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.
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.
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.’
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