Wednesday, June 22, 2005

Local Issues - 1. Hospital

Right. The Hospital. This is a big issue, and has been for years. Longer than people realise, I think - the original Hospital campaign was set up to get one built, which it eventually was in 1961. In the wrong place. That's where the trouble really started.

West Green is not a bad place for the hospital, but it is far from perfect. Because the site was small, they built up. There were always rumours of expansion, either over Ifield Road or on the old Primary School site. However, in the mid-80's the last time that more investment was put into the Health infrastructure, Crawley lost out. Big time.

Redhill got its old hospital replaced by East Surrey. That wouldn't be a problem on its own, but the real kicker was the building of the Princess Royal to the south of Haywards Heath. At the time, it would have been better to replace Crawley with a major hospital to the south of the town, Pease Pottage would be (and still is perfect). However, political pressure from local notables (you'll see who they are, they have parts of PRH named after them) led the Tory government to build in their areas.

Ten years later, the NHS under the Major Government was talking seriously about closing Crawley down altogether. That was the first time the recent Hospital Campaign got active. Luckily, the threat was withdrawn and the Trust merged with East Surrey. Unfortunately the new trust seems to have been dogged by management and financial problems ever since.

By 1999, when the changes that everyone is complaining about were first officially suggested, things had changed for Health. Whereas a General Hospital serving 100,000 to 250,000 people used to be suitable, providing enough opportunities for training doctors and consultants, nowadays the Royal Colleges are saying that 400,000 to 500,000 people is the right catchment area. This presents a problem for the area between Croydon and Brighton - three Hospitals cater for an area which is too small - if they want to be training hospitals (and they do - or they won't attract any decent young practitioners). The PRH was moving towards Brighton, and Crawley and East Surrey shared the same Trust. And that Trust got to the state where it had to concentrate services on one site, or face losing training status for both.

Without a new build, it is (unfortunately) obvious that East Surrey has better scope for improvement than Crawley. And with East Surrey and PRH so close by, it is very hard to justify a brand new hospital at Pease Pottage. That doesn't mean that it doesn't make sense to do it, but it makes it very hard to convince the bureaucrats in the NHS that this is a good idea. They have far more weight than a local MP ever will (which is just as well, as the problems caused by politically motivated hospital building got us where we are now...). It was essentially the Trust, the regional NHS (and then the Strategic Health Authority) that made the decisions. The Health Secretaries and Ministers of the time were simply acting on advice.

When the local SHA looked at the Bagnall Review, they duplicated the financial work, so reducing the attractiveness of a new build. They then said any new build would have to be financed by the local Primary Care Trusts. The Surrey PCTs voted against any such help, as did the Horsham PCT, while Crawley PCT stood out alone, and so even though they wanted to help, they couldn't act alone.

So, the Hospital Trust carried on with its plan. To make matters worse, they didn't put it into practice very well. Something that had apparently been planned for 5 years (the transfer of A&E) happened as if it was planned on a Sunday evening on the back of a fag-packet. Lack of communication with the local Ambulance service meant that too many minor injuries were sent to East Surrey, resulting in queues. There have been a few changes at the top, but the problems of managment and finances just won't go away.

So, who do people blame?

The Council. Well, this is completely silly. First of all the Borough Council has almost zero responsibility for Health, and so by law is actually not supposed to provide a hospital. What it has done, as long as I can remember, is to support the building of a new Hospital (to the point of offering a site), oppose cuts at Crawley, organise at least one of the demonstrations held in the town. Several councillors (including myself, the current Leader Chris Redmayne and two who lost their seats in 2000 - Chris Mullins and Bill Ward) were actually involved in the Hospital Campaign, until we were forced out because of the ideological intransigence of the SWP-inspired organisers. So, no. The Council is NOT to blame.

The local MP. Laura only really made one mistake. In 1999, instead of instantly and unequivacolly (sic) coming out against changes, which would have been universally popular, she decided to look at things in detail. In the end, she did come out against the changes, but by then the rumour-mill (fed by the trots again) had it that Laura was in favour. Despite the fact that she was instrumental in getting the Bagnall Review, people think that she did nothing. I know exactly what Laura has done, the lobbying on our behalf, and unfortunately it was never going to be enough. The decisions were effectively made already, and no MP could have made much difference. In fact, our previous MP, Nicholas Soames, did virtually nothing when the complete closure was mooted in the mid-90's. Perhaps because he knew he was going to stand in Mid-Sussex by then.

The Government. There is some responsibility here, after all, they hold the purse strings for the NHS, they approve or deny changes like moving A&E or building a hospital. Certainly Alan Milburn did nothing to assist, apparently ignoring letters from locals (well, not replying anyway). However, nationally I think that they have done a lot for the NHS. At least they are building new hospitals, at least waiting lists are falling, at least Cancer survival rates are improving. While they didn't do what we wanted and give us a new hospital, they did put extra money in to improve Crawley and East Surrey.

I can understand why people blame the local Council or MP. It is easy. So easy to point at a politician because they are there to represent you. It is far harder to point the finger at a quango, a team of bureaucrats, a Royal College, or whoever.

Oh, and half the people that complain now were nowhere near the campaign when it really needed support, back in 1999-2001. To those that were, you will remember the work that was put in, and the disappointment we felt each time a decision went the wrong way. To those that weren't - perhaps you are complaining so much to offset your own guilt?

By the way - Henry Smith didn't get involved with the Campaign until he had already been selected as candidate for the 2001 election. While some Tories were around, or did give support (Richard Burrett and Robert Lanzer), his 'intervertion' stunk of opportunism. And if he had become our MP, he'd have had the same weight as Laura - virtually none - while annoying the established Tory MPs in Reigate and Redhill, who are happy that East Surrey was not downgraded in favour of Crawley.

(ooh, controversial, huh?).

4 comments:

Skuds said...

Very useful. Thanks.

Looking forward to No. 2

Gatwick Expansion? Town Centre redevelopment? Travellers? Council Housing transfer? Library provision?

Just stay away from the really controversial topic - cutting grass verges!

Danivon said...

I won't touch the verges (insert your own punchline here)

When I get some time, no2 will be Housing Stock Transfer. Now that the Council has made a decision, I can get into it a bit.

no3 was going to be Gatwick or Travellers. Or something really gritty, like why are the DLs at Ikon/Diva and Brannigans so awful?

Skuds said...

Ooh..

and I forgot Fastway, schools PFI, the North-East sector and new housing/new neighbourhoods generally, flooding, mobile phone masts, Surestart, cycle path provision, and.... pigeons.

Should keep you busy for a while

Danivon said...

Yeah well, I am busy now - I have left the bench and am working again. Luckily it's only 20 miles away.