Sunday, 20 December 2009

Walton hospital: NHS efficiencies or cuts?

On Friday, I visited Walton Community hospital with Ian Taylor MP, to talk to Alison Edgington (Chief Executive, Surrey Community Health) and Yvonne Ryan and Sam Smith who work at the hospital (see below).

Ian Taylor has been a strong advocate for local NHS services, and I intend to continue making the case for keeping healthcare as local as possible. The ‘temporary closure’ of Burwood ward – an 18-bed ward for patients suffering with dementia and other rehabilitation - has sparked local concern. But it reflects a bigger a picture, given wider cuts at Molesey, Cobham, Thames Ditton and Cranleigh hospitals.

Surrey Community Health say two things. First, that Burwood ward has not been closed - they simply opted to consolidate wards when Burwood’s vacancy rate dropped. This, they claim, is a direct result of improved care, which has led to swifter discharge of patients. Second, they argue that flexible provision of NHS care will from time to time require wards at particular hospitals to be ‘flexed’ up or down. This is part and parcel of getting bang for the taxpayer’s buck, and giving patients the most appropriate care.

Unfortunately, the debate over Burwood ward takes place against a wider context. Surrey gets an unfair deal when it comes to local funding – it pays the Treasury £5.5billion in taxes, but gets back a third of the national average level of funding for local services. In Elmbridge, this has led to pressures on secondary school places, threats of police station closures – and now casts the shadow of hospital cuts. People feel short-changed. Their trust has been undermined by twelve years of being taken for granted by this government.

We have heard the language of ‘efficiency savings’ many times before, too often as a fig-leaf for cuts in services. The government’s top-down centralised management has also proved a blunt instrument in practice. It focuses obsessively on in-puts and targets – but neglects the service patients receive in the real world. It knows the price of everything, but the value of nothing. That is why recent threats to police stations or hospital beds may make sense to the bean-counter in Whitehall - but neglect both the measurable and intangible value people place on having NHS and police services nearby.

So, when Surrey Community Health argue that ‘flexing’ down Burwood ward relieves resources for other NHS priorities, people are instinctively sceptical. Even if there is a case for shifting priorities – and resources – the people who rely on Walton hospital are still net losers, unless Surrey Community Health can show they gain in the long run. That is why the lack of transparency over Burwood ward – and the future of other hospitals - is part of the problem.

We need stronger local democracy when it comes to health services. I support the move to Foundation Trust status for hospitals like St Peters and Kingston. People in Elmbridge who rely on those hospitals will be able to elect governors to represent them on their boards. So, those who rely on their services get a direct, democratic, say over how the hospitals are run. But, if we are heading towards stronger local democracy for hospitals based outside Elmbridge, surely we should be strengthening local consultation over the running of our local community hospitals too. From the meeting we had on Friday, Surrey Community Health now appear – belatedly – to recognise this. I welcome their commitment to greater transparency and local consultation in the future. I will support the local community in holding them to that commitment - and preserving local healthcare services.


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