948 </li></ul><ul><li>1948: 16,864 GPs, now 33,364 </li></ul><ul><li>1948: 480,000 hospital beds, now 167,000 </li></ul><ul><li>Women spent 14 days in hospital after giving birth, now 1.7 </li></ul><ul><li>1981 census – 11/1000 babies die before 1 yr, 1900 – 160/1000 </li></ul>22/5/08
  4. 4. <ul><li>After the gold rush. 10/12/09 </li></ul><ul><li>the ‘love-bombing’ of the NHS is over. </li></ul><ul><li>Spending on NHS + 6% a year & productivity </li></ul><ul><li> - 2.5% </li></ul><ul><li>Wanless report 2007 found 40% of extra NHS funding was consumed in pay rises (67% of NHS spending is on pay) </li></ul><ul><li>Since new GMS contract, GPs are working 7 hours less a week – on average </li></ul><ul><ul><li>Scotland’s NHS least productive in UK </li></ul></ul><ul><ul><li>Most doctors and nurses per capita </li></ul></ul><ul><li>Why doctors’ pay keeps on rising 21.02.10 </li></ul><ul><li>38% increase in GP income: 95% of practices have stopped OOH service </li></ul><ul><li>Increase in daytime 999 calls of 35% and OOH 42% </li></ul>sunday herald 2010 Nuffield Trust Funding & Performance report
  5. 5. <ul><li>For 40 years I looked after my patients round the clock - and I loved every minute. So why can't GPs do that today? </li></ul><ul><li>According to figures released this week in the Mail, NHS Primary Care Trusts have admitted that in some areas, such as Barnet and Enfield in North London, there is just one locum on duty at night for 650,000 people…. </li></ul><ul><li>Trendy to slag off docs, but what appropriate alternative for remote & rural? </li></ul>Mail Online 18 th Feb 2010
  6. 6. <ul><li>The wolf is at the door: The global economic crisis and the public sector </li></ul><ul><li>“ What will the public sector look like in future, after the economic crisis?” </li></ul><ul><li>more efficient (17 % respondents) </li></ul><ul><li>smaller (15 %), </li></ul><ul><li>organisations will have to account better for their spending (14 %). </li></ul>http://rd.kpmg.co.uk/WhatWeDo/15876.htm KPMG website
  7. 7. Rural Scotland in Focus 2010 <ul><li>“ compared to urban and accessible rural Scotland, Scotland’s remote rural population is older, with higher levels of retiree in-migration and youth out-migration” </li></ul><ul><li>Lesson across rural regions – more inaccessible places are ageing </li></ul><ul><li>“ Areas where the problem of house affordability are found in many rural areas …” </li></ul>Lack of Jobs Outmigration of young Leaves gap – In-migration of retirees Expensive housing unaffordable for families on low wages Ageing remote communities
  8. 8. How are services to deal with this…? <ul><li>SNP government policy </li></ul><ul><li>Labour/ Lib Dems… </li></ul>
  9. 9. Features of policy <ul><li>Community resilience? </li></ul><ul><li>Mutuality – co-design & co-produce </li></ul><ul><li>Self care </li></ul><ul><li>Greater citizen input </li></ul>
  10. 10. <ul><li>WE SOUGHT TO TEST THIS POLICY & </li></ul><ul><li>SEEK A (BETTER) WAY FORWARD…. </li></ul>