EASTBOURNE MP, Stephen Lloyd, yesterday persuaded Parliament to hold an adjournment debate on the reconfiguration of the NHS in Sussex, notably the future of the DGH and Conquest Hospitals.
The debate, held in the Westminster Hall, was attended by the Minister of Health, Simon Burns, Mr Burns said it was the local NHS driving the changes, and the best way to express concerns was through the official consultation.
He said: “For the vast majority of services, improvements can be made without significantly changing the way we provide the service.
“However, we believe some services do require significant change to make the necessary quality and safety improvements,” it said in a statement.
“The NHS Sussex Board, working with the boards of East Sussex Healthcare NHS Trust and the local clinical commissioning groups, has agreed to consultation on three specific areas where we believe improvements can be made - stroke care, orthopaedic care and general surgery.”
Here is the full text of Mr Lloyd’s speech to MPs.
“I am also gratified that the Speaker has given me an opportunity to address an important local issue, in particular the proposed re-configuration of my own local Sussex NHS Trust – ESHT; the East Sussex Hospitals Trust.
Across Sussex though, a number of re-configurations have already taken place, such as the transfer within the Western Sussex Hospitals Trust, of inpatient elderly care and orthopaedics moved from Southlands Hospital to Worthing in March of this year.
It should be noted that it appears the latest direction of travel for Southlands is for it to become a day surgery and outpatients only hospital. Not something I expect many local residents would agree with.
However, more locally, I’d like to give some detail about the proposed changes to my own local Trust and hospital. The Eastbourne DGH.
Four or five years ago, the then Trust Board wished to downgrade maternity at DGH, whilst maintaining consultant-led maternity at our sister hospital in the Trust; the Conquest in Hastings. There was a substantial campaign, cross party, against these proposals.
Eventually it was referred to the IRP – the Independent Reconfiguration Panel – for consideration.
They found against the proposals and the Trusts proposed strategy was sent to the then Secretary of State for a decision. He, I am glad to say, backed the IRP and our campaign to retain consultant-led maternity on both sites.
There were, of course, a number of reasons the IRP found against the Trust Managers, but essentially the main reason was the poor road link between Hastings and Eastbourne would have meant that a blue light ambulance would potentially take upwards of 50 minutes from hospital to hospital. And it was considered this was too long a time, from a patient safety perspective, for a mother who faced a complicated birth.
You can imagine my surprise therefore, a few weeks ago, that the new Trust Board are again recommending a similar change. Or to be precise: ‘Consultant-led (maternity) unit on one site and Midwifery led unit on the other site’
And for the record; the road links between the DGH and the Conquest Hospitals are even worse than they were when the IRP found in our favour!
That is not all: they are also recommending significant further changes to trauma and orthopaedics, General Surgery, Stroke Delivery, Emergency Care, Acute Medicine, Cardiology, Paediatrics and Child Health. All of these along with maternity!
Now I am no medical expert but even I can see that some of these proposals, if carried through, would lead to a substantial downgrade of core service at the Eastbourne DGH.
This is a much loved hospital in one of the fastest growing towns in the South East; and a town where the fastest growing age group is 25 to 45.
I am not prepared to stand idly by and allow this to happen.
Eastbourne and the surrounding area are not prepared to, all of the political party’s, the business community and the voluntary sector are also not prepared to stand idly by.
We will fight these proposals vigorously and tenaciously and I cannot emphasise this strongly enough to the Minister!
Let me flesh out just a little of what we believe the consequences will be if we lose this fight:
1/ Travel distance; 50 minutes travel time which even with the new Bexhill-Hastings planned bypass will reduce by only 5.5 minutes. Still way outside the guidance from the Royal College for mothers giving birth, as was agreed by the IRP and Secretary of State, five years or so ago.
2/ Whilst I wholly accept that very specialised surgery, for instance, children’s cardiac surgery is better in fewer centres; Sussex patients need good quality care for simple conditions and why would the Department of Health encourage ‘care closer to home’ - then sanction massive movement of patients which would be an inevitable consequence of some of the proposed changes?
3/ There will continue to be 2 hospitals admitting medical emergencies as there are too many patients to put on just 1 unit. Yet the reality is that it’s often difficult to make a diagnosis for elderly people, but the proposals mean that 1 unit will have a surgeon on-call and 1 won’t. Frankly, if you are old, and admitted to the one with no surgeon and you have burst your appendix, or are bleeding internally, you will have to travel from, say, DGH to Conquest; and this simply cannot be safe.
4/ Currently both hospitals fix fractured bones but under the proposed strategy - if you have a fracture you’ll have to travel. This will mean the number of elderly and frail patients with, say, hip fractures having to travel will increase exponentially And - it then takes longer for them to get an operation, with the institutional delay creating worse outcomes! Plus a likely longer waiting period to sort social services and, eventually, sending the patient home, further away.
Surely this is not better for the patient?
In fact, pretty much anyone with a broken arm, leg or hip that needs fixing will need to travel further. It won’t be better quality than now – it will just be slower.
All we have to do is look at what’s happening to other nearby Trusts in East Sussex: Brighton has huge waits and Pembury is full already.
And on Strokes, elderly patients will be moved making it doubly hard for their similarly aged husbands and wives to visit. Good practice for the patients? I don’ think so.
There is more but I am sure the Minister gets my drift!
If not. Let me bring to his attention the contents of a letter that was leaked to me a couple of weeks ago. This letter was sent to the Trust Board from the Consultant Advisory Committee, which is made up of all the most senior clinicians at Eastbourne DGH, following a meeting of 63 Consultants at DGH.
I quote: The main body of Consultant Opinion expressed little or no confidence in significant elements of the strategy. Concerns repeatedly expressed (by the Consultants) were that proposals would not advance the desire for improved access and quality of care for patients in East Sussex.
There was frustration that clinical input from the majority of CAC members into the strategy has not been taken into account. Furthermore, concern was expressed that although Management has described the strategy as clinically led, this has been by a few invited individuals and the majority Consultant opinion expressing concerns regarding many aspects of the strategy has not been adequately expressed.
The CAC stated that ‘our local population rightly expects key services should be maintained at both sites and that these include stroke care, orthopaedics and trauma, general surgery and other core services. The strong recommendation of the CAC was that both sites should be developed to improve quality of care, training issues and access for local patients.
And finally; ‘the clinical strategy as explained and understood by the CAC does not deliver clear benefits to patients and therefore cannot be supported in its current form’
Shortness of time precludes me from going into detail about the cross-party Savethe DGH Campaign Group, the fantastic work done by our Chair, Liz Walke, the strong determination of my constituency to protect core services at the DGH; the tremendous support provided by our local paper, the Eastbourne Herald, for our fight.
Time precludes me from giving the details of the utter financial shambles the Trust has been under successive managements since it was merged with Conquest over ten years ago; it precludes the morale challenges felt by community services as they face stringent cuts whilst at the same time being told, ad nauseum, that they must keep people in the community and not take up expensive hospital beds.
Time precludes me from telling the Minister of the sheer frustration that I and my constituents feel that we have to fight part of a same battle around Maternity all over again despite the IRP’s clear conclusions five years or so ago.
Time precludes me from presenting details of how, if necessary, we should seriously consider de-merging the Trust and setting Eastbourne DGH up as a separate Foundation Trust. Work that we have been doing for many months now as we suspected proposals to downgrade DGH were in the pipeline.
So as time is an issue, I will finish with what is a direct quote from my colleague the Public Health Minister, the honourable member for Guildford, in a letter I received yesterday: ‘The Government has said that, in future, all service changes must be led by clinicians and patients’
Well, the clinicians, as I’ve already reported, have profound concerns, and I can assure the Chamber that the patients, former, and future, also have profound concerns about the proposed clinical strategy formulated by the ESHT Board.
I would ask the Minister take on board our concerns and do what is necessary to address them, and to ensure that my hospital, Eastbourne DGH is still performing as a fully functioning District General Hospital for many years to come. Thank you.”