Dear Bournemouth Health Scrutiny Committee: Here is why the population of Poole, the Purbecks, and large parts of Dorset, fiercely oppose DCCG plans

“Beggaring all belief (star prize for staggering credibility) with A&E and maternity moving ten miles away from Poole (31 miles from Swanage) DCCG claim we will have “care closer to home”.

Cllr David d’Orton-Gibson

Bournemouth Health Scrutiny Committee

Dear Cllr,

I note the comments of yourself and colleague Cllrs as reported in Bournemouth Echo on the matter of referral of DCCG CSR plans to the Secretary of State for Independent Panel review : Hospital campaigners accused of ignoring facts.

You and colleagues take the view any such referral is unwarranted on the grounds campaigners are “ignoring the facts”.

In reply Cllr below is a comprehensive review and assessment grounded in DCCG documents laying out all the reasons why overwhelmingly the population of Poole, the Purbecks, and large parts of Dorset, fiercely oppose DCCG plans.

Al the reasons why the proposals need as a matter of urgency to be referred to an Independent Panel before the county ends up with  emergency critical-time health services inaccessible to tens of thousands in our county.

To given some broad strokes on key issues : £147 million a year is being moved from Dorset NHS operational budgets to capital investment budgets. And on that move Chief Executive of DCCG can tell us : I can assure you that we are not cutting the total spend in Dorset on health services”. But what Mr Goodson doesn’t want to say is operational budgets are being cut by £147 million a year every year, that then covering capital investment along with dealing with £147 million deficit (£157 million by 2022) underfunding.

It’s like for like run down of operational costs and reducing underfunding debt with investment (from what is cut/saved) in one-off £147 capital investment (with government compliance top-up reward of £8 million), largely at RBH.

And so it is out of 17 community hospitals in Dorset we have four closing or closed down (Alderney, Portland, Ferndown, Westhaven), three losing all their beds (DCH, Wareham, Christchurch), Poole A&E (37,000 admission 2017) and maternity (4,500 births 2017) closing down and losing 400 beds. This the cost of funding the deficit and finding capital funding to expand RBH. And to be noted careful reading of DCCG documents is required, ie “transfer of staff” means close-down.

Also to note Dorset Integrated Urgent Care Service will be a “Single Point of Access  (SPOA) system”. All access to urgent care will be through 111 call centres using interactive voice recognition systems. We can expect and we should have no doubt access to GP surgeries will in coming years follow suite. Very much following the model of the catastrophic Universal Credit system – phone and digital device access to services. In the case of 111 service run by agency staff open to using overseas call centres : Indeed one the largest international 111 call handler suppliers operating world wide.

And of course we are losing very large numbers of GP surgeries as we see in all our suburbs and towns. Upper Parkstone typical of all areas. We have lost one of our two major surgeries (Madeira Road) closed down (rescheduled to reopen as a private practice), our one remaining major surgery (Mansfield Road – rebranded Tower Practice) now heavily overloaded. For good measure the practice public car-park sold off for flats all stamped and approved by our council. And this part of government NHS England policy to sell of all NHS land/property that can be vacated through countywide transformations.

And your specific comments Cllr d’Orton-Gibson on “real benefits” of DCCG plans backed by “clinical evidence”. Really Cllr Gibson? Would you like to cite that evidence? I would be very glad to read it.

Or to rephrase that point, on my search of DCCG documents such evidence is non-existent. It does not exist.

Professor Jon Nicholl who led the only known research in the country on downgrading A&E to UCC, as cited repeatedly (non-specifically) by DCCG, states in conclusion : “It is important to highlight that we didn’t find the better outcomes for patients that planners hoped to see from closing these small departments. It isn’t clear that the disruption and anxiety that can be caused by closing emergency departments is worthwhile.”

There is an all too clear case to separate urgent care from emergency cases, but not to close down one of two major A&E departments in a conurbation of 460,000, and growing. That has never been done anywhere else in this country Cllr d’Orton-Gibson by any authority anywhere. And please note in the Keogh Report 2013 driving much of these changes Dr Keogh states : “The number of Emergency and Major Emergency Centres should broadly equal the number of current A&E departments”. 

And Cllr Jackie Edwards and all Cllrs in the Scrutiny group, the whole problem of opposition to plans and referral comes down you think to “media misrepresentation”. That is interesting Cllrs so let me state as clearly as I can in many years researching issues never have I come across such a litany of grossly misleading misinformation as is being put out by DCCG.

And that is not assertion Cllrs. All the specific examples are listed in detail with references below. And as far as local media I think we should be hugely grateful we have open probing reporting bringing to our attention what is going on in our towns giving both sides of arguments : Bournemouth EchoBBC SolentBBC News, ITV MeridianDorset Eye – all giving factual coverage of this huge transformation. But for responsible media people would not have a clue what is going on.

In then “blaming” media “misrepresentation” for the overwhelming opposition to DCCG transformation of Dorset NHS I am of course minded of the current incumbent of the White House : the media is all “false information” and this when notably quality US media are fielding near identical criticism. And same now in Dorset – 50,000 have signed petitions. The population in Poole and into the Purbecks and many parts of Dorset are horrified. The media is then expressing these views – with similar reporting. So you are saying Cllr Edwards all the media in Dorset (Bournemouth Echo, BBC, Solent Radio, Meridian, Dorset Eye) are all misrepresenting the “transformation” of Dorset NHS services?

And indeed in this case, as we have seen, DCCG have the clout to use the media when it suites DCCG – spending some thousands of pounds on four page cover wrappers on Poole and Bournemouth Herald to sell to the public their one-sided promotion of all the benefits of DCCG plans – with silence on the enormous cuts in services. And note DCCG documents are invariably undated and in every case never signed off by any name. I find that very telling when in years to come court cases open senior DCCG executives have ready disclaimers to claim not their work.

In the end Cllrs on close reading DCCG “changes” means close-down ; “merger” means close-down, “re-modelling” means close-down; transformation probably the only accurate descriptor meaning our local NHS is to be transformed out of all recognition. DCCG Integrated Urgent Care system will be access to urgent care through a 111 (and on-line) automated system. And this in due course for GP surgeries. We are heading full scale for 111 call centre automated centralisation. With three weeks training call handlers and call centre agents replacing what would be direct access to receptionists in medical centres.

And in all this A&E and maternity moved ten miles from Poole to RBH which is then going to lead in life-threatening emergencies and maternity cases to more loss of life. On the statistics, from SWAST and other sources, many hundreds or mortalities. This fact is stated repeatedly in all ambulance distance and mortality studies :

FT – Professor Nicholl – Sheffield Research – A&E closures failing to boost patient care :

Relationship between distance to hospital and mortality : “Our data suggest a 10km increase in straight-line distance is associated with around a 1% absolute increase in mortality”. Swanage to RBH is 31 miles – ten extra miles than to Poole A&E. This then in life-threatening cases near 2% increase in risk of mortality, which is then on a figure of 10,000 life threatening cases a year from Purbecks and Poole, 200 extra deaths a year as a consequence of closing Poole A&E.

National Media : thousands die from ambulance delays.

If you are interested Cllrs in understanding why so many thousands are fiercely opposed to DCCG proposals then please look through or better still read through below. Any points wrong – as I have said to Mr Goodson repeatedly – then by all means do explain where information is incorrect or misleading.

The “misinformation in media and from campaigners” Mr Goodson’s repeat clarion call – but with little explanation of where exactly information is misleading.

Mr Goodson please answer the following : Key critical question that have not been answered in two years.

Explaining the issues … Tuesday 13th November …:

Jeff Williams

Resident

Parkstone

26th November