NHS Suffolk board invited to Haverhill to hear clinic closure protests
Wednesday, 2nd May 2012.
In the wake of its poor efforts at a public forum last week to justify closure of the Crown Health Centre, NHS Suffolk has now received an invite to hold a board meeting in Haverhill.
Haverhill town clerk Will Austin, on behalf of the town council, has made the invitation in a strongly-worded open letter to the primary care trust's chief executive Paul Watson.
In it, Mr Austin explains councillors accept the possible closure of the centre, but only if services are replaced in other ways, which they claim is not part of NHS Suffolk's plans as they have been explained so far.
The full text of the open letter is as follows:
"Firstly, please pass on my thanks to Martin Royal for his attendance at both the town council meeting in January, and his subsequent visit to the ONE Haverhill Public Forum on April 26. The robust receptions he received must have been challenging for him, but I cannot apologise for this – it simply reflects the strength of feeling within the town.
"The town council considered the decision at its meeting on April 24, and I now write to tell you that we take exception to the way in which this decision has been arrived at, and to the apparent absence of a detailed plan to accommodate the needs of former Crown patients after October.
"This is not to say that we consider the Crown Health Centre to be indispensable. The town council accepts that the Darzi Centre may not be the most efficient way of delivering health care and understands your desire to consider more cost-effective routes. It is, however, wholly unacceptable that you have not yet considered how GPs will be resourced to accommodate the 900 registered patients of the Crown, and the 22,000 unregistered attendances it currently deals with annually. The report on which the PCT Board made its decision makes vague platitudes on this issue, but the people of Haverhill expect and deserve to know how exactly how their health needs will be met after the closure.
"At the ONE Haverhill meeting, Martin referred to a process to re-register the Crown’s registered patients, but as yet nothing appears to have been done other than relying on concerned patients re-registering themselves. He also talked about educating patients '…to access services in a different way', but with no plan for achieving this, and the only practical reference was the use of pharmacists. I feel sure this is not the only route that will be recommended, but many will perceive the message as being that doctors will be replaced by pharmacists.
"Martin claimed that GPs would work longer hours to compensate for the closure, and Harmoni have indicated that the out-of-hours service could be adapted, but there is no indication of where the funding will come from, and it seems that detailed discussions are not yet under way to achieve this by October. Furthermore, with many patients reporting waiting times of two weeks for a GP appointment now, and with no target for waiting times, those present found it hard to believe that there is any coherent plan that will enable them to receive timely diagnosis and treatment.
"The PCT appears oblivious to the major change process that will need to be implemented to facilitate the transition from a Darzi Centre to other ways of accessing healthcare in Haverhill. You have spent years cultivating a culture that relies on the walk-in facility, and now anticipate that people will simply change their habits overnight. Even if you do provide additional GP resources, the immediate service provided by the Crown will surely simply prompt people to circumvent the appointment process by attending A&E, thereby undermining your efforts to reduce A&E attendances. After all, the Centre was set up in part to address rising A&E attendances, so what is it that makes you think people will not simply revert to that route?
"These issues have been raised repeatedly throughout the ‘engagement’ process you have conducted, but have been summarily ignored along with a range of additional matters:
The promise of x-ray and other diagnostic equipment, made when the Crown was opened;
The increasing population of Haverhill, expected to rise to some 35,000 over the next 20 years;
The increase elsewhere in A&E attendances compared with flat growth in hospitals serving Haverhill, which suggests that the Crown is not failing in its role in this regard;
There has been no evidence presented to show that A&E attendances from Haverhill are any less valid than those from other areas; and
The out-of-hours service has been reduced and already refers many patients to the Crown and to A&E, so there is little to indicate that it can help in addressing the excess demand created by the closure.
"It is an insult to the people of Haverhill that you have arrived at your decision without even having the courtesy at least to respond to these issues. Indeed, Martin’s presentation to ONE Haverhill appeared to re-inforce the view that Haverhill is at best ignored, and at worst actively derided by the PCT. At one point he appeared to justify the decision in part based on one anecdotal and unsubstantiated example of someone attending A&E with a cut finger. This is simply deplorable and warrants a public apology.
"Haverhill may be a long way from Ipswich where your decisions are made – in private. However, this does not mean that we are not entitled to a voice; nor does it mean we are any less of a priority than other parts of Suffolk.
"Matthew Hancock MP attended the ONE Haverhill meeting and confirmed that NHS Suffolk has received an additional £24m this year. Not only does this bring into question your protestations that budget reductions are required, it also suggests that Haverhill is being targeted for service reductions while other areas are presumably benefiting from the additional support you are receiving. We insist that we get a demonstrable fair share, and if this is alongside the closure of the Crown, we demand the equivalent investment in the GP and out-of-hours services.
"It is clear that you have not thought through the consequences in arriving at your decision, and that you have not paid attention to the needs and views of our town. You do have an opportunity to reassure us, however. The town council considers that the closure does not have to happen immediately. The borough council has confirmed that the lease and planning permission could be extended, and this would allow time for a meaningful consultation process, an effective education programme that does not threaten the health of residents, and a proper plan that provides effective primary care to the people of Haverhill.
"To enable a full and accountable discussion of these issues, the town council invites the PCT board to meet in public in Haverhill. Town councillors will be only too happy to represent the views of residents to the board at that meeting, and to engage in constructive discussion over future provision. We consider that the board was misled and under-informed by the report on which it based the closure decision, and we believe that if Board members are fully appraised of the reality of healthcare in Haverhill, they will accept that your plans are inadequate. We have a vision – not for the indefinite retention of the Crown, but for a facility that properly serves the town and its future expansion, and we look forward to sharing it with the board."
Haverhill town clerk Will Austin, on behalf of the town council, has made the invitation in a strongly-worded open letter to the primary care trust's chief executive Paul Watson.
In it, Mr Austin explains councillors accept the possible closure of the centre, but only if services are replaced in other ways, which they claim is not part of NHS Suffolk's plans as they have been explained so far.
The full text of the open letter is as follows:
"Firstly, please pass on my thanks to Martin Royal for his attendance at both the town council meeting in January, and his subsequent visit to the ONE Haverhill Public Forum on April 26. The robust receptions he received must have been challenging for him, but I cannot apologise for this – it simply reflects the strength of feeling within the town.
"The town council considered the decision at its meeting on April 24, and I now write to tell you that we take exception to the way in which this decision has been arrived at, and to the apparent absence of a detailed plan to accommodate the needs of former Crown patients after October.
"This is not to say that we consider the Crown Health Centre to be indispensable. The town council accepts that the Darzi Centre may not be the most efficient way of delivering health care and understands your desire to consider more cost-effective routes. It is, however, wholly unacceptable that you have not yet considered how GPs will be resourced to accommodate the 900 registered patients of the Crown, and the 22,000 unregistered attendances it currently deals with annually. The report on which the PCT Board made its decision makes vague platitudes on this issue, but the people of Haverhill expect and deserve to know how exactly how their health needs will be met after the closure.
"At the ONE Haverhill meeting, Martin referred to a process to re-register the Crown’s registered patients, but as yet nothing appears to have been done other than relying on concerned patients re-registering themselves. He also talked about educating patients '…to access services in a different way', but with no plan for achieving this, and the only practical reference was the use of pharmacists. I feel sure this is not the only route that will be recommended, but many will perceive the message as being that doctors will be replaced by pharmacists.
"Martin claimed that GPs would work longer hours to compensate for the closure, and Harmoni have indicated that the out-of-hours service could be adapted, but there is no indication of where the funding will come from, and it seems that detailed discussions are not yet under way to achieve this by October. Furthermore, with many patients reporting waiting times of two weeks for a GP appointment now, and with no target for waiting times, those present found it hard to believe that there is any coherent plan that will enable them to receive timely diagnosis and treatment.
"The PCT appears oblivious to the major change process that will need to be implemented to facilitate the transition from a Darzi Centre to other ways of accessing healthcare in Haverhill. You have spent years cultivating a culture that relies on the walk-in facility, and now anticipate that people will simply change their habits overnight. Even if you do provide additional GP resources, the immediate service provided by the Crown will surely simply prompt people to circumvent the appointment process by attending A&E, thereby undermining your efforts to reduce A&E attendances. After all, the Centre was set up in part to address rising A&E attendances, so what is it that makes you think people will not simply revert to that route?
"These issues have been raised repeatedly throughout the ‘engagement’ process you have conducted, but have been summarily ignored along with a range of additional matters:
The promise of x-ray and other diagnostic equipment, made when the Crown was opened;
The increasing population of Haverhill, expected to rise to some 35,000 over the next 20 years;
The increase elsewhere in A&E attendances compared with flat growth in hospitals serving Haverhill, which suggests that the Crown is not failing in its role in this regard;
There has been no evidence presented to show that A&E attendances from Haverhill are any less valid than those from other areas; and
The out-of-hours service has been reduced and already refers many patients to the Crown and to A&E, so there is little to indicate that it can help in addressing the excess demand created by the closure.
"It is an insult to the people of Haverhill that you have arrived at your decision without even having the courtesy at least to respond to these issues. Indeed, Martin’s presentation to ONE Haverhill appeared to re-inforce the view that Haverhill is at best ignored, and at worst actively derided by the PCT. At one point he appeared to justify the decision in part based on one anecdotal and unsubstantiated example of someone attending A&E with a cut finger. This is simply deplorable and warrants a public apology.
"Haverhill may be a long way from Ipswich where your decisions are made – in private. However, this does not mean that we are not entitled to a voice; nor does it mean we are any less of a priority than other parts of Suffolk.
"Matthew Hancock MP attended the ONE Haverhill meeting and confirmed that NHS Suffolk has received an additional £24m this year. Not only does this bring into question your protestations that budget reductions are required, it also suggests that Haverhill is being targeted for service reductions while other areas are presumably benefiting from the additional support you are receiving. We insist that we get a demonstrable fair share, and if this is alongside the closure of the Crown, we demand the equivalent investment in the GP and out-of-hours services.
"It is clear that you have not thought through the consequences in arriving at your decision, and that you have not paid attention to the needs and views of our town. You do have an opportunity to reassure us, however. The town council considers that the closure does not have to happen immediately. The borough council has confirmed that the lease and planning permission could be extended, and this would allow time for a meaningful consultation process, an effective education programme that does not threaten the health of residents, and a proper plan that provides effective primary care to the people of Haverhill.
"To enable a full and accountable discussion of these issues, the town council invites the PCT board to meet in public in Haverhill. Town councillors will be only too happy to represent the views of residents to the board at that meeting, and to engage in constructive discussion over future provision. We consider that the board was misled and under-informed by the report on which it based the closure decision, and we believe that if Board members are fully appraised of the reality of healthcare in Haverhill, they will accept that your plans are inadequate. We have a vision – not for the indefinite retention of the Crown, but for a facility that properly serves the town and its future expansion, and we look forward to sharing it with the board."
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