Tuesday, February 06, 2007

Hospital Campaign built on thin air?

When I first heard about the Campaign for Pease Pottage Hospital, I was suspicious, it sounded just like an opportunistic attempt by local Tories to jump onto a bandwagon.

After some time, the campaign has produced a document, which they say backs up their case and anyone who disagrees is clearly just trying to land political blows.

Having now read the extensive (!) 7 page proposal document, I am even more sceptical about the Smith-Maude campaign.

First of all, I spotted at least two spelling mistakes. Now, that may mark me out as a pedant, but they are clear and they are evidence that the document was not properly proof-read. One wonders if any of the numbers are also incorrect.

Next, it is full of assumptions. Firstly, that the acute healthcare spend in Horsham PCT per person is uniformly applied across the other areas covered. Secondly that the percentage of that to be spent at the new hospital would be 75%. Thirdly that the refinancing (what we call interest) rate would be 7%. Fourthly, that East Surrey Hospital will be affected but will still be tenable if it widens it's catchment along the M25 (but no consideration of the knock on effects to the East or West of Redhill) - oh, but if it isn't the new hospital would be able to cope and the people of Redhill and Reigate would be happy.

There are lots of numbers, but some are given as 'of the order of', or 'indicative' (which means that they are not accurate estimates) and others are absolute, despite seemingly having been derived from the earlier estimates. The operating cost is given based on Frimley Park, but no more local hospital 'given their state of turmoil', and because that is a larger hospital it is scaled, but the scaling has not been enumerated. Are there local factors which differentiate this area from Camberley such as housing pressure?

Some startling omissions as well. Nowhere is training mentioned. Nowhere does it refer to Royal College guidelines. Why should it? Because the Royal Colleges suggest that for training to be of sufficient value, a unit must have a decent catchment area, of around the 400-500,000 range. In order to attract employees, a hospital really wants to be recognised by the Royal Colleges, as most doctors want to move up the ranks and gain experience. The proposed 300,000 catchment area might be too small, and this was pretty much the same problem that Crawley Hospital had in the first place. Find me an acute hospital which has lost accreditation from a Royal College and where that service is not under threat (or already gone).

Also, this would not be a PFI hospital, it would be privately managed, rather than being run by the NHS and leased from a PFI vehicle, according to the proposals. Do we have such a hospital in the UK? Would the managers seek to carve out part of the hospitals facilities for lucrative private care? What will the costs be to the NHS of oversight of a privately run hospital? Will the operating company be allowed to make a profit? If it makes a loss, or suffers financial strain, what are the guarantees that services will be maintained?

Bagnall's report was far more detailed, and we were able to see the 'working out'. I supported the Bagnall Plan because it was well considered and the proposal was a viable 776-bed hospital. The C4PPH proposals are, going by a document of seven pages, less grounded in detailed research and less sustainable.


Richard W. Symonds said...

Your first paragraph says it all for me...except for mentioning our little Henry, who has a big problem with 'Foot in Mouth Disease'...

Danivon said...

Well, I think that it is important to try to challenge your initial assumptions.

I tried, but the document is pants. If I produced something of that quality for work, I'd get a rollicking, and this has apparently been signed off by Henry & Francis as well as being approved by several local bodies.

Standards are slipping

Skuds said...

Ah yes - but it uses phrases like "isochrone analysis" so it sounds very scientific.

On the other hand, it also uses phrases like "although detailed analysis will need to be undertaken". All well and good for an outline, but the initial hype implied that there was something a lot more substantial than an outline. Or even a "full outline"

They still talk about "fully costed" proposals but then give a breakdown of the £168 million capital cost in 3 lines - and one of them is a 25% contingency! If I was getting my driveway paved I would want a more detailed estimate than that.

Even the name is misleading. The scant 7 page document finds room to more or less say that there are problems with Pease Pottage's AONB status and that near the A264 juntion would be better from that point of view, but the whole thing is called the campaign for Pease Pottage Hospital.

By the way, did your list of spelling mistakes include "Cottismore"?

Skuds said...

The one thing I would have liked to see there is an opinion from Crispin Blunt...

Danivon said...

That was one of them. The other two are out there to find. It seems that they spellchecked it, but didn't proof read it.

I also posted this on the Maidenbower forums. Duncan has already led the reaction...

Skuds said...

Dammit. I have just been over there and found you have been busy saying all the things which I would have wanted to say - and then a lot more besides.

It seems I did not get there quick enough to see Duncan's comments which were deeemd to be so offensive that a moderator edited them out of his post - was it anything juicy?

Danivon said...

Just accusing three other users of being the same person and coming from Ashington.

The responses from FFS, Becker and Hamish pretty much tell you what they were reacting to.

'Cllr Crow is a liar'. Oh, Duncan, why do you do this to yourself?