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At the heart of general practice since 1960

On the buses

This month, the controversial location of a planned super-surgery opens a can of transport worms for our long-suffering diarist

This month, the controversial location of a planned super-surgery opens a can of transport worms for our long-suffering diarist

The story so far

Dr Peter Weaving is a GP in north Cumbria and locality lead for Cumbria PCT.

As a former chair of a large PBC consortium he can see many sides of a PBC argument and regularly finds himself sandwiched between clinicians and managers. This month he is put in the unfamiliar position of having to get his head round bus routes and timetables...

‘The good doctor won't get the bus,' booms the honourable member of parliament for our fair city. ‘He doesn't understand the importance of bus routes; that people move house to be near a particular bus route, that they put their children on particular buses.'

We are all gathered in Barrow's town hall for the PCT's board meeting, which will approve – or not – the site of our planned supersurgery in Carlisle for 35,000 patients of six practices. The supersurgery will be our biggest provider of services with clinics for ophthalmology, musculoskeletal medicine, urea-breath testing and near-patient testing. The meeting is public and a small section is set aside for questions from the public – and now our local MP is asking questions.

He has a point. Yes, for some wards in the city, it will be harder to get to the new site by the current bus service. But from my angle, looking at the whole city, it's well covered by three proposed developments – one north of the river and one west, with the largest to the south-east being the supersurgery. For those patients who prefer and find it easier to travel to the city centre, two practices remain there.

The whole project seems to be swaying on this site's handiness, or otherwise, for the buses. The facts are that 55% of patients currently travel by car to their surgeries, cannot park and complain bitterly about that. Some 17% travel by bus and 22% walk.

The deputy chief executive of the PCT has now rolled up his sleeves and sat down with the bus company, a map and a timetable. Now, if 250,000 patient contacts occur in a year and 17% come by bus and the bus company needs to take £30 an hour to be viable, then how many routes can be diverted up the hill? I haven't mentioned our site's on a hill, have I?

‘That hill,' continues our MP, ‘the highest point in the city, is the old gallows hill where they hung the Jacobites. Now it's becoming Heart Attack Hill for the people of Carlisle.'

There's no snappy reply to that, I think miserably – no soundbite that encapsulates the guarantee that you're much less likely to suffer a heart attack if you walked up the hill than went up it in either a bus or a car. Personally I would rather see 100% of patients arriving on foot or by bike than on the bus, but I'm not going to hold my breath.

However we do have a bus service up the dreaded hill at the moment – which, to my surprise, provides 40 journeys a day. Surely that should be plenty.

‘Forty a day?' comes the parliamentary reply. ‘There's an alternative site a few hundred yards away that gets nearly 40 an hour!' I'd forgotten he is on the Commons public transport select committee…

Somewhat against the run of play, the site is approved by the board – subject to sorting out the buses. I am distracted from the timetables and route maps by a niggling heretical thought: Isn't public transport a bit like a health service – it should work for people, rather than the other way round?

On the buses

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