NEWS ANALYSIS: Hospital survival hangs on comms

As a new health minister moots a huge restructure of the NHS in London, unions and pressure groups are looking at how they can defend hospital services. Kate Magee analyses some tactics employed in the past.

On the march: local communities are in uproar over many hospital closures
On the march: local communities are in uproar over many hospital closures

When the strategic health authority for NHS London announced Sir Ara ­Darzi’s radical proposals for a reorga­nisation of healthcare services last week, it used a classic embargo strategy to ensure the controversial material was presented fairly.

The Evening Standard, BBC London and The Guardian were briefed in ­advance of the embargo while other media outlets, including the specialist trade press, were given the opp­ortunity to question Darzi on specifics at a briefing on the launch day.

NHS London was wise to be cautious about how they presented the report to the media. Healthcare is an incredibly emotive issue and the proposed reforms look set to be the political issue in London this autumn and beyond.

With all the major healthcare bodies keeping their eyes firmly focused on the development of such proposals, the Government should expect to be challenged every step of the way.

Currently, the British Medical Association, UNISON (Britain’s largest trade union), the Royal College of Nursing and the Royal College of Midwives are all analysing the report. And although most are cautiously positive, they are holding off judgement until more details are announced.

Finding allies
The pressure group’s main focus is ensuring their inv­olvement in the consultation process, as the spokeswomen for UNISON illustrates: ‘We are generally supportive of the report and a knee-jerk reaction is not appropriate at this time. Instead we will work closely with a range of people, including the Labour Party, the Mayor’s office and GPs, to ­influence the direction of the report’s progression.’

One body charging into battle, how­ever, is the London Health Emergency. The pressure group, which focuses on acute services, is worried that moving services from local hospitals to new poly­clinics or specialist hospitals may mean closures of hospital A&E departments and maternity units.

Head of campaigns Geoff Martin, who co-founded the organisation in 1983, said he and his staff are dissecting the report to put together a counter-arg­ument. This will be expressed through an ‘aggressive PR’ campaign, which will see the body using the same tactics they did to fight previous proposed changes to healthcare – the Tomlinson Report of 1992 and the Turnberg Report (1997). ‘We knew this was coming and we have succeeded before,’ said Martin.

‘We will be putting political pressure on MPs’, he adds. ‘If they have a majority of 5,000 in a constituency and suddenly they see 5,000 constituents campaigning, it will make them listen.’

This tactic has been successful in the past. Communities and Local Government Secretary Hazel Blears joined her constituents on the picket line in December 2006, when she was chair of the Labour Party, to protest at a decision to close the maternity unit at Hope Hospital in Salford.

Secretary of State Jacqui Smith campaigned against the loss of maternity services at the Alexandra Hospital in her Redditch constituency last year when she was chief whip.

‘There are a number of Labour MPs in London who won their seats against Tory policies of health cuts. They are signing their political death warrants if they go along with what we see as a cuts and closures policy,’ Martin warns.

Stunts play an important role in campaigns to save hospital services. Dac­orum Hospital Action Group, which is fighting the closure of hospital services in Hertfordshire, org­anised a ‘bed push’ last year, where a hospital bed was pushed from Hemel Hempstead to Watford to gain media coverage. Demonstrations are also a popular technique for marshalling support and providing photo opportunities. But the jury is out on their success – London Health Emergency org­anised a series of public events in the past year to save Epsom and St Helier Hospital’s maternity unit, but the board of the local NHS Trust voted last month to close it.

Inside out
Nevertheless, Martin stresses the ­mp­or­tance of harnessing support from local community groups which already have influence in the affected area, as well as getting local media on side. He will make sure the media is fully briefed and will be running targeted press campaigns on a local and national level.

Director of London Communications Agency Luke Blair, who handles PR for some NHS Primary Care Trusts, believes that because the issue is so emotive and can become very personal, messages can be oversimplified; ‘Issues can be terribly exaggerated with melodramatic claims that “people will die”, or misguided slogans such as “save our hospital”. These make it hard to communicate more complex messages such as the fact that care is being reallocated, not scrapped,’ says Blair.

‘The provision of healthcare touches deeply felt local opinions and has led previously to the door-stepping of CEOs and even children being bullied in the school playground because of what their parents believe.’

As the opposition groups rally their firepower, the Department of Health can at least take heart that Brown’s appointment of Darzi to conduct the review has scored plus points. As Blair notes: ‘The group that the NHS needs to get on side most is the clinicians.’

FIGHTING THE GOOD FIGHT
Save Chase Farm Hospital...
Started when the local hospital’s A&E department first came under threat in 1994. Restarted 18 months ago and two members have now been elected on to the local council. It is now a registered indepen­dent political party – ‘Save Chase Farm’.

Save the Royal Surrey...
The South East Coast Strategic Health Authority is considering options including the total or partial closure of the Royal Surrey County Hospital. The campaign to save the hospital kicked off last year with a mass rally. As well as a long list of MPs, the campaign is backed by UNISON, the RCN and the local Chamber of Commerce.

Save Whipps Cross Hospital...
The campaign to keep Whipps Cross Hospital open started at the end of last year. It calls for the £33m deficit at April 2007 to be written off and asks for new investment to be provided to fund the modernisation of the hospital buildings.

Save Hemel Hospital...
Dacorum Hospital Action Group was set up by Zena Bullmore in 1975 to save Hemel Hempstead Hospital. Activities have inclu­ded rallies and marches and keep­ing the pub­lic informed with leafleting and local press and radio. It has also coll­ected signatures for petitions to the Department of Health and Parliament via local MPs.

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