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Date(s) - 19.10.2013


Swiss Cottage library


 Socialist Health Association/Camden Co-operative Party Walkabout and Discussion

A discussion about  the idea of creating in Camden a modern version of the ‘Peckham Project’, a ground-breaking project providing an integrated approach to public health by focussing on the prevention of illness through the early identification of causes and symptoms rather than concentrating exclusively on treatment, this being achieved by the provision of community activities and facilities all in the same location. The Project proved to be a major factor in improving the health and thus the lives of the surrounding population in Peckham and so we have given some thought to how its principles could be adapted to the Camden environment and have had contact with the Socialist Health Association about this.
   As a result we have organised a walkabout and informal discussion with the SHA at the Swiss Cottage site at 12 noon on Saturday, 19th October. We have chosen Swiss Cottage because it contains a wide range of community activities: apart from medical centre, there is a community centre, a leisure centre, library, theatre -all with cafe facilities –  the Mora Burnett elderly persons residential home and the Winchester Project children’s and young persons facility.
   There are other possible locations for a ‘Peckham’-style project in Camden – in Kings Cross and Somers Town – but Swiss Cottage is we think an appropriate background against which to assess the potential for such an updated innovation. All members are therefore invited to participate.
                                                     ` Health before Illness ’

The present NHS emerged out of a society in which only ill people sought a doctor.  This way of working, seeing people as sick persons, entered the NHS at its foundation in 1948 and is the mode of approach which still dominates today’s medical culture and practice.

The treatment of Illness presently costs the UK £108.9billion, or 9.6% of GDP.  If we are to maintain improvement in health and a steady increase in life expectancy of our growing population,  achieved, as we must note, as a consequence of having formed  in 1948 a NHS with a remit to serve all of the population with costs paid for from general taxation. However, as people accumulate illnesses with ageing, and with growth of the aforementioned numbers of aged people, the funding of the NHS will rise to an estimated 12.6% of GDP by 2020 and require an extra £30bn of funding.

To deal with this budgetary problem, it is suggested we begin to move the NHS from its almost total concern with sickness, to one with health as an equal partner: for if people are healthier it follows they require less ‘illness’ treatment and cost- besides contributing more to a GDP and  being fitter  persons.

To bring into use a change which deals with overconcentration on `Illness’, we have to introduce `Health’ as a new speciality within the NHS.

Presently, a GP is the primary first visit of a patient with a problem for a practice to examine  probably  also from a family in a neighbourhood practice. Examining GP’s bring into action a memory bank of histories culled from experiences gained from attending to this individual /family and the many thousands of patients examined over the years. Hence, it is ILLNESS which predominates in thought and consequent action from the GP.  More than likely a particular illness drove a patient to the GP in the first place but and, however, a GP will by induction examine that `part’ of the person which is the source of complaint.   From this process of particularity rather than as a whole person, the GP prescribes the treatment to cure the complaint. If doubt remains, the patient is referred to hospital for its specialists to decide on further treatment, or not-given the paucity of diagnostic facilities carried by present-day GP’s.

Because there is no regular examination of all patients on a GP’s panel, a patient can attend the GP when in distress which often may require a hospital consultation where it is found the problem is too late for remedial action to be successful-though hard work at very high costs is attempted to put right what could have been successful if done earlier. The patient’s usual excuse is on the grounds of not wanting to either worry the family, or bother a busy doctor.

If however the NHS can put in place a solution to ‘late’ arrivals for hospital treatment by having  a primary system preceding  the present GP’s, then the case load of hospitals would be reduced and freed up for earlier treatment of waiting list cases.

A Health Practitioner (HP) system is suggested which could be introduced as a pre-examination factor in a patient’s treatment process, and which is prior to that of visiting a GP-as is presently the case.

The HP’s approach is to have families (where possible) as members of a practice, and via regular check-ups and discourse with the individual and family-either in joint-session or individual meetings, encourage the family to help each other to remain healthy. Thus, a HP sees people as` healthy’ , as a whole person, who deduces by alert observation and discourse with patient and family, any deviation from wellness which  warrant referral to a GP.

And, whereas an enhanced GP surgery is a diagnostic and treatment centre for an illness, a HP practice is a Family Wellness centre for health maintenance.

In the above pattern of having a HP service and a GP service and placing the HP as primary with the GP as secondary. A Health before Illness HbI service is introduced into the NHS which will reduce budgetary costs: provide healthier people; of greater service to their community- also to the economy of England.

THE Peckham Pioneer Health Centre.

New as the above may seem, it is not so to those concerned with preventative medicine and have kept themselves informed of the above Centre and its success in reducing visits to GP’s and population health-betterment during the years from 1935-39 when its full programme could be introduced along with its designed and purpose built Centre- opened in 1935, after several years  piloting the project and campaigning for its introduction in the Peckham neighbourhood of  London. See description of Peckham by Lesley Hall, Senior Assistant Archivist in the Wellcome Trust Library. Appx. A

Swiss Cottage Civic-Cultural Centre, Camden.

In 1998 the Council of the above Borough began to develop on its Swiss Cottage location, a set of projects which though spread around the site as individual enterprises, have now completed   collectively the facilities of Peckham: swimming pool, library, community centre, gym, outdoor pitches and public open space, theatre as well as a GP surgery. Appx B

Therefore, is it not possible to attempt to carry forward the vision and recognised value of the Pioneer Health Centre, by having a successor scheme following on at Swiss Cottage?

Using the Health & Wellbeing Board of Camden Council, arising from new powers and arrangements vis a vis the Clinical Commissioning Group of the NHS. An approach to The Wellcome Trust could be made for it to be the lead organisation in a follow-on project of the Peckham Centre at Swiss Cottage. Appx. C

Kings Cross Leisure & Community Facility.

Opening in the summer of 2014 is an integral facility containing almost the same elements as Swiss Cottage: two swimming pools, library, gym, spa and customer service centre. Brought into the Welcome-Peckham project at Swiss Cottage. It could provide an HbI facility for families in that area to share in its Health & Wellness programme. Appx. D

St Pancras & Somers Town Ward.

Prof. Anthony Kessel headed a research team for Camden’s Primary Care Trust which identified St Pancras & Somers Town as  “ the most deprived ward in Camden and one of the most deprived in London-35% higher than national average” CNJ 3/1/2008. Such a damning report should have brought into being a special unit from amongst the gathering of London University, University College Hospital, Medical Research Council and Wellcome Trust, all with substantial presence within ten-minutes walking distance from Somers Town & St Pancras. Not so. Not a whimper let alone a roar at having this ‘35%’ problem on its door-step. Hence, we may legitimately put this `blindness’ into our project as a must do test-context for verifying Swiss Cottage and its value in reducing this serious problem in health-and perhaps as a HbI template for similar problems elsewhere in the UK.

Favourable to this aim is Camden Council’s immanent intention to rebuild the Edith Neville Primary School & Children’s Centre-Somers Town.

As part of this rebuild, can we not have a Wellcome/Pimlico Family Health Centre as an element of its renewal. Providing a meaningful-if not to say crucial learning dimension to this essentially family project?.  Appx.E

Forethought or fortuitously as it may be, Camden, London, has the opportunity before it to help bring into being a new arm of the NHS which will prove as beneficial as any other taken in the aim to provide ` Freedom from Fear’ in health matters as propounded by its founder, Aneurin Bevan.

I hope we can take it as I believe he would have done had matters been more favourable to his overall mission than that allowed to a nation suffering all the difficulties of an emergence from WWII.

Alan Spence Chairman, Camden-London Branch. The Co-operative Party.  15/7/2013






One Comment

  1. I am inviting Janet Guthrie, Labour member of our local CCG.

    Ruth Appleton.

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