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.