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06 May 2003

Horton General Hospital

My understanding is that the deficit of the Oxford Radcliffe Hospitals last year was nearer  40 million than the  20 million to which the Oxford Radcliffe NHS Trust will admit.

Certainly the predicted overspend of the Trust this year is  40 million and even with agreed plans to make savings of  12 million, the Trust still has a forecast overspend of  28 million.

To me, this gives the impression of an organisation that has lost financial controls and has no adequate financial control systems.

It is as against this background that the Trust has decided to have yet another Review of the Horton Hospital.

The actual terms of the Review have yet to be made public, but my understanding is that they will seek to focus on:

• What model of services the Horton Hospital can provide and should provide, and
• In what sort of shape the Horton Hospital should be in the future.

Clearly we cannot prevent the Oxford Radcliffe NHS Trust carrying out yet a further Review of the Horton, but I think it should be made very clear to all those responsible that so far as local people are concerned, there will be only one serious test of what is bring proposed:

• After any changes, will the Horton Hospital still be a general hospital providing the range of services that one would expect a general hospital to provide?

I anticipate that we may hear a lot of rhetoric about the Horton Hospital providing a "key element in the choice agenda" for patients in Oxfordshire, buzz phrases like "centre of excellence" and talk of "diagnostic and treatment centres". I fear the danger is that this is all going to be language and rhetoric which is going to be employed if we are not careful to seek to hide the fact that what is envisaged is in reality the downgrading of the Horton from being a general hospital to effectively a local satellite of the John Radcliffe.

What I envisage then happening over time is more and more key decisions and key services being transferred to the John Radcliffe and over time the Horton Hospital looking less and less like a general hospital and increasingly like a community hospital - although that will never be admitted.

I am also apprehensive that it is part of the agenda to discourage patients from Northamptonshire from using the Horton, obliging them to increasingly use medical services in Northampton. Referrals from Northamptonshire amount to a not insignificant number of patients at the Horton and obviously deterring GPs from referring patients from Northamptonshire to the Horton will further undermine the Horton�s viability as a general hospital.

I think the Thames Valley Strategic Health Authority is seeking to place the local Primary Care Trusts, i.e. the Cherwell Vale PCT based on Banbury and the North East Oxfordshire PCT, based on Bicester, in an invidious position by seeking to suggest that if there is any overspend in the Oxford Radcliffe NHS Trust it is their fault! This seems to me to be real scape-goating and simply seeking to deflect attention away from some crucial facts which are to me the clear responsibility of the Thames Valley Strategic Health Authority and the Department of Health �

• That the financial controls of the Oxford Radcliffe NHS Trust have broken down;
• A large part of the reason for this is:
• • the very heavy dependency at the John Radcliffe on employing agency nurses at the John Radcliffe and a failure by the Department of Health to provide reasonable "Cost of Living Allowance" for nurses and other medical staff in Oxfordshire and
  • a complete failure to sort out what part of the John Radcliffe�s budget is as a consequence of it being part of the University of Oxford and a teaching hospital and what part as a District General Hospital.

As co-operation in the past has demonstrated, the well-being of the Horton General Hospital is an issue that should and must transcend any party politics locally and I think it would be sensible for us to establish an Action Committee locally made up of representatives of all political parties locally and other community representatives to ensure that whatever proposals are put forward by the Thames Valley Strategic Health Authority and the Oxford Radcliffe NHS Trust are rigorously scrutinised as against the test of maintaining the viability of the Horton as a local General Hospital and if it should appear that that is not the agenda or the intention, to campaign vigorously and effectively to seek to retain the integrity of the Horton as a General Hospital providing the fullest possible range of general hospital services to patients in Oxfordshire, South Northamptonshire and South Warwickshire.

To establish such an Action Committee, a meeting is being called fro Friday 16 May at 17.30pm at Banbury Town Hall under the Chairmanship of the Mayor of Banbury, Councillor Mrs. Rosemarie Higham. I don�t envisage the meeting taking longer than about half an hour. I hope that it may be possible for you to attend.

I am copying this letter to all County Councillors, District Councillors and Town Councillors in Banbury and will also be inviting others with a key concern for the Horton Hospital to attend or to send representatives including local GPs, Medical and other staff at the Horton.

I think it is very important that as a community collectively we calmly and clearly put down a marker at the outset that we are determined to ensure that the Horton remains the Horton General Hospital and that it is not to be downgraded.

Tony Baldry