‘Not about money’ for health bosses as Horton maternity downgrade assessment continues

The Horton joint health overview and scrutiny committee meeting at Banbury Town Hall
The Horton joint health overview and scrutiny committee meeting at Banbury Town Hall

The boss of the organisation that runs the Horton General Hospital said ‘it’s not about money and safety trumps everything’ as a committee continued to assess the impact of the maternity unit’s downgrade.

At the Horton joint health overview and scrutiny committee (HHOSC) meeting today (Thursday, April 11), chairman Arash Fatemian asked Oxford University Hospitals (OUH) NHS trust representatives whether they believed the downgrading has improved the quality of service for pregnant women in Banburyshire.

Chief executive Bruno Holthof said safety was their biggest concern, with money not playing a part, and without enough staff to run the service it would be ‘impossible’.

“Safety for us trumps everything else. When we have a safety concern we will act as a trust board,” he said.

“It’s more important than patient experience and patient quality as defined in terms of outcomes, safety is a show stopper. And we’ve acted along those lines consistently in the past.”

He added: “The money will not play into the trust’s decision-making, if safety is guaranteed we will look at other criteria, if safety is not guaranteed then it will be impossible to provide a service.”

The HHOSC was set up under the advice of the Secretary of State for Health following his review of the decision to remove consultants from the Horton in 2017, making it a midwife-led unit meaning much fewer births can take place there.

Today’s meeting provided an update on engagement work done to hear from Banburyshire mothers forced to give birth at the John Radcliffe Hospital and a financial overview since the changes.

At the end of the meeting, Cllr Fatemian referred to Dr Holthof’s comment last week that ‘all decisions the trust makes are driven by quality and safety for patients’.

He said: “Can you honestly say, based on the evidence this committee has heard so far, the quality for women in the Horton catchment has improved by not having a full obstetric service here at the Horton?”

Dr Holthof replied: “On behalf of the trust we are taking decisions in terms of quality and safety therefore... it’s not about the money. So we want to provide safe services and if we don’t have enough clinical staff it’s hard to provide a safe service and that’s my biggest concern is not having enough staff.”

OUH clinical lead for maternity Veronica Miller added: “I understand there’s been some very poor experiences but what I think’s really important to understand is we couldn’t keep going the way we were going, we couldn’t run a service with the doctors we had there.”

Earlier OUH was criticised for providing ‘incomplete’ data on its finances since the Horton downgrade, which HHOSC members requested in September to show if there has been any income loss from fewer women choosing the JR to give birth.

Figures showed how much OUH received from all the different clinical commissioning groups (CCG) and how much Oxfordshire’s CCG paid to NHS trusts for births.

But figures were not provided from previous years to see the impact since the Horton downgrade, nor were the statistics comparable.

OCCG director of governance Catherine Mountford said it was ‘not good enough’ and Cllr Kieron Mallon said it does not give people confidence in the trust’s presentations to HHOSC.

In terms of engagement, women who have given birth in the last two years have been asked to share their experiences in a survey.

With the deadline on Monday, so far 958 women and 450 of their partners have taken part, which the committee applauded.