Monday, 17 December 2012

Walk, Cycle or Die: what should the NHS do?



Gven the Daily Mail
What about the NHS? What are they going to do without waiting for the Daily Mail to become "enlightened".

Freewheeler used to criticise the NHS in Waltham Forest for being car-sick. That's pretty common round the country.

  1. They implicitly encourage their staff to drive in, by providing infrastructure to enable this.
  2. They implicitly discourage their staff from driving in by providing shit cycling infrastructure.
The shit infrastructure goes further than the hospital site -the adding of an extra lane at the A38/A4174 Airbus roundabout is to cope with the extra traffic of the expanded Southmead hospital. The NHS now knows that driving is bad for the long term health of the patient, yet they aren't translating that into actions on the ground.

Anyone who has tried to park a bicycle at a Bristol/S Gloucs hospital will know they will have to trudge round looking for an obscure bike park which will be:  in an random corner of the site,uncovered, blatantly insecure and not even well signed.

Supermarkets with eight bike stands in front of their supermarket entrance alongside a 500+ car parking area have better bike parking facilities than most hospitals, as they have eight bike stands somewhere useful.

In Bristol, The BRI is pretty awful: one row of bike stands 6? in a well known theft zone. That's all. There's also a four storey staff car park round the corner and various other parking zones nearby. Not much visitor parking, but once all the staff parking is taken care of, there's little room.

Frenchay? It was pretty bad too. Apparently they were looking at a scheme whereby the amount staff paid to park was proportional to your salary: the more you earned, the more it cost. That's a nice idea. Frenchay also suffered from: no secure bike parking, minimal bus access. Regular patients knew the best tactic was to park in a nearby street and walk in. 

Southville -which is expanding as Frenchay gets shut down- will be test for Bristol and the North Fringe. Will it discourage driving by staff and patients, or will it encourage it.

The roundabout fiasco sounds like they aren't trying to discourage it, not matter what they say.

Yet a hospital staff should be the ideal place for the NHS and NICE to see if they could effect change in UK driver's habits

They NHS has an opportunity to change the reward scheme for transportation choices -in a way that it lacks for all other employers. 

It could
  1. Provide secure and convenient bike parking for staff, where secure means "your bike and its lights will be there when you get back", convenient: closer to your office/place of work than any car parking. Some electric charge points could be good tool
  2. Provide changing and shower facilities for staff. Yes, this is just icing on the cake, but it makes cycling more acceptable amongst colleagues -and if you live in Bristol, you will know about getting wet on the commute. You need somewhere to dry your wet things.
  3. Provide convenient and secure-ish parking for visitors. Here, covered, near the entrance parking with good lighting and CCTV coverage is what to hope for. You want every patient going to the hospital to see the extended bike park even closer to the entrance than the disabled parking bays for the heavy smokers.
  4. Provide safe cycle access to the hospital premises.
  5. Provide information and assistance on cycling to work. Loan electric bikes, adult 1:1 cycle training  which covers the route from  home to work -these can come after the infrastructure.
  6. Provide information to patients on cycling to the hospital. Today: little leaflets on parking and public transport. Nothing about cycling. An outline map of the approaches to the hospital, with details on how this connects to the rest of the city, could be good here.
  7. Provice disincentives to driving. For staff, salary-proportional parking fees. For patients, pay to park. There's complications there: not just the disabled patients, but the long-visit day patients on dialysis, chemotherapy, etc. You can't expect them to pay a lot, or cycle in. At the same time, you don't want the Scottish vote-seeking model "free hospital parking". 
The safe cycle access is critical. Staff will come on the same routes regularly, so you need non-leisure routes that aren't too indirect, slow or unsafe. The development of these access routes could be an integral part of hospital development. Not meaningless 'we have a cycle plan' pieces of paper, not 'some S106 cash for some shared pavement', but "make increasing the percentage of cycling staff and patients a short-term goal. Short term, because failures and success needs to be visible within a year, to stop you pretending that 'by 2020 15% will cycle', when nothing is happening towards that goal. 

How is southmead coming close to this. It isn't.
How will you make it easier to get to Southmead?
The Trust has agreed to pay £1.5 million for improvements to public transport and almost another £1 million for improvements to road junctions in Bristol and South Gloucestershire. Work is underway between the Trust and the local councils.  A Joint Officers Transport Group has been established to lead this work and this will include identifying how the Trust’s public transport investment should best be spent in order to enable as many people as possible to get to the hospital by bus. An accessibility study has been produced which helps to inform these discussions.  It will also finalise proposals for how the road infrastructure funding will be invested and ensure there is appropriate provision for those who may come to the site by bicycle or on foot.

See that?  £1 million for improvements to road junctions. And a footnote about appropriate provision for those who may come to the site by bicycle or on foot. As if that will be a special case that they mustn't forget about -not the way they expect most of their staff and many of their patients to come by.

The NHS -if they want to fix society, they should look in the mirror first.

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