Epsom Hospital Update
MP says Trust divorce may be the only option
Chris Grayling MP has written to the six key senior managers involved in the review of local hospitals warning them that if a decision is taken that works against the interests of residents and patients from Surrey, he will campaign for a split in the Epsom and St Helier Trust. "Few people locally believe the merger was a good idea, and I know that the NHS in Surrey is becoming increasingly frustrated with cross-border issues", he says. "If the NHS refuses to take the right decision, then breaking up the Trust may be the best option for Surrey."
This is the text of the letter he sent:
23rd April 2004
Joint letter to Julie Dent, Keith Ford, Lorraine Clifton, Simon Robbins, Ian Ayres and Alan Kennedy
I am writing to express my continuing concern about the financial viability of the process that the NHS is going through locally in relation to the Clinical Services Strategy and about the nature of the process as it is evolving.
The thing that has renewed my concern is the consultation document that has gone to staff in the Epsom and St Helier Trust asking for their opinion about weighting the criteria for site selection.
The basic issue is that, notwithstanding the NHS's careful work to ensure that it is not seen to prefer one site over another, I have not talked to a single person either inside or outside the NHS who believes that the process will not lead to a recommendation to build a new hospital in Sutton. The criteria, taken in isolation from the affordability issue, would certainly seem to lead in that direction.
But you have asked staff just to assess the criteria without even addressing their views on how they should be considered in the context of affordability. This seems to me to be like offering someone a choice of different new cars without telling them that choosing something that is too expensive may mean they have to live in a smaller flat.
That is the reality of what we are discussing. The replies that I and my parliamentary colleagues have received to our enquiries about affordability have all centred on some basic facts. A new build at Sutton will cost £20m a year more than the current spend on hospital services. You say you will pay for that through a 15% increase in activity by 2010, and that under the new
financial arrangements that the NHS will have after 2005, when payments are made by activity rather than through block grant, the PCTs will have no option but to pay that bill. So, you have said, the scheme is affordable.
The flaw in this argument is that the PCTs do not have the money to pay that bill, and I see no prospect that they will be given it. They have a statutory duty to balance their books, and so cannot pay more cash than they have. And they, and the Epsom and St Helier Trust, are already struggling with deficit issues.
So there is no evidence at all that there will be sufficient cash in the local health economy in 2010 to pay for the additional cost of a new hospital, and no evidence about where such additional money could be found without cuts to community-based services.
Yet the NHS is rushing headlong towards a site selection that is likely to favour Sutton, undermining the short term future of both Epsom and St Helier, when there is no evidence that it can afford to do so.
It remains my hope that the NHS team meeting on June 17th will see sense, and pursue an option that is clearly and demonstrably affordable.
But whilst up to now I have, while promoting what I believe to be a better option for the NHS in the form of a rebuild at Epsom, been careful not to challenge the principles of the Clinical Services Review, I have to say that I am rapidly losing confidence in it.
If the outcome of the June meeting is to pursue an option which I believe will force cutbacks in other services and lead to a disproportionate spend in the local health economy on acute services, then I will campaign vigorously for the break-up of the Epsom and St Helier Trust and for decisions about the future of services in Surrey to be taken locally and in the context of what our local NHS purchasing bodies can actually afford.
Chris Grayling
MP for Epsom and Ewell
Telephone 020 7219 8194
