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| A packed hall at Applemore Recreation Centre |
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At least 100 people were turned away from a packed hall at Applemore, following the hastily re-arranged venue for the New Forest PCT Consultation meeting.
This second meeting was set up after fears for health and safety at the original meeting held at Hythe Community Centre in July.
What is it all about?
The PCT propose to change the way it manages care of the elderly in the New Forest by seeking to focus care in the patients home rather than having "unneccessary time" spent in hospital, and thus cost less.
Wendy Pettifer, Chair of New Forest PCT, who lives in the New Forest area, gave an introduction, dealing swiftly with background details and acknowledged that this was a highly emotive subject for local people, and what followed was a whistle stop tour of the PCT's proposals given by Denise Foster, Director of Adults and Older Peoples Services.
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| Wendy Pettifer, Chair of New Forest PCT |
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The key messages she spelt out were:
1 Health Care for Older People was changing
2 Overspent on the budget
In essence: the PCT wish to spend less on hospital care – more on local services and provide them round the clock to enable more people to be cared for at home, which would mean fewer hospital beds needed.
The proposal's “credibility” was illustrated by Sheila Johnson, Professional Lead for Occupational Therapy, who described the success of Respiratory and Orthopaedic care teams in the community setting. Ultimately, suggesting that by following that model of care, it would be both beneficial to the patient, as well as saving the PCT money.
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| John Richards, CEO of New Forest PCT |
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John Richards, CEO of New Forest PCT, emphasised the fact that NHS Clinicians and Managers were involved in the presentation, and that the purpose of the consultation was to have a “reasoned debate”. "It was not about voting but for the board to make the decision, which included taking in the views of people.
The PCT acknowledge the strong affection that people in Hythe have about the local hospital, and that it is part of the fabric of the community, and that passions run high. We respect that view but try to make decisions that is right for the local population”.
Hampshire County Cllr Brian Dash said: “Any proposals to close Hythe Hospital must be resisted at all costs”. (Full text from Cllr Brian Dash). To huge audience applause he suggested that, “money was the major driving factor” for the proposals.
It was denied that money was the major driver, but John Richards agreed that it was true that the PCT had the largest deficit.
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| Cllr Brian Dash |
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Questions from the floor:
A community nurse specialist, asked how 24 hour care was going to be delivered as posts were frozen and recruitment was difficult. Cllr Allan Glass, Deputy Chair Fawley Parish Council also reminded the PCT that “as 85% of the beds to be closed are used due to inadequate services at home, short of increasing work for undertakers, how will the proposals work”?
The response was that it was felt that with the introduction of the Community Matron role the recruitment of staff would be possible.
But how many would need to be recruited to ensure that the proposal worked was not mentioned. Nor the fact that the Community Matron role is really a coordinating/managing one rather than a "hands -on," down to business – ie caring for the individual at home over a 24 hour period as would happen if the person was in Hythe hospital.
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| Members of the PCT |
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It would in reality mean that the onus of care would be transferred more and more to family and friends, with a few visits during the day, and probably in touch by phone at night, a scenario which was put forward by Father Ray Lyons, who suggested that a phone call is not a substitute for getting someone to the toilet during the night.
The proposals were further challenged from the floor, when the panel was reminded that there had been constant reduction in beds and services. “Hythe Hospital was given by the people as a War Memorial, and that it was felt that morally it was not up to the PCT to dispense with it”.
“God help us if the very managers who helped to create the deficit are asked to stay on – it’s a bit like asking Harold Shipman to shore up GP services.”
For many attending the meeting, the issue of the deficit crippling the New Forest PCT is a major one. Which is unfortunate for the PCT who are struggling on one hand to correct finances but on another is having to set down a new framework for care that the public sees as part and parcel of the disastrous financial management that the PCT has endured.
Dr Julian Lewis, New Forest East MP, also addressed the meeting, and suggested that it was only a legal requirement for the PCT to hold these consultation meetings, and that in all probability, the views of the public would be ignored.
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| Dr Julian Lewis |
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He then instigated a “straw poll” asking for those in favour of closing beds. No one put a hand up for that option. He urged people to attend the demonstration on 12 September. (Details of the rally can be found here) (Click here to read the text regarding community hospitals in the New Forest made in the House of Commons 4th July 2005.)
John Richards tried valiantly to put the focus back onto the notion that it was strategy for the Elderly and NOT on Hospitals, but he and the PCT failed once again to convince the audience that this was the case.
He sought to assure people, “When people need to be cared for in a hospital bed, they will get it.”
The audience immediately responded by asking, “WHERE”?
One resident of Hythe, put the case of his GP practice outlining 3 reasons why it was not practical to visit a patient at home:
1 it was not an efficient use of time of a skilled professional.
2 Not practical for the use of specialised equipment
3 Difficulties in parking, security especially at night and also access to flats.
He asked how this would be different in light of the PCT proposals. Mention was made of the "Rapid Response team" in ensuring that elderly people could remain as independent for as long as possible, but as to point 3, no mention was made on how this could be met.
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| Cllr Lee Dunsdon |
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County Councillor for South Waterside, Cllr Lee Dunsdon asked the panel about the Minor Injuries Unit that was closed without public consultation, and wondered if there was any prospect of it coming back? Responding to this it was stressed that it was an issue of training and recruitment, but at present there was a GP available, evenings and weekends.
This was met with derision by the public, who felt that it was very difficult to be seen, and how they were often forced to go to Shirley, Southampton for health advice/treatment out of hours.
Retired Hythe GP, Dr David Markby, spoke saying he didn't envy the position that the PCT was in, but suggested that the PCT should involve more GPs in addressing the needs of their patients in hospital and in the community.
Interestingly, a more long term possibility, that should the hospital become “surplus to requirements.” The League of Friends or other local authorities would be given “first refusal,” but that the PCT had a statutory obligation to obtain a valuation from an independent valuer, with any monies from the sale landing up at the Department of Health, which in turn could make money available for capital development at local level.
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| Captain G H Draysey |
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Captain G H Draysey (RD) was incensed, saying that, “2 years ago money was used to refurbish Hythe hospital for extra beds, now you are closing them. The end-result of this is a whitewash. Hythe Hospital is a War Memorial given to the community in 1919 after WW1; if you sell then the money should go back to the community”.
To the people of Hythe and to many others in the New Forest who are faced with the PCT proposals, the very idea of bed closures is fraught with tension, and brings on a deep distrust of those empowered to organise our local healcare system.
To give the New Forest PCT their due, they have recently had a management change which has left them with a significant financial deficit, which will require the talent of a financial wizard - if one exists?
But it will also need someone capable of winning local people around to the PCT's way of thinking, which quite frankly, they do not seem to be doing so, judging by the mood of people at the end of the meeting.
Many had been prepared to listen to what was on the table, but for others it smacked of a paper exercise, just going through the motions before jumping in with two feet and executing either of the PCT's options: bed closures in all or some of the 5 local hospitals in the New Forest area. |
