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Evesham Community Hospital

For the second time in two weeks I am extremely grateful to Mr. Speaker for the opportunity to stand in this Chamber and defend a vital local service. Two weeks ago the issue was the impact of the Licensing Act 2003 on a range of institutions and organisations, especially village halls. At first sight that was a national issue with local implications, whereas today's debate appears to be a strictly local affair that has implications that go no further than Evesham. However, that assessment would be wrong for three reasons, which is why it is right that the Minister should have the opportunity to explain. The first reason is shown by the presence of the hon. Members for Worcester (Mr. Foster) and for Wyre Forest (Dr. Taylor). The proposal virtually to halve the size of Evesham community hospital by closing two wards, removing general practitioners from caring for patients in another ward and transferring orthopaedic services to Kidderminster has serious implications for the whole county of Worcestershire and its surrounding areas. The second reason is that the proposals fly in the face of one of the Government's key national policy objectives for the national health service; local service delivery and accountability. In 2003, ““Keeping the NHS local: a new direction of travel”” challenged the perceived wisdom that biggest is best, and committed to the delivery of as local a provision of services as possible. It also strengthened the commitment for the NHS to work with and not for local people in developing options for the delivery of services. In 2000, ““The NHS Plan: a plan for investment, a plan for reform”” and in 2004, ““The NHS Improvement Plan: Putting people at the heart of public services”” again committed to a major investment in services closer to home, particularly the management of patients with long-term conditions. South Worcestershire primary care trust is doing the exact opposite. It is reducing local primary care services in order to support the costs of a large acute hospital sector that provides a range of services that could, and should, be provided close to patients' homes and in primary care settings. The third reason is that the drivers of the outrageous proposals are all national. The cuts being considered by South Worcestershire PCT, of which the proposals for Evesham community hospital are just a part, are its response to national policies imposed on it, often against its will. Its experience is far from unique. The proposals for Evesham were developed not on clinical grounds, but simply because it is the largest part of the PCT's budget over which it has any discretion. This would be the second round of damaging cuts at the hospital in three years and has four equally unacceptable parts. The first is the proposal to close the enormously successful and essential rehabilitation ward, Bredon ward, which offers a vital service to support the county's acute hospitals and was developed only two years ago with the current PCT. Closing the ward will mean many things: patients being stuck in an acute hospital where the focus is on primary treatment not rehabilitation; increased pressure on an already seriously overstretched acute sector; patients not being able to return near to home for post-operative care and rehabilitation; more travelling for families to see and to support relatives; and less locally co-ordinated discharge planning and so more chance of problems on discharge. The second part is the closure of the immensely well regarded Willows stroke unit. The letters I have received about that proposal would melt even the stoniest heart. I have many of them here and if time permitted I would quote from them extensively. The stories they tell of hope reborn and of outstanding nursing care show how much the service achieves and how precious it is. The ward is widely recognised as a centre of excellence. It was opened only a few years ago by the late Sir Harry Secombe, and the PCT itself has invested in it significantly. Early discharge of the kind of people treated on the ward would be to betray their best clinical interests. It would lead to huge pressure on families, and would severely compromise treatment and rehabilitation and, crucially, jeopardise successful outcomes. The closure of those two wards would undermine the viability of the staff grade doctors' role at the hospital. That would probably lead to the closure of the one ward, the William Astley ward, otherwise unaffected by this package. The attempt to keep that role viable probably explains the third proposal, to remove GPs from Izod ward, which would mean a reckless loss of continuity of care from local GPs who know their patients' circumstances and full medical history. The quoted saving for ending the role of GPs seems remarkable, because the current total Izod ward bed-fund payments for all the GPs put together amounts only to little more than a third of the quoted saving, and there would probably be redundancy payments to make as well. The fourth proposal is the transfer of orthopaedic services to the independent sector treatment centre at Kidderminster. The only reason for that is that the Department of Health has forced the primary care trust into a contract that it, the local GPs and the patients do not want. On a case by case basis, Evesham community hospital is cheaper than the treatment centre. The Kidderminster centre is a 55-mile round trip from Evesham; therefore, the journeys that would have to be made there for an initial consultation, surgery and a single follow-up visit would amount to a combined trip of 165 miles. That assumes that patients have easy access to cars, which many do not. By public transport, the journey is a nightmare, especially from the villages of south Worcestershire. The PCT must know that the loss of orthopaedics would also lead to physiotherapy and X-ray at Evesham becoming less viable. What makes this proposal truly bizarre is that, under the Government's policies, most local people will choose to be referred to the much closer Cheltenham general hospital, where the cost will be even greater than at Evesham. In summary, these cuts are as unacceptable to the people of Evesham and the surrounding community as the downgrading of Kidderminster hospital was to the people of Wyre Forest. The hon. Member for Wyre Forest is present, and I am grateful to him for the support he has given us.