A Banbury GP says Oxford hospital bosses had no interest in hearing about the safety concerns family doctors and paediatricians have about moving consultant-led maternity to Oxford, at a recent meeting.
Hightown Surgery GP Victoria Morrell says, in a letter to the Oxford University Hospitals Trust (OUHT) and others that managers dismissed reports of maternal deaths after similar downgrades at Northwick Park and Kidderminster as ‘not relevant’.
“At the recent meeting between the Trust and local GPs, it was clear that the Trust had no interest in hearing the safety concerns of local GPs and paediatricians. We believe the Trust has not adequately assessed the risks.”
Dr Morrell said senior paediatricians had not been properly consulted on loss of Special Care Baby Unit.
“They believe staff losses will inevitably make it almost impossible to re-open. There had clearly not been any discussions with paediatricians about how the Horton would manage re-admissions for jaundiced babies, babies failing to gain weight or who needed day case antibiotics.”
Dr Morrell said there were concerns about gynaecology at the JR where there will be ‘significantly less time’ for routine treatment because of the increased use of operating theatres for Caesarian sections.
“This, with the ongoing downgrade of surgery at the Horton and loss of inpatient gynaecology beds is surely going to precipitate a further crisis in training and service provision in an already stretched service.”
She described current downgrading as happening at a ‘terrifying pace’.
Dr Morrell said her surgery is ‘disappointed’ at a maternity downgrade since the crisis in maternity staffing, used as justification for the move, has been ‘entirely predictable’.
“These issues have been clear to the Trust since January. At that time a large number of new midwives was recruited to the JR to meet ‘an expected increase in demand’ in the autumn. Despite this, the Trust has maintained that the current crisis was unexpected and did not share this information until mid-July.
“We were clearly told removal of funding for academic posts was a University decision – it appears to have been a Trust decision. Middle grades feel opportunities were not forthcoming at the Horton and opportunities to research limited and not funded. The posts were therefore removed due to lack of interest and lack of research output - a foregone conclusion. There has also been the issue of recruiting overseas doctors, with reports that well-qualified doctors have been discounted. Jobs have been advertised with a much lower rate of pay than for similarly qualified ‘middle grades’.
“We are increasingly anxious that the crisis has been managed to support the reduction of services at the Horton. This is an exact replica of what happened with emergency surgery and we understand similar situations are likely to occur in A&E and Trauma within the next six months.”
Paul Brennan clinical director of OUH said: “We realise that this subject is a highly emotive one and the concerns and opinions of the many people will be considered. These include the women using the services, the clinicians, our staff especially midwives, the ambulance service, GPs and the local community.
“Ultimately a decision will be taken based on the most significant overriding factor, which is patient safety.”
Dr Morrell’s letter continued: “The current staffing crisis is not helped by the increasingly poor morale of staff who fear for their jobs and understandably are seeking employment elsewhere.
“We believe decisions made about a crisis situation made in maternity will lead to a domino effect that causes a widespread, inevitable and unconsulted downgrade in services at the Horton.
“The IRP (2008) clearly stated it did not support proposals to reconfigure services in paediatrics, obstetrics, gynaecology and the special care baby unit at the Horton.
“Specifically they noted ‘The IRP does not consider that the [downgrade] will provide an accessible or improved service to the people of north Oxfordshire and surrounding areas’.
“It is clear the current proposals are in direct conflict with the report’s findings and appear to be being introduced without adequate consultation with stakeholders – the public, patients, GPs and even the Trust’s own staff. The rate of change of services has meant that downgrading is happening via the back door seemingly to side-step the IRP’s recommendations regarding reconfiguration and consultation in an ever growing area of local population.
“General Practice in Banbury is currently at breaking point, and therefore the ‘fight’ has gone out of many people who were instrumental in the last campaign and the Davidson enquiry. Despite this, feelings remain strong about the need to maintain services at the Horton. I hope that this letter outlines our concerns and the pressing need to ensure that downgrading of services is not allowed to continue at the terrifying pace currently being followed by the OUHFT. We strongly believe this is not in the best interests of the local community, raises serious safety concerns, and represents a way of achieving centralisation without adequate or appropriate consultation.”