Make sure you respond to the Consultation

I hope that as many people as possible will take advantage of the fact that the "Closer to Home" consultation has been extended to 1st February to read the document and respond to it.

We have had a lot more information come out since the consultation started, some good, some still giving cause for concern. But we need to engage with the trust and make sure they are listening to our concerns on issues like the number of beds.

I also hope that people in the community with exertise with numbers will be going through the PCT's figures and financial projections, and indeed those which the Acute Hospitals Trust has put out for the Foundation Trust status bid, very carefully.

The historic debts of the acute trust and the previous PCT were a millstone round the neck of the NHS in Cumbria. It is very important that we keep our hospitals solvent.

Closer to Home

At the Millom Neighbourhood Forum on Monday evening, Peter Clarke, the PCT's associate director of public engagement, gave a presentation.

During the discussion he repeated the important news that the consultation period has been extended to 1st February. There will be a public meeting in Millom in January (we had previously been told that there will also be one in Whitehaven.)

He also further clarified the proposals in the report on the number of beds in Community Hospitals such as those at Millom and Keswick.

While the consultation document does appear to read as though a reduction in bed numbers is proposed, Mr Clarke said that this was not necessarily intended and added that the document could perhaps have been better worded.

The bed numbers quoted on page 24 of the consultation document are the intermediate step up and step down beds required to support the "Closer to Home" strategy but local decisions will be made on the number of beds required in each. Mr Clarke emphasised the possibility that there will be other beds at these hospitals and that the number of beds will not necessarily reduce.

I suggest that anyone who is concerned about the number of beds at the community hospitals should respond to the consultation and say so.

Further thoughts on CATS

Today's "politics show" on the television was asking whether the dropping, at least from central government's perspective, of a number of proposals to bring in private sector expertise represents a slowdown in the reform process. The CATS proposals for Cumbria and Lancashire is one of the schemes cited.

I stand by the view, also expressed by many doctors and NHS managers, and supported by petitions signed by more than 10,000 people in Copeland, that the CATS proposals in their original form were a mistake and would have been a disaster for West Cumbria. The national CATS model was not right for an outlying area with low population density and communications problems such as Cumbria: the Acute Hospitals Chief Exec, Marie Burnham, reiterated in response to a question from me a few days ago her view that the national CATS contract would have jeopardised West Cumberland Hospital.

The grossly mismanaged PFI scheme for the Cumberland Infirmary at Carlisle has also poisoned the water for private-public partnerships in Cumbria.

However, this does not mean that we should either automatically reject, or indeed automatically support, any local proposals to involve the private sector in public health care which are designed to meet the needs of Cumbria.

If private clinics in Cumbria can provide a service which is not currently available locally and for which patients would otherwise have to travel to, say, Newcastle, and if this can be done at an acceptable cost without jeopardising local hospitals, then the option should be considered. Let's just make sure we are not too quick to support any badly thought through schemes.

CATS - the plot thickens

The announcement by the Health Secretary last week that the Lancs and Cumbria CATS project would not proceed appeared at first to be the end of the matter.

I am hearing very mixed messages on this subject, but it now appears as though CATS have risen, Dracula-like, from the grave.

The national announcement means that the Primary Care Trusts (PCTs) in Cumbria and Lancashire will not be compelled to buy the service under the national contract. This has to be welcome. In response to a question from myself at a Copeland council meeting on 21st November, the Chief Executive of the North Cumbria Acute Hospitals trust, Marie Burnham, confirmed her view that the national CATS contract would have posed a serious threat to West Cumberland Hospital. She also said that any local CTS arrangement should aim to provide services which are not available at present rather than compete with existing services.

However, later at the same meeting, a representative of the PCT, Peter Clarke, said that they are still considering the possiblity of what he called a "CATS-like solution. I have seen in several quarters the suggestion that private clinics might still be set up to provide Diagnostic and Treatment services.

It is a good thing that we will no longer have a "one-size-fits-all" healthcare model of CATS which does not fit the needs of Cumbria imposed on us by Westminster. But any local proposals will still need to be carefully examined to make sure they could not have a similar prejudicial impact on existing hospitals.

Hospital proposals: public meeting to be held in January

Following on from the extension of the consultation period on "Closer to Home" there will be a public meeting in Whitehaven in January on the proposals.

As soon as I learn the details I will post them here and email them to everyone who has signed one of the NHS petitions we have organised and for whom I have an email address. If you would like to receive that email please send me an note on chris4copeland@btinternet.com and let me know.

Consultants meet the PCT

Hospital Consultants at West Cumberland Hospital met the PCT yesterday to discuss the "Closer to Home" proposals.

From the report given to Copeland Councillors today I had the impression that it was a lively discussion.

We were told that one issue on which there was some degree of consensus is the number of extra transfers from WCH to Carlisle and other hospitals as a result of the proposals. This is apparently now expected to be 1 to 2 out of hours emergency surgery cases per week.

On a number of other issues discussions are continuing.

Marie Burnham reshuffles the Acute trust team

I have been sent a certain amount of email correspondence lately about the future of the management team of the North Cumbria Acute Hospitals trust which runs West Cumberland Hospital in Whitehaven and the Cumberland Infirmary at Carlisle.

Marie Burnham, the trust CEO, was giving a presentation to Copeland Councillors today on the proposals for Foundation Trust status for our acute hospitals, so I asked her about changes to the Trust leadership through this process.

She explained that she has reshuffled the Executive Directors and senior management team to meet new challenges but expects to see the proposals through herself.

Consultation Extended to 1st February

A lot of new information has come out in the past 24 hours about the "Closer to Home Consultation.

The first of these, and very welcome, is that the consultation period has beene xtended and comments can now be made up to 1st February. The Trust representative acknowledged at a meeting with Copeland Councillors today that some information which should have been made available at the start of the Consultation had not been, and the PCT had recognised that more time was needed for the public, patients and staff to have a full opportunity to take part.

CATS proposals abandoned

I welcome the news that the CATS proposals for Cumbria and Lancashire have been dropped.

The Health Secretary made a written statement last week with a list of Health Service proposals which were being dropped because the NHS director general had concluded that "they were unlikely to provide acceptable value for money as the local NHS has successfully improved capacity to meet patients' needs."

These included the Cumbria and Lancashire "Clinical Assessment and Treatment Service" or CATS.

Thousands of people in West Cumbria signed either the petition which local doctors organised against CATS or the similar petition organised by local Conservatives.

The problem with the CATS proposal is that it was a "one size fits all" solution which was not right for Cumbria and would have jeopardised existing local services, particularly at the West Cumberland hospital but probably also at local Community hospitals including Millom and Keswick.

We were not necessarily against new services, but the numbers on the national CATS contract did not seem to add up in the view of local hospital managers or doctors.

WCH Consultants speak out

According to tomorrow's Whitehaven News, more than 20 consultants at West Cumberland Hospital have signed a letter expressing concern at the "Closer to Home" consultation document.

The letter suggests that much work needs to be done before the proposals are clinically acceptable and fulfil the principles of good clinical care.

The 22 consultants who signed it say that they cannot support the "Closer to Home" options as they stand.

All credit to the doctors for speaking out in view of the unhelpful email from the Acute Hospitals Trust which suggested that doctors who spoke to the press might risk being reported to the General Medical Council. However well intentioned this email may have been, it was totally counterproductive in terms of the urgent need for a well-informed and constructive debate on the proposals.

Mental Health meeting - 28th November

The CLeator Moor meantal health support group is organising an "In Depth Idea Sharing Session" on the issues around support for local people with needs in this area at Cleator Moor Civic Hall on 28th November from 6pm to 9pm.

It will be facilitatted by Enterprise Development workers Anne Cunningham and Trish Cairns.

Discussion on hospitals before Whitehaven PCC

At 7pm tomorrow (Monday 5th November) there will be a disussion on the current hospital proposals, "Closer to Home" at the PCC (Parochial Church Council) for the Anglican parish of Whitehaven.

It has been agreed that this discussion will be open to all Whitehaven parishioners.

It will take place at St Nicholas's Centre in Lowther Street, Whitehaven at 7pm.

Despite the date I will resist the temptation to make a witticism about fireworks because the implications for local health care are far too important to be seen as a joking matter.