Minutes:
The following request to speak at Agenda Item 5 had been agreed from
Councillor Andrew McHugh – as Cabinet Member for Health and Wellbeing, Cherwell District Council
He re-stated the wish of Cherwell District Council (CDC) to see obstetrics re-established at the Horton Hospital and offered CDC as a strategic partner to work with the Trust and/or the CCG to help ensure that this was achieved.
Councillor McHugh welcomed the Trust’s decision to embark on a recruitment programme in South Asia. He had become aware, from a reliable source, that there were a number of highly trained, highly motivated and highly suitable candidates in both nursing and medical roles. He understood that the campaign in South Asia had been focusing almost exclusively on recruiting nursing and midwifery staff. If this was the case, he felt that this might call into question the seriousness of the Trust in trying to recruit doctors for obstetric posts at the Horton. He suggested that the Committee re-visit the commitment of the Trust in relation to this.
He stated that he had attended a stakeholder engagement event, organised by the CCG, concerning options for the Hospital. He felt it was well organised, and was pleased to see that the CCG had taken on board the points raised by Councillor Hudspeth at the 19 December meeting of this Committee. He had suggested that there could be a re-drafting of the catchment areas for the future obstetric service. Councillor McHugh pointed out that the CCG report before the Committee today included CCG projections for additional births based on predicted housing growth. These predictions predicted between 800 and 1600 additional births per year by the year 2031 in an expanded Horton catchment area. He wished to emphasise to the Committee that these projections were based on current District Council projections and did not factor in any additional growth that was likely to come with the Oxford-Cambridge arc. He added that what he thought the projections showed was that it would be possible to establish two mutually supportive obstetric services – one at the Horton and one at the John Radcliffe, sharing the 8.5k (approximate) births per year.
Another point raised at the stakeholder engagement meeting was that the John Radcliffe had spare capacity. He refuted this, pointing out he had understood from reliable sources that the system was under stress, the system that, in order to deal with pressures of demand, had had to close the midwife-led unit at the Horton, in order to redeploy midwives to the John Radcliffe. It was his view that two obstetric units would be able to mutually support each other to balance out the peaks and troughs in demand in the two locations.
He informed the meeting that the purpose of the stakeholder day was to review the criteria by which the various options for obstetrics in Oxfordshire would be compared. There were 14 separate criteria covering domains of quality of care, access, affordability and value for money, workforce and ease of implementation. He pointed out his belief that one domain had been ignored which was deprivation and health inequality. The CCG had responded that health inequalities was covered in the first two domains. He reported that he was unconvinced of this, stating that one of the reasons why he wanted the obstetric service to be maintained at the Horton was in order that a service could be delivered to the women and families of the deprived areas in Banburyshire and West Oxfordshire (he was not disputing that the 11 wards in Oxford and Abingdon were also in the first or second decile for multiple indices of deprivation, but these were within easy reach of the John Radcliffe Hospital. The remaining wards were situated in Banbury). Councillor McHugh reminded the Committee that the link between deprivation and poor health outcomes was clear. Numerous studies had reinforced this link, more specifically in obstetrics, a possible link between deprivation and more severe maternofetal morbidity had been identified in the work of Convers et al, published in the friend journal Gynaecology, Obstetrics and Fertility in April 2012.
He concluded that any future decision on obstetrics across Oxfordshire that did not see the reintroduction of an obstetric service at the Horton would be embedding and formalising health inequalities for the deprived communities of Ruscote and Grimsbury. He believed it essential for openness and transparency that the effect of each of the options before the Committee on deprived communities in Banbury and surrounding area was assessed alongside the other 14 criteria. He requested the Committee to scrutinise this.