PANTA CHOREI IN CORNWALL

16 July 2008

Post offices

Forty nine of the 277 post offices in Cornwall have been listed for compulsory closure by Royal Mail. These are throughout Cornwall and in both rural and urban areas.

These forty nine are part of the national program to close 2500 of the current 14 000 branch post offices in Britain. The reasons for closure are fewer customers and pressure about competition and subsidies. Changes in the way we live mean that the post offices have lost many services: television licences are no longer sold in them, benefits and pensions are paid directly into bank accounts, car tax can be paid online. The government sees the financial losses and fewer customers – for which its own policies such as benefits payments are partly responsible – and its simple response is to cut back the service to try to stem the losses, a policy that might lead to even fewer customers and more and more closures. This simple response is what happened in the 1960s to branch railway lines.

People can tell Royal Mail what they think of the proposed closures: the consultation for Cornwall ends on September 1st.

Opposition to closures has to face economic realities. At present the post office in Britain makes a loss of £3.5 million a week. Does anyone think that can continue unabated? Can the present losses be borne? Can the losses be eradicated without closures? Can the number of users be increased significantly? Can the services available at the post office be increased? There is an important social question too: What will happen to those who cannot easily get to other post offices for their benefits and other cash, despite the Royal Mail’s assurances about the nearness of the alternative open post offices? Can the present services be provided conveniently and satisfactorily for present customers elsewhere as is done through Royal Mail’s “outreach” system? Indeed, is there a longterm future for discrete post offices at all?

An additional issue in branch closures is that many of the post offices are part of a shop: the loss of the post office part might mean the loss of its customers to the shop and the consequent closure of the shop.

Opposition has to come up with a coherent response and plan rather than plaintive wails, parochial complaints, and attempts at party political blame – and in the end closure.

You can read about the closures at the royalmail.com site here ; scroll down to Cornwall. The overall plan is given, along with some details of each branch listed for closure, including the local population and the weekly customer use which is challenging information.

Relocation of cancer surgery

At the same time as branch post offices closures in Cornwall are debated, the proposed move of some surgery from the RCHT hospital at Treliske, Truro to Derriford Hospital, Plymouth is under debate. The county council has called for further public consultation on the Cornwall primary care trust’s proposal to move surgery for upper gastrointestinal cancer (stomach and gullet cancer) to Derriford: treatment before and after surgery would continue at Treliske. The reason for the move is, in line with national guidelines, to improve outcomes for patients, that is to increase the survival chances of patients and reduce incidents of complications. In order to maintain their skills surgeons need sufficient patients to operate on and in the RCHT part of Cornwall only around twenty five patients a year have an operation to remove their tumour: note that only those twenty five would be affected by the proposed relocation. The arguments for the consolidation at Derriford are set out fully by Cornwall primary care trust here .

Although the move sounds reasonable on these grounds, Derriford is eighty miles from Penzance and that is a long, stressful – and expensive – journey for patients and their families: that is a reasonable caveat and objection and should be explored fully. We should hear from the patients who would be affected by the relocation.

The present reality is that nearly three in ten people in Cornwall – those in the eastern parts of the county – already look to Exeter or Plymouth for their hospital care. Health care should have no inappropriate county borders.

Change

Panta chorei said Heraclitus, according to Plato, but change is difficult for people, even change for the better and it is not certain to everyone in Cornwall that the post office and cancer surgery changes are for the better. There are no easy solutions to these two issues neither of which is about dismembering Cornwall. What is needed is neither sentimentalism nor parochialism but hard thinking about what is the best to help and serve people.

_______________________________________________________________

Panta chorei (everything changes, moves): Plato in his book Cratylus, referring to a saying of Heraclitus.

Advertisements