Bracknell Liberal Democrats

Point of View - Local Hospital Services

Local people will be presented with a major consultation on the future of local hospital services this year (expected in August). Bracknell Lib Dems are ready for the campaign ahead to get the right health services in Bracknell and to resist unfair Tory plans.

The Bracknell Primary Care Trust has unveiled a Strategic Outline Case that considers the future of Heatherwood Hospital. This documentation goes into great detail on the benefits of a single new modern hospital to serve East Berkshire.

Lib Dems have already asked questions and raised concerns with the PCT's Chief Executive on a perceived bias in the documents, the importance of Heatherwood to local people and the need to include the location of any new hospital in the evaluation of the options.

Lib Dems have also learned that Conservative health plans unveiled last year could threaten the survival of local NHS hospital care in the Bracknell area altogether by sucking out NHS funds to subsidise those who already pay in full for private care. The PCT has made clear that any new NHS hospital must be the preferred provider in our area.

Questions

Has the Decision already been made?

The most obvious impression from reading the materials provided by the Primary Care Trust is that the professional medical community has decided that the best way to deliver better care is to have a new hospital replacing Heatherwood and Wexham Park. It should be noted that the PCT "did not pick up any bias in the documentation" and have stated repeatedly that no decision has been made yet.

However we believe the following taken from the material provided by the PCT suggests that preferences have already been made - we let you draw your own conclusions

· The Executive Summary for the East Berkshire Commissioning Strategy (Item7A) starts off with the service vision - Section 1.2 - which articulates the need for a single site acute hospital. The SOC "reflects the shape of future services agreed by commissioners and providers across East Berkshire - subject to public consultation".

· The Heatherwood & Wexham Park hospitals Exec. Summary(Item 7B) in the SOC talks of a move to the new model of care.

· The SOC itself (Item 7C) states in section 1.9 that the "PCTs and Trust have agreed a strategy".

· Section 1.8 - Patient involvement p.13 states that users see real value in a single site. (This should have some qualification added - location for one).

· In a 53 page document only one section looks at the merits of Heatherwood - just 1 page with some heavy reservations added for good measure. Most of the document positions the case for a single acute service in East Berkshire. With recommendation for major change to meet the new care model.

· In the Question & Answer document (Item 7E) it's clear from the response to the question regarding Heatherwood and Wexham Park that this is not the preferred option.

Note: this documentation is available from the PCT or by contacting us.

The Importance of Heatherwood

Local health services have been a hot topic in Bracknell for many years -especially for Accident & Emergency cover - where the options are Wexham Park or Frimley Park in the Trust area and the Royal Berkshire in Reading is also used. None of these are ideal locations in an emergency situation given the traffic congestion in our area.

Heatherwood provides a minor injuries unit and acute hospital services for local people - for many treatments patients need to travel to Wexham Park Hospital north of Slough - it's well known that public transport from Bracknell to Wexham Park is inadequate at best.

Heatherwood is old and in need of maintenance and repair - there is a multi-£million backlog of work required and we are concerned that the SOC will be an excuse to defer much needed maintenance at Heatherwood and increase the likelihood of closure.

One of the options put forward in the SOC and the consultation is to invest in Heatherwood and rebuild it into a new modern facility - this would require more funding overall as Wexham Park would also go through substantial redevelopment. NHS capital budgets and likely PCT commissioning revenues will determine the viability of this option.

The PCT feels that the promised Bracknell Healthplex could take on many of the activities of Heatherwood and would therefore allow more specialist services to be concentrated into a new hospital and allow Heatherwood to effectively close.

Another part of the plan is that the land at Heatherwood could be sold off for development - currently some land has already been sold off to build key worker housing. We believe that if this option is pursued then it should be used to meet the local need for key worker housing rather than sell it to the private sector.

Including the Location of Any New Hospital in the Consultation

In any decision between closing Heatherwood or choosing a new modern hospital which would mean closing Heatherwood - we need to know where the new hospital could be located. We understand that planners are already looking for locations but the PCT has not revealed any possible locations. The reality is that most of the "catchment area" in East Berkshire is north of Bracknell and any new hospital is very likely to be further away from Bracknell than Heatherwood is today.

We therefore think that the possible locations of the new acute hospital needs to be made known as part of any decision.

The response from the PCT on this explicit question was as follows:

"If we were to go further on a new site then any actual location is understood to be very significant. Clearly options on any site would be limited by availability of land. The process to determine what areas are suitable is important and will be linked to consultation."

We also want assurance that public transport infrastructure will be improved substantially to help people reach any new site.

The Tory Threat

We put the following question to the Primary Care Trust:

"The SOC business case is reliant on good growth in PCT funding and whilst "choice" within East Berkshire would probably work in our favour with a new hospital - is there not a concern that the Conservative policy of "passports" to the private sector would be a risk to the plans you have developed?"

The response was as follows:

"The SOC does assume that the HWWP Trust will remain the trust of preference for the majority of patients in East Berkshire. It will be beholden on the Trust to ensure this is the case or the risks are real for their income."

The Tory health policy - unveiled last year and available from their website - will allow patients who currently go to private hospitals and pay for their treatment to claim a subsidy from the NHS. The level of subsidy will be 50% of the equivalent NHS cost to carry out the same service. For example a primary hip replacement with BUPA would cost between £7,200 and £9,000 and the NHS "average cost" is £4,660. Under the Tory plan someone already prepared to pay the BUPA cost would be given £2,330 from NHS funds.

The Tories recognise that this is a "deadweight loss" to the NHS - i.e. not a single extra treatment will be performed as a result of this policy and in fact NHS hospitals will face both lower and more uncertain revenue streams. Nationally, this outflow of funds from the NHS on day one alone is estimated at £1.2BN.

The Tories do not deny that some NHS hospitals may fail and close as a result of their health policy. The longer term consequences could mean that we will only get treatment if we can afford to pay for it in private hospitals or are forced to travel very long distances - some choice!

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