Lymington Times – 18 June 2005
An investigation into the closure of the Fenwick Hospital has been demanded in Parliament as the New Forest's MPs cranked up the pressure on the Primary Care Trust – a month before its healthcare proposals go out for what promises to be a fiery period of public consultation.
The exchanges in the Commons came before another noisy meeting when PCT executives presented an early indication of their proposed reorganisation of the area's healthcare at a full meeting of the district council in Lyndhurst this week. It was a precursor to three months' consultation starting in July, during which New Forest District Council will draw up its own response to the plans which have so far centred round the closure of the village's much loved Fenwick.
Although remaining services continue, the hospital's 20 in-patient beds were shut at the end of January for at least three months. Health executives pointed to safety issues with the facility's growing reliance on expensive agency staff, and at last month's PCT board meeting the closure was extended until October at the earliest.
Last week in the Commons Julian Lewis branded the state of the PCT's finances as "catastrophic". The New Forest East MP told the Leader of the House Geoff Hoon:
"With a multi-million pound deficit, it is finding excuses to close down in-patient beds in cottage hospitals. It is threatening to close down all those beds.
"It promised a consultation exercise. It has not held it, yet it has reduced the options from five to two – one is that it will close all the beds. This is a total breach of faith with the people of the New Forest. It is a scandal and we urgently need an investigation".
Requesting a debate on the PCT finances across the country, New Forest West MP Desmond Swayne added:
"New Forest PCT is only one of many trusts that are running a deficit. We really dp need an opportunity to examine claims that proposals to close services and withdraw beds represent not just financial savings but, somehow, new models of working needed to improve services – that, in some way, fewer means more".
Mr Hoon replied that health spending between 1996/97 and 2007/8 will have trebled.
The fate of the Fenwick however rests on the final shape of the "community services strategy" – a wide ranging review of how to provide the New Forest's health care. Five options earlier this year were whittled down to two by the PCT in May. They involve shutting all the community hospital beds to treat more patients in their homes under an extended community care structure, or a less radical shake-up that would keep more beds.
PCT Chief Executive John Richards told councillors and the public on Monday evening:
"We don't expect to be popular because of all this. But we will find a way to implement what is best for the local people. We're not saying we know what this is, and that is why we need your help".
Mr Richards admitted the New Forest Primary Care Trust was suffering one of the largest deficits in the country – a combined debt of £12.1 million for 2004/05. Savings of £18.9 million were required from the annual budget of around £190 million, he said which could result in £4.3 million saved from prescriptions, £15 million from emergency care, and £1.4 million from management costs.
Too many patients were sent into acute care hospitals such as Southampton because there was no alternative, he said, which forced the PCT to buy expensive services from the city's trust. Implementing the community services strategy over the next few years was about "balancing" the local system between serious and chronic illnesses, he insisted.
It was not about closures by stealth, selling property, or regressing to unsuccessful models of "care in the community," he said.
"We need a more systematic and joined up approach to providing for people's care needs for long term conditions that grind people down year after year."
Following the noisy crowds of up to 350 at the last public debate at Lyndhurst's Community Centre, Monday evening's meeting was switched from Appletree Court to the Lyndhurst Park Hotel to accommodate up to 100 members of the public who arrived to make their voices heard.
PCT Executive Director Dr Hockey explained he had just come from a ward round at Lymington Hospital, which is set to be replaced next year by the £36 million, 107 bed PFI facility. He claimed 10 of the 24 patients he had seen that afternoon did not need to be in hospital, and could be safely cared for in their own homes.
However, accusations that decisions had already been made by the PCT were levelled again amid continuing concerns that an aging population, insufficient nursing home provision, and a lack of home carers would leave the district worse off if the PCT continued in its present direction towards cutting beds. The more efficient use of drugs also raised worries patients might not get the best treatment to save costs.
A 4,300 name petition was handed to NFDC Leader Coun. Mel Kendal to be included in the authority's report. Treasurer of the League of Friends of Fenwick Hospital, Frank Letch, read out a combined proposal with the Friends of Lyndhurst Surgery to keep the facility alive by providing, for instance, rehabilitation, a centre for chronic disease, or for complementary medicine such as reflexology.
Coun. Kendal explained views of councillors and members of the public would be taken into account in NFDC's report, which will go to the Hampshire County Council Health Review Committee to assess the PCT's future strategy. The body has the power to "call in" the plans for closer scrutiny, although they could eventually go to the Department of Health if sufficient concern is raised.
Afterwards, Coun. Kendal said:
"I hope that any reduction in beds will not occur until all the support services are in place for secondary care in the home. Even then I hope we could expect to see all of the existing community hospitals maintained at least for day care and outpatient's usage because of the problems of access for many people in our community.
"This could allow a spread of beds for secondary care. The remainder of hospital space could be used for community health facilities by the local authorities or as frail care beds by Hampshire County Council who will need to increase capacity for an aging population.
"All of these options would require more work but there is time available before the new extra beds at Lymington Hospital become fully operational. NFDC will continue to work with all partners to ensure that the optimum solution for the people of the New Forest is found."