A CHINK IN THE CLOUDS??  FINGERS CROSSED
An important meeting with the PCT about the Hospital took place on Friday. Your Editor thought it was very encouraging - but perhaps he's just being an optimist.

Chunky Townley and Clive Hill (Chairman and Secretary of the Hospital Action Group) - pictured with District Cllr Hilary Biles (Member of the Oxfordshire Joint Overview Committee on Health)

It may yet turn out to be a false dawn but the clouds seemed to start lifting slightly on the Hospital row yesterday (Sept 17th). The PCT came to town to meet with the Stakeholders Group and the Action Committee. Out of town visitors arrived in dribs and drabs in the chilly Lower Town Hall- looking wet and shell-shocked - having clearly been in traffic jams for ages followed by a wind-swept walk from the New St Car Park. Things needed time time to thaw out - but once it became clear that the PCT really were prepared to listen and that the Action Group were not going to be rude the atmosphere became very constructive. Despite the music from the Mop Fair blasting away outside, the meeting got down to  some serious talking that extended over nearly four hours!  It was agreed by everybody that two big issues continue to divide the town from the PCT as far as a reassurance about continuing service levels is concerned. One is their proposal to reduce the number of beds from 18 to 12 and the other is the closure of the MIU Unit with no clear proposals for a replacement. Most of the afternoon was spent talking about the first issue - the number of beds. The PCT admitted that estimating the number of beds required was not an exact science. However, there was clear evidence that even at the current reduced level of 14 beds they were not fully utilised. They proposed to commission a minimum of 12 beds - but if more were required they could be quickly purchased from the Order of St John who were managing the whole complex of Residential Care Home plus Hospital. Somebody  suggested that it might not all be so easy when it actually came to the point of asking the Order of St John to give up a private care bed (presumably being marketed at top rates) to the hospital who would be presumably be paying a substantially lower rate.  (What an outrageous suggestion ...don't people understand that the modern way of doing things is via public/private partnerships which are not about crude things like profit and money. Pull the other one....But that's another long story for another day!)   Much more debate. Anecdotal evidence that many people had wanted to go into Chippy for intermediate care but had not been able to. Evidence from the Radcliffe Strategic Review team (which the Action Group had heard in Oxford at the Overview Committee) that they did not have a reliable system for knowing about availability of beds outside Oxford. Demographic trends quoted - more old people living longer. How could we possibly need fewer beds?. Our MP told the gathering that the Chief Executive of the Radcliffe Trust had told him that there were not enough beds in Oxfordshire. The PCT said that the Radcliffe Trust had told them they supported the PCT Plan of replacing beds with Domiciliary Care (in home) which is what people wanted these days. The GPs had told us that Domiciliary Care was not working - so a 12% expenditure  increase on a terrible service wasn't going to mean much....and certainly wouldn't compensate for lost beds. The PCT told us we didn't understand Domiciliary Care. Did we understand that there were two types. Long-term care was one thing.  Then there was an intermediate kind which was all about getting people back into operation in their own homes after an illness or operation...which lasted probably just two months. This service was working very well in Chippy (whatever the GPs said). 55 people had benefited from it in Chippy last year. This is what the PCT was talking about increasing. The objective was to get people straight from the Horton or Radcliffe back to their own homes and so cutting out the need for an intermediate hospital stay at all. And this is what patients actually want. Some of us shuffled uneasily. Well no perhaps we hadn't understood that very well but then nobody had explained it to us before. Wasn't the problem that the PCT wanted to take a big leap into the unknown - cutting the beds and assuming Domiciliary Care would all work fine. A way through began to emerge. Stay with 18 beds in the Hospital. If these were really too many then the Order of St John could be asked to find occupants - which surely would not be a problem! The PCT grumbled about not wanting to carry the risk - but it became pretty clear that it was'nt really much of a risk. (Could even be good business).  The PCT should concentrate on communicating intensively with the town about the Domiciliary Care Service make sure its working and is really effective. As this becomes accepted so the PCT could consider  gradually reducing the number of Hospital beds it was purchasing. Initially from 18 to 16. This proposal originated with the Chairman, Keith Ruddle - was finessed by Councillor Alcock - strongly supported by David Cameron and given a final blessing by Steven Weston. Difficult to ignore. The PCT seemed sympathetic and promised to go away and cost it. It felt like there might be the makings of a deal there.

But the discussion on Minor Injuries never got so far. The PCT seem to regard Minor Injuries as a bit of a nuisance all round. There are aren't enough of them so a Minor Injuries qualified Nurse will not get enough practice and lose their qualification. Minor Injuries patients at a hospital will distract nurses from their real jobs of looking after in-patients. And the stupid patients (according to the PCT) don't seem to know what is a minor injury and what isn't. Last week someone with constipation presented themselves and blow me if the day after somebody with a meat cleaver in their head turned up. The first one should have been at their GPs and the second should have been at A&E. Minor Injuries was getting in the way and confusing things- often delaying treatment. The meeting wasn't buying any of this. It all sounded so contrived. What people in Chippy are thinking about is something really very simple.  Particularly young mums with kids and older people. You never know when something nasty might happen - a bad cut, a wasp sting, a burn, a sprain, a fall, a really bad allergic reaction, a nail through your finger, a hammer smashing a thumb, a hand through a window, something in your eye. Something that seems much worse than it probably is but still has you looking for some fast reassurance and help from an expert - maybe a stitch or two. You may be feeling queezy or a bit sick. Not nearly serious enough for an ambulance but you're certainly not feeling like a taxi ride to Banbury. This is the service the Hospital offers up to 9pm - although in practice because there is always a nurse around all night somebody will see to you at any time. This is what is to be abolished. The PCT now propose that Minor Injuries will be dealt with at the two surgeries - but only up to 6pm.  The Action Group feel very strongly that a Minor Injuries Unit should be based at the hospital - and should be available 24 hours a day. Clive Hill explained this at the meeting. There is obviously scope to see how the surgeries might be involved and whether the Ambulance Service (with its First Responders) could be part of the whole setup. This needs some creative thinking and more goodwill from all the parties (including the GPs) than has been on show so far. But for goodness sake, it should be perfectly possible to find a way through.

The Action Group made it clear that if a way through could be found on the Number of beds and the MIU.  they stood ready to help the PCT with what many think will be the most difficult persuasion job of all. The idea of  moving the hospital from the present site to a new one - probably along London Road. Many people in the town will not like this at all and are not convinced that a proper study has yet been made into the feasibility of maintaining the existing hospital site (and building). Others see the logic of providing modern new services in a spanking new building with space to expand - located well away from the growing pollution in the town centre and linked to different parts of the town with a frequent shuttle bus service. They understand that the NHS need to realise some of the asset value in the existing Hospital site to help fund services into the future and they see this a reasonable quid pro quo. But this debate is still to happen - let alone be resolved. Eve Coles for one at the meeting made it clear that she is not endorsing a move from the present site without a lot more evidence.

The Petition signed by 10,000 people did not demand the retention of the existing building. It simply asked for no cuts in services . The location of the hospital is a completely separate issue. People want  reassurance that what is planned is a proper hospital with at least the existing range of services before being dragged into a complicated discussion about "new build" and a "new site". The Action Group has always argued for a two step decision to disentangle the two issues. Persuading the town to abandon the old site for a new hospital on London Road may just be possible if at least all existing services are in place - but not otherwise.

The Action Group continue the dialogue with the PCT on Monday in Banbury and plan to report back to the town on Progress at a Public Meeting towards the end of the month. But keep your fingers crossed. For the first time in a couple of months we could be making some progress.
 

THE HOSPITAL "NO CUTS" CAMPAIGN PAGE IS  HERE