Minutes:
The Chairman had agreed the following requests to address the meeting:
Victoria Prentis MP
Cllr Eddie Reeves
Rt Hon Sir Tony Baldry DL
Cllr Andrew McHugh
Cllr Rosie Herring - SNC
Cllrs Jacqui Harris - SDC
Keith Strangwood, Chairman KTHG
Victoria Prentis
MP
Victoria Prentis MP thanked the members of the Committee for their
efforts and thanked mothers for their powerful evidence to the Committee.
Speaking for the whole area Victoria Prentis MP stated that they were
furious at the recommendations but would not give up. Needs in the area had not
diminished since 2008 and there had been population growth and increased
traffic congestion. It was not that local people distrusted the service offered
at Oxford but simply that it was too far away. She expressed shock that her
traffic survey was the only one available and highlighted the experience of
people travelling on average 1 hour 40 minutes to The John Radcliffe Hospital
(JR) whilst in labour.
Victoria Prentis MP was encouraged by the suggestion of an annual review
(chaired by herself) and by discussions on working together to apply for
funding for essential rebuilding. She expressed her displeasure that over the
last three years no applications had been made.
Councillor Eddie Reeves
Councillor Eddie Reeves, County Councillor for Banbury Calthorpe, which
included the Horton Hospital, stated that this was the fourth time he had
spoken in the last two years and there had not been a lot of change in that
time. The de facto downgrading of The Horton was on the cards. The public
consultation given the manner of it was consultation only in a very elastic
sense. What remained as a fact was the geography of the area. The Committee had
heard the harrowing testimonies in December and Councillor Reeves felt that the
OCCG and OUHT had not engaged meaningfully with the evidence. The cynicism felt
by local people due to past experience had not been
addressed.
Local people believed that poor administrative decisions were being
presented as good clinical decisions. He asked that no-one be under any
illusion about the strength of feeling. It had not abated.
Sir Tony Baldry DL
Sir Tony Baldry DL, speaking against the recommendations made a number of points:
·
He urged
the Committee to refer the decision back to the Independent Reconfiguration
Panel. He referred
back to the decision of the Independent Reconfiguration Panel in 2008
which had not supported the Trust’s proposals to reconfigure paediatric,
gynaecological and obstetric services because they failed to provide an
accessible or improved service for local people. Since then nothing had changed
except the growth in the population in the area.
·
He
questioned what type of provision the Horton Hospital was now providing. Was it
a general hospital or a hospital at all or was it just a random collection of services. In 2008 it had been described as a General
Hospital but looking now it would not necessarily be considered the case. He
asked the Trust and OCCG to set out the vision for the Hospital and the
services to be provided.
·
In not
applying for funds during this period the local community were effectively
being punished for their opposition to the proposals.
Councillor Andrew McHugh
Councillor
Andrew McHugh, Cherwell District Councillor for Adderbury, Bloxham and Bodicote, expressed
his devastation at the recommendations set out in the paper to the OCCG Board
on 26 September 2019. He had been hoping that the change in Leadership in OCCG
and OUH would have led to
break in the Oxford centric approach and the start of place based
services.
As a member of Cherwell
District Council executive and the Oxfordshire Health and Well-Being Board he
had been pleased to work with the Trust and with the CCG in order to help
secure the health system that I, and the vast majority of North Oxfordshire and
surrounding district residents, feel we need. At the Cherwell Community
Partnership Network, the CCG had spoken of its ‘Population Health and Care
Needs Framework’. This document outlined the way in which the CCG would engage
with communities to identify population health and care needs now and in the
future. It talks about an approach that is open and transparent with high
levels of engagement to develop future models of care to meet identified need.
Mr McHugh stated that
he had embraced this Framework in good faith. At times, he had felt uneasy with
what I was being asked to do. He took part in the scoring panel for the options
appraisal for Horton obstetrics. I was uneasy because if as part of the scoring
panel, it was shown that having two obstetric departments was unfeasible, he
would be seen as guilty of finishing off Horton
Obstetrics. He had been surprised and delighted when the weighted scores of the
scoring panel showed option 9- two separate obstetric departments, one at the
Horton, one at the JR to be the best option, albeit by a narrow margin.
With
regard to
difficulties in recruitment Councillor McHugh stated that the Trust had told
him that the presence of the KTHG banners around Banbury had created a negative
impression that resulted in some good candidates choosing not to proceed with
their application following a site visit. If this is the case that could have
been easily remedied by the Trust and the CCG announcing their newfound faith
and confidence in the two obstetric department option. If that had been announced,
it would have been very easy to create the right “civic atmosphere” to attract
the brightest and the best.
Councillor McHugh
announced concern at the open ended nature that the proposals for maternity at the Horton
were for the foreseeable future. At the very least the decision needed to be revisited on an annual
basis.
Councillor McHugh added
that the CCG paper talked about developing a plan for the Horton including
flexible clinical space that could possibly be used for obstetric services as
well as other services. He was pleased to report that he had this afternoon,
seen some evidence of The OUH starting to move towards meeting that commitment.
If the trust of the
people of Banburyshire was to be rebuilt evidence of
good faith was needed. Dates, plans, contracts tendered, work started were
required.
Whilst welcoming the
offer of a redeveloped Horton he would continue to fight to ensure that
obstetrics are a part of that redevelopment.
Councillor Rosie Herring
Councillor Rosie
Herring, South Northamptonshire District Councillor for Danvers and Wardoun expressed disappointment but not surprise at the
recommendations in the paper. She welcomed that the door had been left open for
services to resume at some time in the future. The Horton Hospital wa an asset for the whole Trust. Councillor Herring
referred to the opportunities in place for mothers to visit the JR in advance
of their labour, but this service was massively oversubscribed. The hot line
referred to should go further with a holding site available for mothers to come
in early. Councillor Herring welcomed the facilities making it possible for
fathers to stay but there was a need to put provision in place so that they
were not expected to drive home, with mother and baby once discharged unless fit
to do so.
There was no reference
to the ambulance currently sited at the Horton in case of emergency transfer
being retained and she assurance on this point.
Councillor Herring welcomed
recommendations 6 and 7 but queried who would monitor this. It should be part
of someone’s job description to monitor and report regularly to the Oxfordshire
Joint Health Overview & Scrutiny Committee. In addition
the engagement with mother’s should be an ongoing commitment.
Keith Strangwood
Keith Strangwood, Chairman of the Keep the Horton General (KTHG)
commented that the contents of the report were expected.
Referring to the report
detail Mr Strangwood:
·
Stated
that the annex quoted 46 midwifes were needed to reopen unit. The unit was
previously being run by 29 in total at 5 per shift. not the 46 that the report
states are needed. This was confirmed by a ex midwife
at time of temporary closure
·
Noted
that refurbishment of the maternity block is quoted in the report at a cost of
£17.1 million. Yet in December 2018, a GK condition report requested by the OUH
quoted £10.3 million for the whole Horton site, with the maternity block part
costing £1.3 million. At a CPN meeting,in
June 2015 Paul Brenan ex OUHFT confirmed that if the SOSH/HHOSC decided
Obstetrics had to be returned, the finances would be found to do so.
·
Stated
the report also quoted that obstetrics at the Horton would cost £9.463.357 per
annum to supply. When the unit was running prior to closing in 2016. it was
costing £2.3 million PA. The report also
stated that only a MLU service would currently cost
£2.6 million, £300k more than the full Obstetrics unit was costing in 2016
·
Queried
the level of estimated births if a Obstetrics unit was
returned to Horton (1060 per year as set out in the annex table 7). He
commented that in the last year of a full Obstetrics service Horton delivered
1466 babies.
·
Highlighted
that from the figures quoted for overall births there is a decrease of around
500 overall, choosing to give birth at neighbouring trusts. This
constitutes a f loss of income to the OCCG.
In
addition, Mr Strangwood noted the importance of the
reinstatement of the training accreditation to reinstating Obstetrics at the
Horton.
Mr
Strangwood argued that the data needed to be
independently verified before being presented to the OCCG Board. He noted that having always been told that it
was not about money that now seemed to be the main point.
Mr
Strangwood thanked the Horton HOSC for their work and
suggested that the matter must again be referred to the Secretary of State for
Health requesting a full Independent Reconfiguration panel review. The report
stated that since the downgrade of Horton to MLU, it had been proven to provide
safe quality services overall. He referred to specific examples where the
people involved would not agree.