North Thanet MP Sir Roger Gale has branded an east Kent NHS option to remove services including A&E, maternity and inpatient care for children from Margate’s QEQM hospital and move them to a new-build site in Canterbury as ‘a blind alley.’
The proposal is one of two being put forward by Kent and Medway NHS for changes to hospital services in east Kent.
Currently the three main hospitals – at Ashford, Canterbury and Margate – each provide different services, with A&E departments at Margate and Ashford and an Urgent Care Centre at Canterbury. A range of specialist services are at different hospitals, such as the trauma unit at William Harvey Hospital and inpatient kidney services at the Kent and Canterbury Hospital.
NHS professions and the East Kent Hospitals University Foundation Trust (EKHUFT) say specialist services, such as stroke, trauma, vascular and specialist heart services, need to be centralised and located together.
There are two proposals concerning A&E.
The first option is for an A&E at William Harvey Hospital as part of the major emergency centre which would also provide specialist services plus an A&E department at QEQM.
This would be supported by 24/7 GP-led care, including an Urgent Treatment Centre treating illnesses and injuries which are not 999 emergencies, in Canterbury.
The second is for an A&E department for east Kent at a major emergency centre within a new-build hospital at Canterbury. This would mean that A&E, acute medical care and complex inpatient surgery, which currently take place at William Harvey and QEQM, would relocate to Canterbury.
This would be supported by 24/7 GP led care, including Urgent Treatment Centres treating illnesses and injuries which are not 999 emergencies, in Ashford and Margate.
Both of the options propose bringing together all specialist inpatient services, including trauma, specialist heart services, inpatient treatment for veins and arteries (vascular services) and specialist renal, urology, head and neck services and children’s inpatient services in a major emergency hospital with specialist services.
This would be at William Harvey Hospital in option 1 and Kent & Canterbury Hospital in option 2. These services would not then be provided elsewhere in east Kent. They are not provided at all hospital sites now; but they are provided at different sites rather than one specialist site.
But Sir Roger says the idea of centralising all services at a Canterbury ‘super-hospital’ is “not achievable, not affordable, is unworkable and for the majority of people unacceptable.”
In a facebook posting he has also branded public listening events to discuss the proposals as a “low- flying and ill-designed kite.”
He added: “In their briefing paper the (clinical commissioning) groups say that “ Our aim is to design modern health services that are high quality, meet people’s changing needs and are sustainable for years to come.”
“Few would quarrel with that aspiration and I have never personally sought to stand in the way of measures, including for example the re- location of Neonatal Intensive Care or the creation of a hyper-acute stroke unit backed up by stroke recovery centres, that I am persuaded will be in the long- term healthcare interests of those that I have been elected to represent.
“The creation of a ‘super hospital’, on the outskirts of Canterbury at the expense of the downgrading of A& E and other services at the QEQM hospital in Margate and the William Harvey Hospital in Ashford, does not fall into the ‘best interests’ category.”
Sir Rogers says that due to an increasingly elderly population and the road and public transport systems a large ‘teaching hospital’ would need to be in Whitfield rather than Canterbury.
He added: “There is also the small matter of the £800 million plus that would be required to build, staff and equip one large hospital, wherever it is located, together with the network of GP super- surgeries that would be required to support such a development. .That money is not at present available and funding is already committed, not before time, to expanding the A&E units at the QEQM and the William Harvey.
“The proposed new build offered by a property developer in exchange for a vast new housing estate in Canterbury could, if progressed carefully, provide a welcome replacement for some time- expired premises on the K&C site but it is not anything like large enough to accommodate the range of services that it is suggested would be located there.”
‘Unite and fight’
Carly Jeffrey, of the Save Our NHS In Kent campaign group, said the fight is for essential services in all three main east Kent hospitals.
She said: “Roger has thoroughly condemned a new hospital at Canterbury, but all he is doing is falling into the usual trap of one area fighting its neighbours for essential services. What’s the use in pushing to keep our hospital in Thanet full of the services we need, if other hospitals in the area are being degraded and suffering closures bit by bit?
“The downgrade of Canterbury’s emergency care some time ago has had an impact on Ashford and QEQM’s A&E – waiting times are now very bad. Let’s unite with Canterbury and Ashford, and say no to all of these centralisation plans – after all, there’s no evidence that centralising A&E improves patient outcomes. In the studies we’ve seen, the NHS throw money at centralisation plans, and the outcomes still don’t improve – they stay the same. Imagine if they invested that money and didn’t relocate services, which means longer journey times – maybe then we’d see a genuine uplift in patient outcomes!”
“We call on Roger Gale, Craig Mackinlay and everyone in Thanet to demand a third option for the A&E consultation next year. The option must be for full A&E and acute services in each of East Kent’s three main hospitals – in Canterbury, in Ashford and in Thanet. We can give this feedback now before the consultation begins, and the NHS managers should do as we ask, as consultation options are not supposed to be narrowed down in this manner, as they are attempting to do.”
Labour Parliamentary candidate for South Thanet, Rebecca Gordon-Nesbitt said the proposals appear to be a first step in downgrading QEQM services.
She said: “I have grave misgivings about the proposals being put forward by EKHUFT to centralise East Kent’s health services in Canterbury or Ashford.
“I disagree with Sir Roger Gale that the proposal to remove stroke and neonatal intensive care services from QEQM is in the ‘long-term healthcare interests’ of the people of Thanet. It feels very much like the first steps in downgrading Thanet’s hospital, and it seems sadly inevitable that other closures are now being proposed.
“The unpopular Health and Social Care Act – which Roger Gale’s party introduced in 2012 and which paves the way for chopping up, and privatising, the NHS – has this to say:
Each clinical commissioning group must, in the exercise of its functions, have regard to the need to—
(a) reduce inequalities between patients with respect to their ability to access health services, and
(b) reduce inequalities between patients with respect to the outcomes achieved for them by the provision of health services.
“Thanet suffers from huge health inequalities and poor health outcomes. By removing services from this deprived population, health commissioners would be failing in their statutory duty. Our MPs should be holding them to account.
“I am also troubled by the idea of putting the future of our healthcare in the hands of a private developer. We have the benefit of hindsight that public–private partnerships, especially in healthcare, rarely end well.”
Initial analysis carried out by the Trust estimated a new build hospital would cost circa £665.3million. However, this estimate was made before the offer from Quinn Estates to provide the hospital shell in Canterbury as part of a development of 2,000 new homes.
A similar analysis looked at the costs of removing all services from one site and relocating them onto the other two sites. The total cost of this proposal would be circa £436.9million
The document says of the Quinn proposal: “A proposal has been received from a commercial third party, to build the shell of new hospital in Canterbury, adjacent to the existing K&CH site and gift this to the NHS.
“This proposal represents an opportunity to consider a further option that would see the construction of a single major emergency centre with specialist services in Canterbury, on and adjacent to, the current K&CH site. This would be supported by two peripheral hospitals) no longer providing emergency care.
“The proposal from the developer represents an opportunity to establish a single major emergency centre with specialist services at Canterbury and would see inpatient services consolidated at this site from the QEQMH and the WHH.”
The document also states: “The provision of a single Major Emergency Centre with specialist services at K&CH and the provision of two supporting sites (Integrated Care Hub / Urgent Care Centre) would free up significant estate at both QEQM and WHH.”
‘Modern health services’
Caroline Selkirk, Managing Director of East Kent Clinical Commissioning Groups, said: “We want to test with the public our emerging proposals which are still being developed, led by doctors, nurses and others from the hospital and clinical commissioning groups.
“This will help us understand people’s views, and take onboard their ideas and concerns. It is a vital part of the process we need to go through as we identify options to take to formal public consultation next year.
“Our aim is to design modern health services that are high quality, meet people’s changing needs and are sustainable for years to come.”
The proposals are not yet part of a formal public consultation. It is expected that formal consultation on any proposed changes will take place later next year.