Horton campaigners say they will continue to fight for full services at the Banbury hospital following yesterday’s (Wednesday) trust Board decision to remove consultant-led maternity services from October 1.
Keep the Horton General (KTHG) chairman Keith Strangwood told the Banbury Guardian: “We’re disappointed but not surprised they’ve taken this decision. They’ve been trying to get rid of their poor relative in the north for two decades.”
Mr Strangwood said KTHG believed board members of the Oxford University Hospitals Trust Board, who made the decision, were not aware of the full facts behind efforts made by the trust to recruit suitable doctor cover. The Trust says a lack of middle-grade obstetric doctors meant it has had to move consultant-led maternity to the John Radcliffe on safety grounds but that it hoped to reinstate it when doctors are recruited.
Mr Strangwood added: “Those directors only acted on the limited information put in front of them. So we’re approaching trust governors who have the ability to ‘call in’ a decision made by the Board for review.”
After the Board received an approach from lawyers on the morning of the meeting, the final decision on the future of Horton services could come down to a legal challenge that could lead to a judicial review.
The dispute over staffing at the Horton maternity hospital has centred on when the trust could reasonably have known when there would be a gap in rotas – based on contracts ending – when and where they advertised the posts, and whether the posts were sufficiently attractive to draw applications from suitable candidates.
The trust claims it did all it could to recruit replacements while the campaigners and a local GP have claimed the situation should have been taken in hand many months ago.
Wednesday’s decision also means the temporary cessation of the inpatient emergency gynaecology service and the establishment of a seven day ‘ambulatory’ emergency gynaecology unit at the Horton, meaning anyone needing admission would be sent on to the JR.
On the same day as the loss of full maternity, the trust is to close 28 beds in Oak Ward and F-Ward reducing the ability of the Horton’s experts to accept and deal with overflow trauma cases from the JR Hospital, Oxford.
Dejected Horton supporters left the Board meeting many described as ‘stage managed’ asking where the downgrade of the Horton’s maternity unit was going to lead.
One midwife predicted that without genuine efforts to recruit doctors, the midwife-only unit might not even last until Christmas, because of a birthing disaster or because the convoluted system the Oxford University Hospitals Trust intends to put in its place will be ineffective.
Others said they believed downgrading of the Banbury obstetric unit was only the start of a plan to push through the ‘options’ the OUH has already made public to downgrade most, if not all, of the Horton’s core consultant-led services, from the children’s ward to acute medicine, trauma and A&E.
Maternity in the care of consultants – with access to operating theatres for emergency Caesarean-sections, tears or other unforeseen complications - will be ended on October 1 and Special Care Baby Unit (SCBU) will close.
At Wednesday’s emergency Board meeting, OUH clinical director Paul Brennan, repeated previous assurances that the trust had tried, but failed, to recruit sufficient doctors to keep the Banbury unit safe.
He said the new MLU – which will have one trained midwife and a support worker on duty round the clock, would have a dedicated ambulance with an emergency care assistant, sitting outside the maternity unit in Hightown Road 24 hours a day in case of complications.
The audience did not agree with Mr Brennan’s assertion that any emergency in childbirth – such as a haemorrhage, a cord around a baby’s neck or shoulder dystocia - could reach the JR specialist unit in Headington within 30 – 45 minutes.
Stephen Kennedy, in charge of obstetrics and gynaecology at the trust, said a new portable operating theatre would be installed for gynaecology operations while the permanent gynaecology operating theatre would be devoted to planned Caesarean-section operations.
The move means the JR unit will be taking on over 1,000 extra births a year – or some 100 a month extra if the new arrangement is temporary.
Mr Brennan said if doctors were appointed by the end of October the unit could reopen as early as January 9. He said there would be an eight-week ‘implementation’ period between sufficient doctors being appointed and a reopening of the unit.
The trust has devised two options for downgrading acute, core services at the Horton. One would remove all consultant-led services including A&E, all adult acute medicine, trauma, maternity and paediatrics and the other would leave A&E as the sole acute service.
Dr Bruno Holthof said in a statement after the meeting: “We are extremely disappointed to be in this position today and have taken into consideration the views of many groups of people who are affected by this decision.
“Having tried exceptionally hard to recruit to these posts, using every incentive available to us, we would prefer to be maintaining the obstetric service at the Horton and will keep on with our recruitment drives.
“However, we clearly cannot run a service without doctors to provide it. This outcome reflects national difficulties in recruiting to obstetrics. We will continue with our ambition to reinstate the obstetric service at the Horton as well as the Special Care Baby Unit that goes alongside it, as soon as we have the staff to operate safely.”