070401 RSCH Letter

Letter to Secretary of State for Health

1st April 2007

 Rt Hon Patricia Hewitt MP,

Secretary of State for Health,
Department of Health,
Richmond House,
79, Whitehall,London,

Dear Mrs Hewitt

In the matter of:  The Royal Surrey County Hospital, Guildford

A matter of 111 days ago I wrote the attached letter to you and have not yet received the courtesy of an acknowledgement or reply.

I would be grateful if you would address my concerns as yet again there appear to be significant manipulations of process and data surrounding the consultation process.

On this occasion the manipulation to which I refer is the adoption of partial answers to loaded questions in assessing the clinicians’ views of scenarios (gathered at meetings on 29th and 30th January) in a subsequent publication by Matrix Research and Consultancy called “West Surrey Health Community: Squaring the Triangle”.

This latter document comprises comments not supported by the RSCH clinicians and which have a considerable amount of life-threatening flawed logic – particularly with regard to the vast areas of Surrey and Sussex which would be too far from any hospital to have a reasonable expectation of surviving serious trauma events where the speed of delivery to hospital are of paramount importance.

Furthermore, I understand that the proposal adopted was thatFrimleyParkHospitaland Ashford St Peter’s Hospital retain their A&E presence at the expense of theRoyalSurreyCountyHospital.  The minutes of this meeting have not been signed off by the RSCH clinicians as a true and accurate reflection of the discussions.

The ‘Emerging Principles’ referred to in the document comprise, for example, the contention that a full A&E department “in the future would need to be supported by a catchment population of between 450,000 and 500,000 people”. This seems to be based on residents whereas some of the major pressures on the regional healthcare systems (both on a frequent and disaster basis) are related to the transience of population and this should take account of the transport networks (rail, trunk roads, motorways, airports) in an assessment of catchment.

The thought that no emergency healthcare provision can be provided locally for rural communities is frankly appalling and your urgent reassessment of this is required.  Having read the “Commissioning Framework for Health and Well-Being” I am convinced that the approach seems to be an urban-centric one, where access to a variety of care provisions can be provided for a ‘critical mass’ of population.  Under these circumstances there are two major observations I would seek to have you respond to:

1)            How can it be appropriate to completely re-engineer patient care – to the extent the patient becomes fully responsible for its own well-being but (assuming it can assimilate all of the management consultants’ reports and identify the community-based structures that will be put in place) it will have access to a wide range of support – whilst at the same time dragging away the safety nets of A&E and other emergency care?  How many patients will have to die in order to educate the population as a whole in how to survive in the brave new world of devolved responsibility?

2)            How much duplication of resource (both capital and personnel) will there need to be to ensure that patients (in the utopian long-term that the academics and management consultants have defined) do not fall between the cracks.  Has the Social Exclusion Unit yet managed to complete its task of ensuring total inclusivity of public policy?

These are very real concerns and there are lives attaching to getting not only the long-term vision right but also the means of migrating to that vision if it is even appropriate to do so.

I believe the round of hospital cuts and closures you are currently supervising is putting the cart before the horse and I reiterate my concerns and proposed recourse to action should this not be tackled with the due fiduciary care you hold as Secretary of State for Health to the population as a whole and to the rights of individuals within our society.

I await your urgent response.

Yours sincerely

Julian D S Lyon

cc        Anne Milton, Member of Parliament for Guildford

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