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Last Updated: Thursday, 25 May 2006, 18:37 GMT 19:37 UK
Hospital faces axe as debts bite
By Nick Triggle
BBC News health reporter

At the beginning of the year, the government said community hospitals were the future of the NHS.

But crippling deficits are forcing the closure of many such hospitals, say campaigners.

Sign in Westbury
The local community wants to keep the hospital

When you enter the Wiltshire town of Westbury, the signs are clear for all to see.

"Save Westbury Hospital - join the fight", they say.

The hospital in question is a community hospital housed a stone's throw from the high street.

Until inpatient beds were stripped away earlier this year, the building had a specialist stroke unit, palliative care beds, district and school nursing teams, health visitors and social workers.

The palliative care and stroke beds have now gone and the rest will follow, under plans being consider by local health bosses in a bid to save money and redesign community care.

But this is happening little over three months since the government unveiled a white paper which demanded more care be carried out in the community, by investing in a new generation of community hospitals and multi-disciplinary care teams.

Long journeys

"The Westbury Hospital was everything the government was saying it wanted," said Erica Watson, part of the hospital campaign group and a health visitor.

Speaking in her campaigning role, she added: "It just does not make sense to close the hospital.

"There is only one GP practice in the town, so local people relied on the hospital for community health services.

"When the white paper came we thought, yes, this will be good for the hospital. But it has not turned out like that.

"It is motivated by saving money, but it will lead to patients suffering by having to travel long journeys for care."

Erica Watson
The Westbury Hospital was everything the government was saying it wanted
Erica Watson, local campaigner

The local primary care trusts ran 21m over budget last year and, coupled with 34m of historic debt, the pressure is non to save money.

But it has denied cost-cutting is the only motive.

Carol Clarke, chief executive of Kennet and North Wiltshire and West Wiltshire PCTs, said: "Even if we were in financial balance, we would be making these changes.

"Community services in this part of Wiltshire have not had the investment and development that they should have had, and it is essential that we bring community services here up to date.

"However, it is also true that we are in a tough financial climate, and these changes do deliver some savings.

"The changes proposed, however, strive to strike a balance between the need to modernise and improve our services, and pull back our expenditure. We believe that we can do both."

Savings

And the PCTs are targeting community services despite the fact that they spend much more on major hospitals and GP services.

A fifth of the two PCTs' 347m budget is spent on community services, with 8m a year being spent on the hospital buildings alone.

Government guidelines state that there should be only one community hospital per 100,000 - the area has eight for 320,000 people.

Under three different plans being considered, between five and seven of the hospitals will be shut, potentially saving up to 8.1m.

In each case, Westbury has been earmarked for closure, to be replaced by 24-hour community teams of district nurses, health visitors and social workers.

Westbury Hospital
The hospital is earmarked for closure under all three options

The town, like some of the others losing community hospitals, may also get a primary care centre comprising the traditional GP care with a range of extra services such as dermatology clinics, diagnostic tests and minor surgery.

However, nurses said they were unconvinced about the changes.

The BBC spoke to several nurses who did not wish to be identified because of fear over their jobs.

One said: "They have made promises about community teams and primary care centres, but hospitals are closing and as yet there is nothing to replace them.

"There is no guarantee nurses will want to work in these teams and communities could be left without sufficient services."

Local residents also said they were concerned. Judy Rose, of Dash2, a campaign group fighting to save services in the nearby town of Devizes, said: "It is hard for people who do not live in rural areas to understand, but local transport is very poor.

"Many find it hard to travel around and by taking away community hospitals, the PCTs risk leaving many without services."




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