Nick Herbert welcomes decision to refer hospital changes

Arundel & South Downs MP Nick Herbert has welcomed the decision of a local health committee to refer controversial proposals for reorganising hospital services in West Sussex to the Secretary of State for Health.


Mr Herbert was speaking after he gave evidence to the Joint Health Overview and Scrutiny Committee (JHOSC) at County Hall in Chichester last Wednesday (23 July).  The Committee has been reviewing proposals from the West Sussex Primary Care Trust for the reorganisation of hospital services in the County.

At the meeting, Mr Herbert had urged the Committee to refer the PCT's decision to the Secretary of State, saying that he did not believe they were in the interests of the health service in the area. 

Speaking after the decision was announced, Mr Herbert said: "I congratulate the Joint HOSC for referring the hospital changes.  I cannot see how proposals which would hollow out health services in West Sussex and see the downgrading of one of the best hospitals in the country would be in the interests of local people."

At the meeting of the JHOSC, Mr Herbert was joined by Bognor Regis and Littlehampton MP Nick Gibb, East Worthing and Shoreham MP Tim Loughton, Chichester MP Andrew Tyrie and Mid Sussex MP Nicholas Soames.  A message of support from Havant MP David Willetts was read out at the meeting.

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 that it was unacceptable that the community should have to choose one hospital over another, or have such a decision imposed on them.

Mr Herbert discussed the original argument for change, saying: "I think that we do have to remember that the original premise for this reconfiguration was driven, very largely, through financial considerations, to make savings because it was said that accumulated deficits would make these changes necessary. 

"On publication of the proposals for consultation, it became clear that the resource position had changed fundamentally, that in fact the existing configuration would not result in a deficit and therefore the resources would be available to maintain services in their current form.

"Nevertheless, the driving presumption, that there should be one Major General Hospital remains and the grounds for a change has moved towards clinical justifications.  I think we need to examine exactly what those justifications are.  The whole issue of access simply has not received the attention in this process that it merited and, only belatedly, became a consideration for the Primary Care Trust - partly, when it became clear of the scale of public concern. 

"What, I think, is objectionable about this whole process is that the existing configuration was never really tested as an option.  There has always been the presumption that there had to be some kind of change, even when the finances did not necessarily argue that it had to be the case."

Mr Herbert said the evidence base for the changes was "highly questionable" and continued: "We have a great deal of confusion now about the extent to which A&E services are going to be retained in St Richard's.  We have the claim from the Primary Care Trust that they are being retained, largely, in their current form.  We have the claim of the St Richard's campaign and consultants that, actually, the A&E changes will mean that little more than an Urgent Treatment Centre is to be maintained at St Richard's, which was, in fact, the original proposal of the Primary Care Trust. 

"Similarly, in relation to maternity, we have conflicting evidence from around the country about the necessity for large maternity units.  In other parts of the country, such as the East of England, changes are being moved forward on the basis of smaller consultant led maternity units.  Therefore, I think it has been very difficult for us and for the local population to know what has been the true evidential base for the changes. 

"There does seem to be a guiding philosophy behind these changes - and that's the philosophy of ‘big is beautiful' - the idea that, somehow, it is always the case that bigger units are going to be better than smaller ones.  I think that has never properly reflected the rural nature of West Sussex, and the fact that travel times and access is an immensely important consideration for patients and the patient experience."

Mr Herbert questioned whether the proposed changes were in the interests of patients, saying: "Has this been a process that has been driven by producers or by consumers?  These changes, if they were to be made, should be made in the interest of patients.  When so many patients will be losing out as a consequence of the changes, it ought to make us very wary indeed about accepting them."

Mr Herbert raised the issue of accountability, saying: "I think a huge problem here is that the Primary Care Trust is essentially unaccountable locally, is answering to the centre, and it's not therefore clear that it has had to answer to patients in the way that I think that it should."

In his concluding remarks, Mr Herbert said: "What I think we're seeing is a serious ‘hollowing out' of services in West Sussex, such that 10 per cent of A&E cases at St Richard's, at the least, are now going to have to be treated much further afield - either in Portsmouth or Worthing.  And, of the more than 4,700 mothers who would have had their babies in the Princess Royal or St Richard's, over 8 out of 10 of them will now have to travel out of the county altogether. 

"The real concern must be, quite apart from the inconvenience caused to so many of those people, that a long term effect of moving to a single Major General Hospital will be not just a diminution of services at St Richard's, but also the posing of a serious threat to the future of the hospital.

"It is for that reason, Mr Chairman, that I urge you to refer this matter to the Secretary of State because I do not believe these changes are in the interests of the health service in the area."

At the conclusion of the afternoon session, the JHOSC agreed unanimously that the proposals were not in the interests of health services in West Sussex and decided to refer the PCT's decision to the Secretary of State for Health.

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