Health

The Beatles’ concert at Litherland Town Hall is legendary: it was here 46 years ago that “Beatlemania” began. Where once young schoolgirls screamed, doctors now tend to patients.The new Health Centre in the north of Liverpool is reminiscent of the title of a Beatles classic: “Come together.” General practitioners and specialists, pharmacists and physiotherapists all work under one roof. The medical centre, designed and operated by Bilfinger Berger, is a patient-friendly way of taking some of the pressure off the health care system.

Walking across the Litherland Town Hall parking lot on her way to a doctor’s appointment, a woman in her mid-sixties pauses to answer a quick question: does she remember the Beatles playing here? Her eyes twinkle with delight through her pink-framed glasses. “Of course I remember them appearing here!” That would be back in December 1960, when posters proclaiming “Direct from Germany,” appeared prior to the band’s gig here in Town Hall. “Lots of girls started screaming wildly.” The Beatles had just returned from Hamburg where they first made a name for themselves, and now the young people of Liverpool were converging on Litherland. “The Beatles’ cars were here in the parking lot. Several girls started writing love letters on the windows. With lipstick,” says the woman with a smile as we head off inside.

Today, there are no reminders left of those wild times in Litherland Town Hall. The building has become a modern medical practice with bright and friendly consulting rooms, a state-of-the-art X-ray department and small operating theaters. The reception is located in a lofty, oval room with Regency striped walls. Keys clatter as staff in dark blue uniforms enter data into computers, while waiting patients sit in a surrounding ring of chairs. “This was the concert hall,” whispers the woman, pointing to the domed ceiling high overhead. Then she turns around and points to a small waiting area with seats bolted to the floor: “That was the stage over there!”Where once the Beatles rocked, there now hang posters on how to give up smoking, the fight against head lice and the benefits of breastfeeding.

Better medical care in the suburbs
Since summer 2005, emergency medical services, general practitioners, heart specialists, dentists, diabetes experts, pharmacists and physiotherapists have been working together in Litherland Health Centre, all under one roof. The facility is known as a Primary Care Centre, a part of the reform of the British health service. “We aim to provide modern medical care where it is really needed,” says Centre spokesman Tim Seamons. Some of the poorest urban areas in England are to be found here in the north of Liverpool. Many of the patients are smokers; chronic diseases are rife, and the diet of the local population is generally poor.

Up to now, those seeking treatment had to travel long distances.Many services were available exclusively in hospitals, from routine examinations and X-rays to treatment for minor injuries. General practitioners’ facilities in the United Kingdom have, for decades, been substantially less well-equipped than their counterparts in many other countries. Only 40 percent of practices are purpose-built; 80 percent are considered too small. Many are housed in run-down apartments or former shops.

For some years, the National Health Service has been rolling out a large-scale reform program to bring the system more directly in line with patients’ needs.While investors were forthcoming to support hospital modernization, improvements in the provision of basic medical services failed to get off the ground. For this reason, in 2002, the British Government established the concept of LIFTs, Local Improvement Finance Trusts. “We bundle several projects together in order to find investors for medical buildings,” explains regional LIFT Director John Garett.We bring together facilities that were previously scattered: specialists in different fields, a pharmacist, a private 24-hour emergency service. And services that were once only available in hospitals can now be found in the suburbs, for instance routine checks for diabetics, treatment for chronic obstructive pulmonary disease and X-rays. “The project is financially interesting for companies that want to get involved in a publicprivate partnership because so many medical professions are together in one place,” says John Garett. “As a result, our health service benefits from investments despite its empty coffers.” Under the auspices of the LIFT initiative Bilfinger Berger has already implemented three health centres in the Liverpool area, with three more due to follow in the immediate future. For a period just short of 30 years, in return for a monthly fee, the company will ensure that the hardware is functioning, that the heating and lighting are in perfect working order, that the windows close properly, that the roof doesn’t leak—in short, that the building remains in top condition. At the end of this time, ownership of the centres reverts to the public sector.

“With the experience of the first three centres, we can now plan with even greater efficiency,” says Martin Pugh, Project Director for Bilfinger Berger BOT, the Group subsidiary that specializes in PPP projects. Standardized construction methods reduce costs, flexible partition wall designs allow the building to continuously evolve. “We can keep pace with the development in health services over decades,”Martin Pugh explains. Until a year or so ago, Doctor Nigel Taylor practiced in an old building: “My examining room was tiny, the other room was barely big enough for a daybed, and my assistant had to run back and forth through the waiting room to give me a hand.” Now the doctor is enjoying the space at the new Litherland Health Centre and is delighted at the extra service he can offer his patients: “I no longer have to send them to the hospital for an Xray, I just send them upstairs.”A pharmacy at the Health Centre also saves the patients from having to travel. And instead of treating 1,800 patients, Taylor now has 2,200 on his list.

More responsibility—more motivation
Paul Mackie is another satisfied man. The male nurse is examining an X-ray on his computer monitor, and zooms in on a small blotch. “Is that normal?” asks a female colleague, indicating the dark shadow on a foot bone. “Yes, it’s not an injury,” replies Mackie, who used to work in a hospital. In the course of reforming the health service, the role of nursing staff has been upgraded. “There were times in the past when I would gladly have done a bit more, especially when people were complaining about how long they had to wait,” says the nurse. But in those days he was not allowed to do what he now does as a matter of routine: he makes an initial diagnosis of patients who arrive without an appointment, analyzes X-rays and prescribes medication. Mackie now has more responsibility, but he is confident that he is up to the task. “The fact that so many professions are gathered together here at the Health Centre is a definite advantage,” he says. “If I want a tip from the pharmacist, I only have to cross the hall!”

Come together: the Beatles song resonates in all the stories that are told. Tim Seamons, spokesman for the Litherland Town Hall Health Centre, is quite clear on the subject: “The key to what we do is bringing things together.” For example, local groups can use rooms free of charge for their meetings.Volunteers organize courses on giving up smoking and on healthy living. The perspective is changing: “We want to spend less time treating sick people and more time promoting good health.”

(Text: Kirsten Wörnle, Photos : Rainer Kwiotek)
Kirsten Wörnle, 38, was an editor for the “Badische Zeitung.” As a freelancer, she has made medical journalism her specialty. Photos taken by Rainer Kwiotek, 45, appear in German magazines including “Spiegel” and “Focus” as well as in the “Financial Times Deutschland.”