Horton consultation meets a barrage of opposition

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Horror stories about consequences of the Horton’s maternity downgrade and fears for future Banburyshire patients dominated a public meeting into healthcare changes at on Thursday.

The Oxford University Hospitals Trust admitted at the meeting at St Mary’s Church there had been 24 ambulance dashes to Oxford during 59 births at the downgraded Horton since October.

And Banbury MP Victoria Prentis promised she would meet Secretary of State for Health Jeremy Hunt ‘tomorrow’ if saving Horton services was ‘just a case of money’.

The meeting was the first of a dozen Oxfordshire events to hear residents’ views on a huge reorganisation of health services that includes a downgrade of the Horton.

Keep the Horton General chairman Keith Strangwood told a shocked assembly of 500 of incidents he had heard of since the Horton maternity unit was downgraded.

And a woman described how she delivered her granddaughter on the roadside with a four hour wait to reach specialists in Oxford.

Mr Strangwood said: “Two weeks after (OUH) removed consultant-led maternity – due to an incident - we find ourselves with a deaf and blind baby.

“Midwifery staff are not obstetricians and you have no right to put them in the position where they have to make decisions for transfer, only to find that the John Radcliffe is full. What exactly is the acceptable collateral damage and loss of life?”

He said the Oxfordshire Clinical Commissioning Group (OCCG) should tell the government it refused to ‘inflict inhumane proposals’ on north Oxfordshire because of funding cuts.

The grandmother described how she had delivered her granddaughter at the roadside.

“We were rushed to the Horton where we had to wait for a Gloucestershire ambulance to take us to the JR. We arrived four hours after the birth (and) were shoved into a dirty side ward. The baby was hardly checked and they muddled her notes up. You tell me what’s good about your Radcliffe?” she asked the OCCG panel.

Dale Harbron, of Banbury, accused the trust of ‘fluffing’ figures of 11 emergency transfers in a dedicated ambulance from the Horton maternity unit to Oxford and ‘picking and choosing’ facts it made public.

He said: “I know for a fact you’ve been fluffing the figures. There have been 24 times that ambulance has gone from Banbury to Oxford. The numbers you’re counting are for women in labour, so you’re saying women before delivery or after (bleeding or not) don’t matter; picking and choosing what facts you give.

“You’re paying nearly £1m to have that ambulance there until the end of this consultation. I’m assuming it’s then going to carry on? If it doesn’t why would (the unit) be safe? Or are you saying it you have £1m to park it outside?”

Paul Brennan, clinical director for the Oxford University Hospitals Trust admitted there had been other emergency transfers but said these were neonatal and post-delivery cases.

“A dedicated ambulance is not there at the other (Oxfordshire) midwife led units (MLUs), he said.s. “If the decision is made for the Horton to become an MLU permanently we will have to consider whether we continue the dedicated ambulance. We are coping with the level of births at the JR,” he said.

Dr Kiren Collinson, an Oxfordshire GP on the panel, said if necessary the OCCG would ‘look again’ at the idea of a helipad at the Horton.

Cherwell district councillor Andrew McHugh received huge applause for his challenge over lack of training recognition at Horton maternity – the justification given by the trust for its inability to staff the unit.

“The Royal College of Obstetrics lists 36 units with 2,500 or fewer births. 16 of these have fewer than the Horton, yet support junior medical staff rotas. Why can Dumfries, Aberystwyth and Barnstaple do what one of the largest, academic foundation trusts in the country says it cannot?”

Dr Tony Berendt, for OUH, said: “The trust is very happy to host trainees if they are funded by Health Education England but it cannot create training posts if the regulator and purchaser does not approve them. We are happy to look at smaller units where training is recognised.”

Mr McHugh said: “There are sins of commission and sins of omission and I don’t really think the trust did what it could to retain training status.

“The combined caseload of the Horton and the JR is over 7,500 births which is large even by UK standards. Combining rotas and having recognised trainers in consultant posts surely would have been enough to persuade the Royal College to recognise training posts encompassing both sites.

The loss of training status suited the trust because that was a way of overcoming the inconvenient decision of the Independent Reconfiguration Panel in 2008 (that obstetrics must remain in Banbury as Oxford is too far to transfer women in labour).”

Banbury MP Victoria Prentis complained the CCG’s plan for more day case capability had not been costed or budgeted.

“I don’t want that promise of apples to be confused with pears - taking away the acute services, A&E, paediatrics and maternity. I don’t want those two things treated as some kind of bargain,” she said.

“I’ve been running a survey about real travel and parking times. The average travel time is 1.5 hours and average parking time 20 minutes, some much longer. Is it safe for people to be having to travel that distance to have their babies?”

Mr Brennan said the trust’s figures showed average transfer times to be 40 minutes recorded by the dedicated ambulance.

The meeting was first in a three month consultation into huge changes and deep cuts in NHS and social care provision throughout Oxfordshire – part of a plan to knock £200m off the county’s budget as part of a Buckinghamshire, Oxfordshire and Berkshire West cash-cutting exercise.

The redesign is one of 44 happening in regions across England as part of the highly controversial Sustainability and Transformation Plan project which will take £22 billion out of normal NHS funding increases.

The OCCG is consulting on closure of hospital beds, stroke services, critical care, making permanent loss of consultant maternity, gynaecology and special care baby unit, and on planned care at the Horton.