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Last Updated: Friday, 17 February 2006, 05:57 GMT
Community hospital battles continue
By Jane Dreaper
BBC radio health correspondent

The recent White Paper on bringing NHS care closer to people's homes has been seen as heralding a bright new future for community hospitals in England.

When the document was published, there was talk of a reprieve for up to a hundred such hospitals that had been threatened with cuts or closure.

Doctor with an elderly patient
Community hospitals can often care for people near their homes

The health secretary, Patricia Hewitt, told NHS managers they should review such plans.

But campaigners say their battles are far from over.

It seems there's not much time left for the quaintly named Walnut Tree Hospital in the ancient market town of Sudbury in Suffolk

Everyone agrees this former Victorian workhouse needs replacing - but the new health facility that is being promised will not have the 32 beds that local people say provide a valuable stepping stone between home and hospital.

We are not leaving this shift of care to chance
Department of Health letter to primary care trusts

Campaigner Michael Mandelstam believes this goes against the spirit of the government's new vision of care.

He said: "The clinical evidence suggests that community hospital beds are highly effective in terms of care and costs - and if there were any doubt about this, the government's White Paper says the same.

"We could almost have written the White Paper - it said precisely what we've been arguing for the past eight months."

The hospital also hosts out-patient clinics.

Alternative plans are being drawn up which would involve some patients getting treatment at home.

People seeing specialist consultants would have to travel to a bigger hospital in Bury St Edmunds.

'Money is significant'

Lorraine Gardner is a teaching assistant who's been receiving treatment at Walnut Tree Hospital after breaking both her legs in a head-on crash in a country lane.

She said: "They have far too many patients really - they can't cope with what they've got - so if they closed, I don't know how any other hospital would cope with it really."

Replacement services for some of these community hospitals are very poorly explained
Helen Tucker, Community Hospitals Association

Twenty miles away, Mike Stonard - the chief executive of Suffolk West Primary Care Trust - is leafing through thousands of responses to the plans.

A decision has been delayed until next month, after it emerged that some consultation responses had gone astray. Mr Stonard admits the outcome is unlikely to please the campaigners.

In the meantime, an auditors' report has spelt out how the trust is facing a 13m deficit - and that's after big savings made since Mr Stonard's arrival.

He said: "Money is a significant part of it, but I don't think you can separate the amount of money we're spending on care and whether it's appropriate - we need to look at whether or not we're providing cost-effective care."

'Rushed'

Although the White Paper made it plain that viable services shouldn't be sacrificed to short-term budgetary pressures, observers fear that's what's happening in some areas.

Closure decisions are still going ahead at community hospitals in another part of Suffolk and in Wiltshire - and there are concerns for the future of services in other areas, such as Shropshire and Gloucestershire.

A national campaign group - led by the Conservative MP, Graham Stuart - is holding a rally in London next month.

Helen Tucker, from the Community Hospitals Association, believes that local consultations over changes haven't always been thorough enough.

"I've read most of the consultation documents produced in recent months - and they are very rushed documents - very light on facts, very difficult for local people to make sense of, and the replacement services for some of these community hospitals are very poorly explained."

Getting tough

The government says it has provided more of the type of beds found in community hospitals, and that there is less pressure on them now, because of extra investment in the health service.

Later this year, ministers will invite trusts to bid for 100m being made available to build or refurbish 50 community hospitals.

Some experts believe there is a time lag between the new capital being provided, and the difficult financial situations faced by some trusts now.

The Department of Health's former head of strategy, Professor Chris Ham, said: "What we need to do - and if I were back in the department this is what I'd be doing - is taking a balanced view of what each community requires - in terms of the balance between what's provided in general hospitals, what GPs in their surgeries are able to do and the place of community hospitals in that."

The Department of Health says it is to issue a "get tough" message to those PCTs who are unnecessarily planning to close community hospitals in the face of local opposition, telling them such closures should not be implemented as "short-term budgetary pressures".

The department's letter will say that where the NHS is making decisions about the future of community hospitals, it should ensure plans are in line with its desire to provide far more care in local, convenient settings.

It adds: "We are not leaving this shift of care to chance" and says "We will reject local NHS plans that do not set out a strategy for providing more care closer to patients."




SEE ALSO:
Move to push NHS into community
30 Jan 06 |  Health
Community hospitals 'face cuts'
15 Nov 05 |  Health


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