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From Dr John Clarke to all practice managers
to share with their GPs (first draft)
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Dear Sirs
We the undersigned, feel it necessary to write to our local papers to express our disquiet at the options proposed by East Sussex Downs and Weald, and Hastings and Rother PCTs for changing Maternity services in our county.
Their document, "Creating an NHS fit for the future " was misleading and contained a number of errors (e.g. numbers of deliveries are increasing, not decreasing, and travel times were only quoted for off-peak.)
On page 14 of the summary document, it states that both PCT Boards had proposed five criteria for assessing and evaluating the options.
1) CLINICAL EFFECTIVENESS AND SAFETY - There are huge concerns amongst us about the safety of options 1-4. To remove a consultant-led service from either site would compromise the lives of a number of mothers in labor and their unborn babies. Although we await final guidance from the Royal College of Obstetricians (and their interim guidance has been somewhat ambiguous at times), we believe that adequate funding should be made available immediately to commission sufficient midwives and consultants to ensure a safe service. (We know there are suitably qualified staff able to fill these posts now). The Ambulance Trust are not confident at present that they have either sufficient vehicles or expertise to cope with the additional transfers or emergency situations en-route.
2) ACCESS AND CHOICE - By single siting, one immediately disenfranchises half of the county's population for both access and choice. Best practice requires, suitably trained personnel and adequate premises to be as close as possible to the emergency situation. The road infrastructure ( flying squads ( found to be unworkable in the 1970's) and lack of public transport will mean gross inconvenience to patients and their visiting friends and relatives.
3) FINANCIAL SUSTAINABILITY - Despite frequent denials to the contrary at the public meetings, the PCTs are hoping to save money ( see number 5 ) Their own figures show in fact that no monies will be saved with options 2-4, and no account has been made for capital investment, redundancies etc
4) HEALTH GAINS AND DEMOGRAPHICS - Pockets of deprivation exist across the county, and GPs have agreed (whether from the North, East or West of the county), that no cohort of patients should be disadvantaged or discriminated against, by removing vital core services from their area.
5) SUSTAINING TWO VIABLE HOSPITALS - We believe that core-services (acute Medicine, acute Surgery, acute Psychiatry, a full A & E department, Consultant-led Obstetrics and Special care baby unit, as well as in-patient Pediatrics) must remain on both sites as a basic minimum. The PCTs should commission services for their population's needs, and the acute trusts (especially as they will soon hope to become Foundation Trusts) should provide all of these necessary services. We have seen in other parts of the country what happens when you lose a core service, ( such as Maternity or A & E ), the "domino" effect inevitably follows; ( which is where the PCT hopes to save money, though the Acute trust will probably lose income).
We as GPs, would have little or no faith or confidence in any organization (especially one set up to oversee the healthcare of our population) that deliberately closed vital services to our patients.
We sincerely hope that the respective Boards examine carefully the other options which enable both towns to retain these services, and not be pressurized by current political directives, which in no way appear to benefit our increasing populations.
Notes:
- the final draft of this was published in the an Eastbourne newspaper.
- this letter has received pretty much unanimous support amongst Eastbourne doctors
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