Speaker Meeting, 6.15 for 6.30pm

When Swindon Rotarian Bill Fishlock reached the grand old age of 2 score and 10 he felt an overwhelming desire to do a career change.  Taking off his accountant’s hat (he was in the same firm as Niall Gurrey) he replaced it with the Chairman’s hat at the Prospect Hospice.  Then, in 2002, he switched again, this time to the local NHS board: the Swindon Primary Care Trust (PCT).  In those days the PCT board consisted entirely of non-medical people and was running a deficit of some £10 million.  

Eight years later the wind of change was blowing again but this time it was not of Bill’s making.  On becoming PM in 2010 David Cameron appointed Andrew Lansley as the Health Secretary in the Con/LibDem coalition government.  A tempestuous two years of proposed health reforms followed thanks to the controversial Health and Social Care Act being steered through Parliament by Lansley.  PCT’s were replaced by Clinical Commissioning Groups (CCG’s) with clinicians on board and in a majority.  And that’s where Bill is today, having suffered eight major changes to the NHS in little more than a similar number of years.

The Department of Health & Social Security funds NHS England ( a ”controller”) which in turn funds all the CCG’s (also “controllers”) and they distribute the funds to the “providers”.  In the current year the Swindon CCG has an annual budget of £300 million.  An accountant at heart, Bill had some more eye-watering figures for us to ponder.

• The annual NHS budget in 1948 - £437 million (equivalent to £15 billion today).
• The annual NHS budget today - £124 billion (only the cost of Pensions exceeds it - £160 billion).
• The NHS is the 3rd or 4th largest employer in the world.

The Swindon CCG pays -

• The Great Western Hospital - £120 million.
• The hospitals in Bristol and Oxford that are “acute providers” for Swindon People - £25 million.
• The 26 GP practices in the Swindon and Shrivenham areas - £27.5 million.
• All the pharmacies that serve Swindon’s population.  
• The Ambulance Services - £9 million.
• The Prospect Hospice - £1.2 million.
• The Integrated Care System for patients with multiple problems - £19.5 million.  
  


• The Swindon area has 26 vacancies for GP’s.
• Swindon’s GWH annual budget - £340 million
• It is currently running a deficit of  £7 million
• Its Chief Executive’s salary - £172,500
• Its non-executive Chairman’s pay - £42,500
• Number of employees - 4,000

Bill admitted he was “staggered” and in awe of how hard people in the NHS work.  Meetings are often held at 1pm – they don’t do lunch!  Briefly looking forward he said the aim is to avoid admitting people to hospital whenever possible because hospital stays are so expensive.  That’s where the Integrated Care System will come in; also an increasing use of technology.

In 1966 Bill Fishlock was one of the movers and shakers in Swindon Rotary Club responsible for getting the “Rotary Club of North Wiltshire” up and running so it was fitting that the member thanking him for his talk was one of our Club’s Founder Members, Mike Bran (in the picture).