Nick Herbert gives evidence to local health committee

Arundel & South Downs MP Nick Herbert gave evidence to the Joint Health Overview and Scrutiny Committee (JHOSC) at County Hall in Chichester last Wednesday (5 March).


The Committee is reviewing proposals for reorganising hospital services in West Sussex.

Mr Herbert was joined by Bognor Regis and Littlehampton MP Nick Gibb and Mid Sussex MP Nicholas Soames.

In his opening remarks, Mr Herbert began by reminding the Committee that residents in his Arundel and South Downs constituency are served by all three acute hospitals in West Sussex (St Richard's in Chichester, Worthing Hospital and the Princess Royal Hospital in Haywards Heath).

He said the drivers for change had to be questioned, saying: "It was only around 18 months ago, perhaps a little longer, that it was being made quite clear to us as Members of Parliament, firstly by the Strategic Health Authority and then by the Primary Care Trust that the prevailing driver for reconfiguration was the dire financial situation in which the Trust apparently found itself in.

"It was being put about that the deficit was going to be £100 million and that this would require drastic action in order to address it."

On the eve of the publication of new proposals for consultation, it became clear that the PCT would be moving into surplus.  Mr Herbert said: "The simple conclusion, therefore, was that the resources would be available to maintain all three hospitals in their current configuration.

"At a stroke, I think the Primary Care Trust lost the argument for such a fundamental downgrading of A&E services."

Referring to public opposition to the proposals, he said: "On no other issue have I ever received unanimity as I did in relation to health care.  I did not receive a single letter or a single e-mail, and have not to date, from anybody saying that they thought these proposals were a good idea."

Mr Herbert welcomed the PCT's "change of heart" on the downgrading of Accident and Emergency services at the three local hospitals.

However, he said: "It is still not clear to me what level of A&E services are to be preserved under the new arrangements.  It's clear that the level of A&E services at St Richard's and Worthing - whichever of those two hospitals will not be the Major General Hospital - will not be at the current level.  

"But the Primary Care Trust has so far failed to spell out, in a way that the public can understand, exactly what level of A&E services will be retained."

Mr Herbert said the issue of maternity remained, with the current plan being to centralise services on one site.  He continued: "I have great difficulty in understanding why the argument is that A&E services should no longer be centralised yet we cannot have three maternity units running safely."  The logic behind the proposition was "extraordinary".

Mr Herbert said that with a growing population in West Sussex and a projected cash surplus for the PCT, money should be made available to provide consultant-led maternity services at all three hospitals.

In his concluding remarks, Mr Herbert said: "Sir Graeme Catto is right that these labels of Major General Hospital and Local General Hospital are divisive and don't really tell the general public very much.  I think we need to start moving away from this jargon and these labels and start spelling out to the public exactly what these changes mean for ordinary patients."

Mr Herbert also noted that the new Ford eco-town had not been factored into the proposals, a point already conceded by the PCT.  He recognised that the decision had not yet been made to build an eco-town, but the Government's announcement on a shortlist of options was imminent. 

He said there could be 5-20,000 new homes at Ford and that these would be over and above the existing housing targets.

He said it was very important to consider the issue of sustainability and ensure that our hospital services are able to cope with future demand.

In response to a question relating to the staffing of maternity units, Mr Herbert said: "I would like the Primary Care Trust to explain why it is that maternity services need to be centralised but A&E services can apparently be run on a different basis.

"It's very important that when we're being told that proposals are clinically-led, that what that should mean is that they are truly about safety and what is in the best interests of the patient.  These reforms must be driven in the interests of the patient - and cannot be driven in the interests of the producer.

"Now you may argue that it is no fault of their own that we are moving forward to the (EU) Working Time Directive.  But if you take a step back and look at it from the point of view of the taxpayer and the consumer of health care, arguments that say the reason we're having to do all of this is that we want to change the basis of the hours upon which doctors are working are not terribly persuasive ... when it comes to then being told that services which were once local are going to be made much more remote.

"If that's a so-called ‘clinical argument' then I don't think it's a very persuasive one to members of the public.

"So I hope that the HOSC will be able to disentangle these arguments and work out what is truly about clinical safety and what is actually about arrangements which may be suiting people but are not necessarily in the interests of patients."

Responding to a question about the conduct of the public consultation, Mr Herbert said: "I think that the manner in which the Strategic Health Authority went about this early on was highly reprehensible."  

"In the House of Commons we had a presentation from the Strategic Health Authority (April 2006) at which no mention was made at all of the potential downgrading of A&E services.  There was general ‘fluffy' talk about reconfiguring services.

"It was only afterwards that we discovered from leaked papers from the Strategic Health Authority that they had had consultants working on these proposals for some time and were at an advanced stage in terms of formally proposing the downgrading of hospitals.

"Then when they published their document, again it didn't make any reference to specific hospitals or specifically to what might happen.  It just talked loosely about redesigning health care in the future.

"As a result, enormous fears were stoked and we had this extraordinary pre-consultation period when it was very difficult to judge what we were consulting about.  They gravely mishandled this."

JHOSC brings together local, district and county councillors from West Sussex, East Sussex, Brighton and Hove, Surrey, Portsmouth and Hampshire.  Its role is to review the ‘Fit for the Future' proposals put forward by the West Sussex Primary Care Trust.


Alexander Black