The meeting of the Appeal Tribunal convened by the NHS Litigation Authority took place at the Langford Inn on 8th February. The job of the tribunal was to make an independent assessment of the ‘rurality’ of the designated area (the Parish of Churchill) and make a recommendation that would either support or dismiss the challenge to the original PCT designation. The only parties officially invited to participate were Tout’s Budgens (3), the PCT (2), the regional Pharmaceutical Society (1), the Avon Local Medical Committee (1) and the Chair of Churchill PC. I was admitted as a solitary observer and, at the end of the hearing, was allowed to make three points:

- why had only Churchill parish been chosen, given the much larger catchment area of the surgery? The Chair answered that this was the only area in which the ‘rural’ designation had been challenged

- given the importance of the issue to the 5,000 patients who had prescriptions dispensed by the practice, why had the meeting had not been more widely publicised and a greater number of local people invited to give their views on the issue of whether or not Churchill was a rural area? The Chair did not feel that this was a helpful question.

- that ‘rurality’ was not simply a matter of fields, trees, agricultural land or demographics but also subjective: did the area feel rural to the people who lived there? The point seemed to be accepted.

The Tribunal’s report will be submitted to the Litigation Authority committee, which will take a ‘fairly rapid’ decision. Given that the appeal goes in their favour, the PCT would hope to re-consider the dispensary move before the end of March - at which time a new body, the Clinical Commissioning Group (CCG), will replace the PCT. So, in anticipating a date for the dispensary move, nobody should hold their breath…

Many people living in the catchment area of the Wrington Vale Medical Practice will be uncomfortably aware that the practice dispensary at Churchill has not been able to move to the new surgery building in Pudding Pie Lane. The delay has caused varying degrees of annoyance and anxiety to patients who have their medication dispensed by the surgery. As the Practice itself says in a published statement, ‘we are very much aware of the frustration this is causing patients – it echoes the extreme frustration that the Doctors and practice team feel about this very difficult situation’.

This delay is emphatically no fault of the Practice, which started the due process required for moving its dispensary many months ago. However, the dispensary and the dispensing team are currently required to remain at the Churchill surgery because the Primary Care Trust (PCT) has not yet been able to consider the Practice's application to move the dispensary from Churchill to Pudding Pie Lane.

Neither is this delay the fault of the PCT, which cannot progress the project because a challenge to the practice application made to a body called the NHS Litigation Authority (NHSLA), based in Leeds. In a regulatory world that seems to consist of legislation and fantasy in equal proportions, the basis of the challenge is that the area around Churchill and Langford is ‘not rural in nature’.

An NHSLA delegation is visiting the area to judge for themselves whether or not this is the case, probably on 8th February at the Langford Inn (starting at 9 am)… Whatever the decision (rural or urban!) this will simply be the first phase in a complicated set of procedures centred on patient numbers and involving further designations around ‘controlled or non-controlled localities’ in the light of legislative requirements.

In the meantime, it is less widely known that the original challenge to the practice application was lodged by Tout Ltd, the owners of Budgens at Langford. The reason for the challenge is apparently to allow the supermarket to open a dispensary at the Langford site. But why challenge the application now rather than wait until the doctor’s dispensary had completed its move ?

There can be no objection to an application to open a supermarket dispensary in due course, once the new practice dispensary is established, but the timing of the challenge suggests a deliberate attempt to prevent or limit the surgery’s dispensing service. If Tout Ltd were to withdraw its present challenge there is a chance that the PCT could take a fairly rapid decision on the rural / urban question, although the lid seems to have been opened on a Pandora’s Box of pharmaceutical regulations.

The Budgens website claims that ‘Tout’s Budgens has been a part of the local community for years. Our focus is to provide the local community with value for money, good quality produce…’

Tout Ltd had no one available to comment at the time of writing but the supermarket group might reflect on whether the inconvenience and anxiety caused by the challenge is necessarily the best way to conduct community relations.

John Adams

From: Laura Hillman, 17 November 2011

Hi I have written to the website a few times, most of you know I suffer from mental health distress, on one of my letters i said i had been sent to horrid place miles away from an wasnt pleasant to be there at all as didnt meet there criteria the people were violent agressive had drink an drugs problems or been in prison as they were deemed to ill to their sentence in prison related to there severe illness, I dont fit into those criteria as i dont drink alchol im tee total, never touched illiecit an never smoked drugs an neither am i viloent

The staff at that hospital can be quite vile to you there. I just want see how many of you would feel if you [experienced things like this]:

     To.have your mobile phone taken away from you or restricted use an supervised calls no cameras allowed to see pictures of you loved ones;

    cant go out when you want to may have wait days or months to be able to go out then have 2 staff escorting you then you cant go where you liked go staff are leading.

     not being allowed to attend family an close friends funerals not allowed take aways.

    restricted times for tea an cofee only allowed 3 x a day

    no sweet treats unless its the weekend an then it is rationed an only allowed 2 have one bar of chocalate or packet of crisps. no puddings at meal times at all, meals are awful too.

    not allowed to have perfume or deodrants on your person

    for people that smoke they are restricted to fags breakfast, lunch, tea an night.

.    you have to be supervised ou in the ward garden if you dont smoke an sometimes dont get out for days or a week.

    no fizzy drinks are allowed on site,so if you fancy a coke a cola you wont get it unless its a special outing an disposed once back to the ward.

.   once people have leave to go out granted by the doctor you can go out on trips out its usualy to the shops or coffee shop, you dont get to got the cinema theatre, walks (although as I left things were improving on that front).

.    you were allowed tvs an radios but they could be removed out of punishement if you didnt obey commands.

.    you were dicted what you could an couldnt wear.

    you werent allowed to keep your money on you an staff would deter how much you could take out to spend quite often it would be no more than a fiver or usualy £2.00 for a drink.

.    you were allowed to cook once a week an heavly supervised cause of the risk of fights, attacks

I m not that much better now i left in 2009 we at the end of 2011 an i feel worse now then before i was sent there it affected me badly an have nightmares that i will end up back there, I was lucky to get out of there just through pure luc, oherwise i would still be there. but what ive got too remember is i did get out an many people are still there being treated in the same horid manor.

i have now lost my house for good it was held open for me for a long time, the landlord was very kind an undersanding over mental well being but he couldnt wait for the money to come in to help me pay for it, so that wonderful place i was supposed to be in has ginen me more grief.

I also feel vey sad how my father is now i find it very distessing from spending so long away from home against my wishes an see he is no longer my dad it breaks my heart.

I would like to ask the villagers how they would feel if they had all these restrictions placed on them, im thinking many of you wouldnt like it some of you may have already expeirenced it.

So another question im going to ask that some people wont like - is it realy too much trouble to travel ten minutes up the road to the new surgery, where you can possibly have more treatment done witout having to travel to weston or bristol an people make transport there. I dont like like travling to weston or bristol for treatment an would rather go 10 minutes at the road.

I still think it would be good for a day centre to be open for local villagers, for people suffering from mental distress. Nothing ever came about that an i still think the new surgery plans could possibly include this.

Also I would like to thank many of the villagers who have been tremendous support an not to much knowledge ever judged me:

Mrs Pauline Wathen, who wrote to me many times when i was away .. Rosemarie Hodges who bounces up to me with a massive hug when she sees me! Mrs Collins who has very kindly wrote a letter for me as well as the other teachers, Amors Stores, David an Fiona Jewel who i know no longer live in the village, Dr Portas has been fantastic support along with the receptionists, My neighbours Caroline Nee Brown, Hayley at the back of me, mike an pam house, an many other villagers have been extremly supportive.

Now im to go onto my close best friends all who onced lived in wrington an went o school there Janita Hadley Nee Snook, Michelle Orchard nee Frapell, Alison Langman nee thorn, An Kirsty Clements nee smith. I actualy met Kirsty at college when i was 16yrs old, Another name I would like to mention who has been very supportive an have had a rough time themselves I met her while doing Rainbows in Wrington about 15 yrs ago - we were both volunteers an have stayed friends ever since, and that is Kathryn Savage from Congresbury, also thanks to Sue Evans an the late Jenny Smythe.