Concern at Ear, Nose and Throat proposals

Government plans for new privately-run clinics to ease local waiting lists have provoked a statement of concern from four leading Ear, Nose and Throat consultants in Cumbria and also from local Conservative MP David MacLean.

The four surgeons say that the proposals will disrupt existing services and have dire consequences for patients across the area.

The Capture, Assess, Treat and Support (CATS) centres proposed for Carlisle and Workington would treat NHS patients to help meet strict new waiting list targets, performing routine operations, diagnostic tests and aftercare to ease pressure on other hospitals.

But they have been met with strong opposition from NHS staff, who fear it will affect quality of care and put their services and jobs at risk.

A petition opposing the centres has already been launched and now the four surgeons have added their combined weight to the campaign.

A letter has been sent to Mike Farrar, chief executive of the North West Strategic Health Authority, signed by Nick Murrant, Donald Clark, Richard Hogg and Andrew Robson – who together conduct ear, nose and throat (ENT) procedures at the Cumberland Infirmary and West Cumberland Hospital.

One of their worries is how far the contracting process has gone – with South African firm Netcare already named as the preferred operator – without any discussion with local doctors.

In the letter they state: “The matter was effectively raised with us surgeons, whose combined consultant experience totals over 40 years, only once a fait accompli. This is an outrageous omission from the perspective of our patients and the general public.”

They say the new clinics will give poor value for taxpayers’ money and add an unnecessary tier of activity, which will result in “wide-reaching, probably irreversible erosion of high quality, consultant-led care.”

They claim that similar centres elsewhere in the UK are already recruiting junior doctors to run these services.

The consultants go on to list nine specific concerns about the impact of creating NHS-funded, privately-run clinics in north Cumbria and demand an urgent response.

These concerns include the financial impact on the existing acute trust, potentially resulting in closure of units, the lack of public consultation and the impact it will have on staff training.

However they are most worried that staff at the new clinics will not have the high standard of training expected, affecting the quality of care.

They say: “It appears that care may be delivered by doctors with either no UK training or by a GP who has undergone a few hours training a week over 12 months.

“Do you understand our frustration that the patient population, which is being sold a relentless ‘choice’ mantra, is in reality having the most fundamental choice – that of consulting with a fully accredited, audited, appraised and reputable NHS consultant surgeon – taken away?”

Ultimately the surgeons stress that there is no need for the private clinics in this area, as they are already on course to meet the new 18-week waiting target by December 2008.

In fact, they say that in 2002 a fourth ENT consultant was appointed in north Cumbria to help do just that.

They add that if there are genuine gaps in the service, such as hearing aid provision, they would be happy to discuss ways to fill them.

The implementation of the CATS centres – at Workington Community Hospital and an unknown site in Carlisle – was initially due to get underway next month. However, this has now been postponed following threats from health unions of a judicial review.

After receiving a copy of the consultants’ letter, David Maclean, MP for Penrith and the Border, has publicly backed their campaign.

He has also written to Mr Farrar calling for essential information about the proposed centres and demanding full consultation before they progress any further.