Epsom Hospital Update
Consultant letter attacks hospital consultation and calls for Epsom-St Helier divorce
MP threatens judicial review if St Helier plan goes ahead.
Virtually all the consultants working at Epsom Hospital have signed a letter criticising the plans to build a new critical care hospital for the area and calling for a split between Epsom and St Helier. The move represents a major setback for the project, which has been sold to Ministers and the public alike as having full backing from local doctors.
"This is a devastating development, "says Chris. "The whole exercise is dependent on support from the doctors and if that support is not there then it cannot proceed in its current form. If the NHS cannot come up with a compromise that doctors and the public can accept, and they press ahead regardless, they will be breaking the rules for these consultations. In that case, they must expect local people to go to court to seek a judicial review of the process."
This is the text of the letter sent by the consultants.
Mr Alan Kennedy
Chief Executive,
East Elmbridge and MidSurrey PCT
September 2004
Dear Mr Kennedy,
We are writing to let you and your board know how concerned consultants at Epsom Hospital are about the Better Healthcare Closer To Home programme, and about the likely removal of acute services from Epsom. We have lost confidence in the process and are extremely anxious about its implications for our patients.
1. We are extremely concerned about the affordability of the whole project, and have been alarmed by the paucity of financial information provided about the project to date. In particular we are anxious that the plan to build a new "critical care centre" or "acute hospital" involves unnecessary expenditure on buildings and diverts a large proportion of the limited funds for local health care away from the community.
2. We share public concern that the options appraisal has been stacked in favour of the two sites in London. We also believe that the consultation document glosses over what would be major changes within Surrey. For example, the consultation document does not mention that closure of Epsom Hospital to emergency admissions implies closure of local children's inpatient services and the Epsom Maternity Unit.
3. While the noble principles outlined in "Better Care Closer to Home" imply a shift of funding to community care and provision of improved facilities in the community, the specific plan seeks to remove acute services from the Epsom area, to close Epsom and Ewell Cottage Hospital, and to divert funds away from primary care. This would be a major reduction of facilities and a move to care further away from home for the people of mid Surrey now served by Epsom Hospital
4. Regardless of local Surrey public opinion, the decision to rebuild St Helier in Carshalton will be taken by representatives of London bodies. Since there would be a delay of at least 5 to 8 years before the new acute hospital became operational, we understand that the Trust would institute a "temporary" arrangement whereby acute services would move to St Helier and Epsom would be a "cold" site. The mid- Surrey community would lose services immediately.
5. If deprived of the acute services at Epsom Hospital most of our patients would prefer to go either to Redhill or Guildford or Kingston than go to St Helier or to a new acute hospital near St Helier. The new acute hospital would be under-used and thereby even more expensive to run.
6. The Epsom Accident and Emergency unit, recently moved to a new building, is well placed to provide easy access for a large number of people in a wide area of Surrey. It is close to the motorway and accessible from both airports. Closure of the unit to major emergencies would leave a significant geographical void which would inevitably compromise the speed of access of many people to care in an emergency. The safety of these people is the responsibility of the EEMS Primary Care Trust
7. If the NHS strategy is to reduce the number of acute centres and deliver more services in the community, it seems utterly illogical to site a new acute centre close to three others in South London.
We propose the following solutions
1. Epsom General Hospital already provides a good quality of care in a range of services which the people of mid-Surrey find convenient, accessible and appropriate to their needs. It also provides quality training for all disciplines of hospital staff and is a popular place to work.
2. De-merger from St Helier would allow considerable savings in management costs, and stop the haemorrhage of funds paid by EEMS PCT to the Trust to subsidise the more expensive London A&E based services at St Helier.
3. The buildings at Epsom are sound and may be progressively refurbished or rebuilt in the future to improve the quality of facilities in an affordable way. Real investment in genuine community based services such as imaging in the community hospitals, outreach one stop clinics and minor injuries units may be achieved.
4. Management of Epsom Hospital by the EEMS PCT would bring about an exciting new opportunity for full cooperation between primary and secondary care, relocation of many services from the hospital to GP surgeries and cottage hospitals, while involving hospital specialists to maintain the very best standards of care.
5. The difficulties posed by the European working time directive have already been overcome at Epsom by some additional appointments and by alteration of working schedules. New initiatives to reduce out of hours operating and different ways of providing medical cover at night will allow us to meet the relevant targets, so there is no longer an argument that the hospital cannot stand alone.
We would urge you and your board strongly to reconsider the current process, and to take steps to separate Epsom from St Helier and allow it to establish itself as a proper, independent local centre for our patients.
