The group had its first session at Birdwood House on 28/10/06 with five people present.
These few people came up with some very clear positive ideas about the future for healthcare in Totnes, including the creation of a big community medical centre, treating the whole person, the importance of medicines being tailored to the person and their problem, and that the necessary boundaries between practitioner and patient should provide positive connections, not divides.

People have since stressed the importance of integrated health care. A well-woman clinic has been suggested as an important contribution to community health, and I’m certain well-man and well-youth clinics would be just as useful. Some people rely on conventional medicines to stay alive and share a deep concern as to how our daily supply of insulin, thyroxine and others will be guaranteed after peak oil. These are not the only groups at risk (anti-psychotic drugs are just as vital to those who depend on them for normal life). The continued supply of such drugs needs to be ensured, or truly suitable alternatives found.

The second meeting was on 28/02/07, with eight people present, and apologies from nine people who wanted to be involved but couldn't be there on that particular night.
We agreed that a Resource Directory, to include practitioners, centres, activities, educational assets, classes and other things that encourage health, is the best way of assessing existing healthcare assets in Totnes and the surrounding district. Carol W will begin collating information, starting with the skills of the group itself, and look at the potential for funding. We considered implications of Peak Oil and Government policy, which we will discuss further and explore of the possibility of funding to look at the implications of peak oil and Government policy of future healthcare.

We discussed the decreasing effectiveness of antibiotics due to over prescribing and the rapid evolution of resistance by bacteria, and the desirability of developing local plant-based medicines further to replace medicinal drugs lost because of pressures on development and transport drugs. Looking at what a localised, sustainable Totnes healthcare would offer and what that care would look like, we agreed on the importance of developing/increasing wellness, of health education, nutrition and positive thinking, and that integrating GP surgeries and complementary therapies was an important priority. We would like to meet with the GP surgeries, Totnes hospital, the Natural Health Centre and other complementary medical clinics.

To develop the vision of healthcare in Totnes in the 2020s, we need to explore and use new models of building health and sharing information on healing processes. An early step would be to identify people who would offer workshops/talks/ hands on healing activities and experiences. Education will be of great importance for sustainable health.
Future sessions will identify what services are particularly threatened, by both peak oil/climate change, and financial, demographic and other emerging problems. We want to collect and collate individual stories of health, illness and wellness. The group’s own stories will be a starting point for the collection.
We decided all future meetings would begin with movement, such as Chi Kung, and shared food.

The third meeting was on 29/03/07 with nine people present and apologies from five people who wanted to be involved but couldn't be there on that particular night.

We discussed the Resource directory and what it would include. Other NHS health resources to include in the Resource directory are the Mental Health Facilities (eg Cabot House) and those concerned with Geriatrics. There is apparently a Well Women Centre at Leatside surgery, where it is possible to make an appointment to talk about health.

We discussed getting local GPs, psychotherapists and other mainstream practitioners involved in planning for medicine beyond oil. Having talks at the medical Centres and attending GPs practice meetings were mooted, as was inviting GPs to give talks in our meetings about sustainable health, and the need to find out what topics would get GPs involved: maybe less oil more natural health? Local MP, Antony Steen could be interested in taking part in a TTT healthcare meeting. The Natural Health Centre hosts regular talks from Catherine House.

We discussed how to move to a culture of wellness, how to significantly decrease the queues at GP practices, by giving back the power of basic health to people. We also discussed mental Health and the community. The Community Herb Garden is already being used by people with mental health issues. The use of one or more allotments (when they are available) for therapeutic purposes was mooted. The Forest Garden could also be used for this and some organic farmers have already made land available for therapeutic gardens but to pursue this we need to create an organization first with a committee and then maybe ask for charitable status.

A subgroup for telling health and healing stories was formed.

The fourth meeting was on 26/04/07, with nine people present and apologies from three people who wanted to be involved but couldn’t be there on that particular night.
Much discussion on the format of future meetings was followed by members’ personal healing stories.

The fifth meeting was on 4/07/07, with six people present and apologies from five people who wanted to be involved but couldn’t be there on that particular night.

We discussed the group’s health projects, i.e.: the collection of stories about healing and illness to wellness journeys current NHS policies, initiatives and perspectives on sustainability for healthcare the Totnes and district healthcare resources list, to be published online and as hard copy, in a similar format to the TTT food group’s “A celebration of local food” booklet the healthcare and wellbeing vision for Totnes 2020, which is the first step towards creating a healthcare and wellbeing energy descent plan.

Any contributions to the debate on the 2020 vision for healthcare can be sent to Carol W to be posted on the website (follow the "2020 vision for healthcare in Totnes and district" link on the main healthcare page). A physical/real world TTT healthcare notice board will be put up in the new TTT office after it opens in September.

Devon Primary Care Trust and Devon County Council are conducting a strategic review carrying of health services and their future, and are asking for patient/public involvement in planning for the future. The website is given in the NHS section of the "Online info" link of the TTT main healthcare webpage.

Local NHS resources are being compiled for the Resource directory.

We don't know whether a patient’s group, to discuss and advise either of the Totnes GP practices on patient issues, exists. Carol W will ask at Leatside surgery. Some case histories from local herbalists could be released to the story collecting group, and the website for the Directory of patient experience (DIPEX) was recommended for those involved with healing stories. Their website address is also given in the NHS section of the "Online info" link of the TTT main healthcare webpage

The vision for the future of healthcare after peak oil, which is the starting point for the healthcare energy descent plan, was discussed. All felt that a far greater knowledge and awareness of herbs in nutrition and medicine will be needed and that positive health, sustaining and maintaining wellness will become much more important. Knowledge and use of natural resources and rural skills will also be important and must be maintained and communicated. Sustainability requires diversity: of plants, skills and many other things.

Obesity is already a big problem; one cure might be a ‘Green Corps’, where young people learn how to manage land. It was suggested we find opportunities to develop such a scheme, like the Duke of Edinburgh Award Scheme or the Woodcraft Folk. Working with schools is also important to ensure young people develop the soon-to-be-necessary skills but grants are needed to fund such projects.

It was said that there are schemes for gardens in schools everywhere in Germany, and the “Devon Promise”, that all schoolchildren will engage some outdoor pursuits during school hours, was mentioned, along with the work being done by the “Eco-Active” , “Edible Gardens in Schools”, “Community Supported Farming” and “Trees for Health”groups, who all engage with schools and schoolchildren.

A peasant-driven project on the Altiplano near La Paz in Bolivia, where knowledge of useful plants and animals and how to manage the land sustainably was being taught in schools, was discussed. This was not inherited knowledge from the native cultures, which had been lost, leaving the poor to start from a worse position, a “lower point” than we do.
It was also pointed out that if you remove consumerism, it must be replaced with something else.

The sixth meeting was on 17/03/08, with six people present.

We identified some problems:
Oil Vulnerability

• Transport - biggest single transport user
  • Patients
  • Staff
  • Supply
• Food
• Equipment
• Plastics
  • Consumables
  • Computers
• Hygiene and Sterility
• Medicines
• Energy - heat, light, medical equipment

Climate Change

• National - International perspective
  • the international issues may rapidly impact on our local issues
• Flooding
• Migration
• Heatwaves

and some solutions:
Paradigm Change

• A change in the whole paradigm of healthcare is needed / wanted
• We have to start from where we are - including the mainstream NHS
• This may be too big a task for us to deal with, but worth keeping in mind
• Expert & empowered patients
• Move from hospital to community
  • ie not specialist based
• Focus on Lifestyle - keep economics and ‘Pharma’ peripheral
• Education
• Self knowledge
• Skills and support network
• At the moment alternative/complementary struggle in competition with NHS
• Priorities changing
• Localisation
• Self-help
• Elders and storytelling of health and wellbeing
  • database of healthy ways of living
• Library

Integration of Complementary with Western

• Complementary therapies are expensive (compared to NHS)
• Increasing privatisation may actually level playing field
• Complementary therapies do give you time for your money
  • may be very important part of healthcare, which NHS can’t provide
• 3000 herbalists in Britain (according to Simon Mills)

Financing / Resourcing

• ‘Happy hours’ in Japan any health / caring activity you take on will earn you tradeable tokens which can be used for distant relatives, for example
  • enhances community - could also be tradeable for food, education
  • • e.g. Brazil, Chicago
• Local financing
  • Would it be possible to set up a local ‘privatised’ health or dental scheme
  • • paying with Totnes Pounds?
  • Would obviously depend on the practitioner - can we find one who would be keen on the idea?

First Steps
It’s important not to get ‘phased’ by the hugeness of the task and the institutions involved (NHS).

• Oil vulnerability audit of hospital or GP practice
  • possibly follow restaurant model
  • contact Fiona Ward
• Clinics - encourage consultants/experts to hold more local clinics so that patients don’t have to travel
• Outreach / Education
  • Healthy Towns initiative
• Complementary directory
  • Feedback
  • (responsibility of content / possible litigation?)
• Sustainable herbs (grown locally)
  • Start Dartington herb garden
• Joint ventures with Food group
• Health Impact assesment
  • use established tools to engage PCT and town council
• Open space health and wellbeing day
• A day in the life of GP in 2020?