Great Western Hospital – a new retail experience?

I recently attended the first meeting of the Board of the Great Western Foundation Trust hospital open to the public. I’ll be writing about the GWH and the NHS in more detail later, but here I’ll jut deal with one item which was discussed: “Retail Opportunities”. This exemplifies the new regime of the “health market” and independent Foundation Trusts, which force these organisation to operate more and more like commercial businesses, with their eye on ‘generating a surplus’ (a polite expression for profit).

A paper was presented to the Board under the title of “Outline of Retail Opportunities”. This was an update “on actions in hand to investigate opportunities to improve the retail facilities for patients, carers and families, staff and visitors.”


Apparently, many hospitals of a similar size to GWH “have expanded their retail offering in recent years by bringing in high street name retailers in to hospital sites, which has dramatically improved the offer to patients and their visitors, carers as well as staff.”


Note the word “offer” rather than service. It’s the new language of competing for patients.


What follows is not some sort of joke or tongue in cheek comment. This is what the paper actually says:


Improving the way that both patients and staff groups regard the Trust is reflected in the Trust’s Strategy for 2010-15, and the introduction of new retail facilities would contribute to delivering the two following strategic objectives:


  1. To improve patient and carer experience of every aspect of the service and care that we are delivering
  2. To ensure that staff are proud to work at GWH and would recommend the Trust as a place of work, or to receive treatment”.


OK, so you will probably be astonished too. I must confess that I struggle to understand how patient and carer experience will be improved by a new shop. Call me old fashioned but perhaps I am labouring under the misapprehension that patient and carers main focus when somebody is ill, is on the treatment they receive when they are in, or visiting the hospital. I doubt whether they could give a damn about the retail facilities.


As for the staff, can’t you just see it? Recommending that it’s a good place to work, or to receive treatment, because of the quality of the retail facilities!


This is a hospital. It strives to make people well, or manage their diseases. This is what the calling of staff is. It is what they are proud of. Regardless of your financial circumstances you get the same treatment.


It is difficult to imagine that anybody could write such a ludicrous and false rationalisation of the justification for the idea of ‘new retail facilities’. The real reason, of course, is that they are proposing to do it for the money. Wouldn’t it have been more honest to have said so instead of presenting the risible argument that it would tie in with “strategic objectives” which relate to the healthcare they provide?


Why are they proposing this? Because in the new “health market” Foundation Trusts are cut adrift from the NHS. They have to fight for their survival by trying to take work off of other providers. If they run out of money they can’t go to the Department of Health for some more. They have to stop carrying out some of their services, or sack some of their staff.


Perhaps the logic of the new system was ably expressed by one Governor, in a discussion about the hospital Academy, which currently makes a surplus. This gentleman said:


If we doubled the profit on the Academy it would have a big impact on our bottom line.”


Bottom line”, or profit. This is the language which by degrees is replacing the ethos of a public service. It’s an American expression, of course, which is very apt, since the previous government borrowed much from the private health system over there. And now the coalition government is carrying through the logic of the “health market” to its conclusion: a free for all in which the NHS would be nothing more than a logo.


One governor, Kevin Small, as reported in the Swindon Advertiser objected to the placing of such a “retail facility” slap bang at the front of the hospital.


I also have problems with the proposed location of the supermarket. “Currently the entrance says ‘Welcome to the Great Western’ but soon it will be ‘Welcome to Tesco, Sainsbury’s or whatever’ because the most prominent thing you will see when you come to the hospital will be the supermarket and not the entrance to the hospital. I don’t believe this is the appropriate location.”


Fair enough Kevin. But the the trust should not have to concern itself with “retail opportunities”. It should concentrate on providing healthcare for its patients. It should not be concerning itself with “retail opportunities””. Why it is acting like a business, I will explain in a future article, together with an examination of its “strategy”. Suffice it to say that the fact that the Trust is even discussing such an item is an indication of the degree to which the NHS, as a public service, has been undermined, and the ethos on which is was based is being abandoned.


Martin Wicks


1st November 2010


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