A WEEK or so ago I read an article by Dr Bhatiani the chair of the Clinical Commissioning Group in the Bolton News. It recommended readers not to delay seeing their GP if they had a persistent cough.

I remembered it when a relative told me of his experience of ringing his GP for an appointment about a persistent cough. At 74 years of age and a life- long smoker, he was referred to the `lung nurse` at the GP practice. She diagnosed asthma and prescribed various inhalers which he used over several weeks.

Finally he was sent for an X-ray which was suspicious so he was sent for a scan and the GP diagnosed lung cancer and COPD. The GP said the scan showed that the cancer had not spread.

The diagnosis now having been made by the GP in Primary Care, he was referred to the consultant at the hospital who ordered a special scan, a PET , which would help her see whether the cancer had spread to glands. This was unexpected and upsetting, as my relative had been told that the cancer had not spread.

Why is this happening? In the Bolton Locality Plan, healthcare is being reorganised to save money: this year the cuts are £25 million, £20.8 million of them at the hospital. ( Bolton Aligned Health Savings and Efficiencies Plan: minutes of Bolton NHS Commissioning Group May 26, 2017.)

'Patients will only be referred to a secondary (hospital) care intervention once a diagnosis has been made' (para2.70-2.72 Wigan Locality Plan) .

'A new workforce (health associates/nurses) will be involved ..with face to face patient care. This will help relieve GPs of a proportion of their patient contacts' (P34 Bolton Locality Plan)

Why are we restricting access to GPs and hospitals, closing beds and downsizing hospitals and moving diagnosis to GPs? These changes are the result of a long-term love affair by politicians and doctors with the American Healthcare system where access to hospitals is strictly controlled because it is expensive, and patients see 'health associates' (lesser qualified and cheaper). Coming soon is another American idea, the 'Accountable Care Organisation' for all out-of hospital care: when appointed in Bolton it will, like the American version, have a capped budget so that healthcare will no longer be based on need but on what the budget will allow. In America it is associated with the denial of treatment.

In the USA they are bearing down on healthcare costs of 17% of GDP, whereas here we are using the same ideas to bear down on costs of 8.4% of GDP, almost 3% less than France Germany and Denmark.

What we are getting is a poorer healthcare system, one in which there is the possibility of inaccurate diagnosis, incorrect treatment, delay in X-ray and in involving consultants and increased distress and worry for patients. Perpetual austerity for the NHS. Clinicians and politicians in Greater Manchester have signed up to these cuts but we in Save Bolton NHS will not: we will campaign against the new healthcare system, because we want a better one, one properly funded and appropriate for the UK, the fifth wealthiest of nations. Join us at the hospital every Saturday at 11am to protest against cuts to the NHS.

Christine Howarth

Withins Lane

Bolton