Why we must fight these latest threats to the Horton Hospital, Banbury…
Why we must fight these latest threats to the Horton Hospital, Banbury…
(This is the text of a letter I have just sent to my local MP, Victoria Prentis, copied to the Prime Minister, and Jeremy Hunt, Secretary of State for Health)
THE FUTURE OF THE HORTON HOSPITAL, BANBURY
It is with consternation and deep concern that I view these latest proposals of the OUHFT (Oxford University Hospitals NHS Foundation Trust) to downgrade or close a number of vital departments at the Horton Hospital. I am sure you must be receiving countless letters to this end, but I feel compelled to add my voice to the many. That the OUHFT is even considering this reckless course of action is bad enough, but these proposals now seem to have been overtaken by the closure of Oak ward (and a loss of 36 beds) without any prior consultation, plus the drastic announcement that with the resignation of three doctors, the Maternity department will be downgraded from Consultant Led to Midwife Led care as of September, should their dubious endeavours to fill these vacancies prove unsuccessful, resulting in up to two thirds of Banbury women being transferred to the John Radcliffe or other hospitals to have their babies. This cannot be allowed to happen.
I was recently made aware of a statistic that for every ambulance mile travelled, the patient’s risk of death increases by 1%. The distance and travel time between Banbury and Oxford has to be the most serious and objectionable issue with the proposed downgrade of the Horton maternity unit, and, given reports of ambulance journeys of well over an hour, I am gravely concerned that mothers and babies requiring urgent treatment will die. Indeed, a retired Horton nurse I used to know said that colleagues colloquially referred to the ambulance journey from Banbury to the JR as ‘the death run’. Since the IRP report of 2008 which rejected the closure of the Horton maternity unit on these grounds, the only thing that has changed is that the unit is more needed than ever because of the vast and continuing population increase with thousands of houses being built in the area year on year. For this reason alone, it is unthinkable nonsense to downgrade services which surely need augmenting instead!
For years now, British women have been able to exercise their choice over how and where to give birth, medically permitting, and I think that this is one of the hallmarks of a civilised society. But by forging ahead with these proposals to downgrade the Horton maternity unit, the OUHFT would be denying local expectant mothers the deserved right to choose to have consultant led care in their local hospital. It will be forcing the most deprived mothers-to-be to have what would be effectively a home-birth at their local hospital, without the choice of an epidural, or access to surgeons should they require it. How can we consider ourselves a civilised society if our provision for medical care is diminishing, if we are taking backwards steps in the safe delivery of babies, and if hospital trusts are making decisions that will increase, rather than decrease, the risk of loss of life?
I feel especially strongly about this issue because my daughter, Clementine, was born at the Horton last September, during the busiest time of year for the unit. With only six birthing rooms, the unit was closing and diverting women to the John Radcliffe on and off in the run up to my daughter’s birth. (It occurs to me that birth rates would be even higher at the Horton if they didn’t have to close the unit during busy periods and I wonder what the number of births would be per year if all the women due to give birth there were actually able to?) I had an excellent midwife, and was also lucky enough to be able to give birth in the one pool available on site. Mine was a low risk pregnancy, and there was no reason to suspect that after such a good and calm birthing experience anything would go wrong. It was only after I got out of the birthing pool that the midwives realised I had torn a major blood vessel, and lost two litres of blood in the space of about five minutes, despite my wonderful midwife doing her best to stem the blood-flow herself. A team of fantastic doctors and nurses arrived within seconds and I was rushed into theatre when attempts to stitch me up under a local anaesthetic failed. I lost consciousness and so the tear was repaired under general anaesthetic, and I was given a blood transfusion. I had to stay in for two further nights during which I was monitored and received a further blood transfusion.
One of the consultants who looked after me told me that if it hadn’t been for the swift action of the team on duty, he would dread to think what the outcome would have been. This, to me, speaks volumes and I believe that if this were to have happened without any access to consultants, I might well have bled to death in an ambulance en-route to the JR. I will be eternally grateful for the care Clemmie and I received, but it is a sobering thought that I am only alive today because of the presence of expert skilled professionals, especially as we would eventually like to have another child. Severe postpartum haemorrhage (which is classed as losing two litres of blood or more) affects 6 per 1000 mothers but research indicates this number is rising. Added to this the UK’s unacceptably high rate of stillbirths in comparison with other countries (2.9 per 1000 births, far higher than Iceland, Poland and even Korea), and we have a recipe for disaster if this plan to downgrade the unit goes ahead.
The aftermath of my daughter’s birth was a very traumatic and difficult time for us as a family but it was made more bearable by being looked after by a brilliant team, as well as being within easy reach of family who could visit around the clock. My poor husband who had feared the worst for me, was able to stay overnight with our baby and me in a private room, plus go home for naps and bring things for us, as our home in Bodicote is barely a mile from the hospital. I cannot imagine how much more difficult and traumatic the experience would have been for all of us if my husband and family had not been so close at hand. At a time when women are at their most physically and emotionally vulnerable, this makes a big difference.
One imagines that the OUHFT must be gleeful that the resignation of these three doctors in the maternity unit has played so conveniently into their hands. The OUHFT has now advertised these vacancies on temporary contracts (ending in February next year), and on fairly unappealing terms, for example, without training prospects for the post-holders. If the Trust really was as keen as it claims to be to recruit replacements to continue with Consultant Led care, then why advertise the posts on five month contracts as if the downgrade of the unit is a fait accompli? Furthermore, if these sorts of clinical research fellow posts do not compete with similar roles nationwide to enable doctors to develop skills and specialise, or to gain higher qualifications as part of the job package, candidates will simply go where the prospects are better. It seems very much as though these roles have been made deliberately unappealing so as to ensure the perpetuation of a vicious circle, created by the OUHFT’s lack of investment in staff at the Horton. This way the Trust receives scarcely any applications for the posts, resulting in a permanent downgrade of the unit on the grounds that they cannot attract the staff needed to safely run the department. And they won’t even be seen to swing the axe!
In the short-term, surely the most logical and low-impact solution to this staffing situation would be to rotate staff between the JR and the Horton. In fact, the IRP made recommendations instructing the OUHFT to rotate staf for, but this has also apparently been rejected by the Trust because it would involve amending contracts which currently don’t allow for this. Surely this is hardly an insurmountable obstacle?! The conclusion that I have come to is that there is no reason that the hospital couldn’t be a fully staffed, well regarded training facility, if the Trust so wished it. Neither do I have any faith whatsoever in the OUHFT’s so called consultation process, which in past similar situations has been so after-the-fact, obfusc and ineptly organised that one suspects their incompetence in orchestrating a fair and transparent consultation process was deliberate.
The above seem to me to be shameful ploys to bring about the downgrading of our hard-working hospital by the back door. The NHS cannot be run as a business whilst still prioritising the preservation of life, and the saving of lives cannot be conveniently centralised to save money. The founding principle of the Hippocratic oath is to do no harm. What a shame this credo does not extend to the decisions of the Trust’s management. These proposals, if carried out, will do significant harm to the people served by the Horton, which in my opinion far outweighs the financial saving to the OUHFT a downgrade would result in.
Everyone I have spoken with about this is thoroughly fed up with the Horton being treated as the poor relation to the John Radcliffe, and seemingly constantly subject to downgrades and further threats. I urge and implore you, therefore, to continue to do all that you can to retain these essential functions of the Horton in full, and to rally around your constituents in the fight against this latest threat. Hospital downgrades are becoming regrettably commonplace and are symptomatic of the government’s perceived underhand and insidious dismantling of the NHS, but with your help, the OUFHT will learn that people of Banbury are a force to be reckoned with and simply will not accept these ‘ship-breaking’ plans for their precious hospital.