The North East Review of healthcare services has generated considerable public interest. We have seen our health services analysed many times and there will be more of this in the future. The very existence of the North East Review, while welcome, tends to support the view that its predecessor, Fit for the Future, lacked a focus on our immediate geographical area and had an emphasis outside of that area.
I thank everyone involved in the North East Review for their hard work in considering the complex issues facing our part ofWest Sussex. While much attention inCrawleyis given to secondary care services (acute hospital services), the review report examines the much wider provision of healthcare services that we have today. It proposes a number of recommendations that benefitCrawleyand our immediate area.
The positive developments include addressing the shortage of health visitors inCrawley, enhancing paediatric nursing support toCrawleyUrgent Treatment Centre and establishing a community stroke rehabilitation team. These and other diverse recommendations are welcome although there seem to be some gaps around addressing the property estate from which some primary care services are delivered inCrawley.
Chapters 15 and 16 of the report give strong coverage to secondary care services and access to those services. Critical to the delivery of healthcare is routing people to the correct service and specifically avoiding admission to secondary services where that is inappropriate. Even allowing that these measures are effective, acute bed occupancy was 97% in 2007/08 within the SaSH (Surreyand Sussex Healthcare NHS Trust) area which includesEastSurreyHospital. This figure compares with a national average of 85% occupancy over the same period.
It is acknowledged that we are at or near capacity with acute beds but the report does not address this in a strategic way. References are made to providing “improved pathways”, reviewing bed capacity on existing compromised sites and having an annual conversation about the issue with key stakeholders. That is not quite as convincing as providing a new general hospital forCrawley. Of the top 66 towns in the country,Crawleyis probably the only one without one and this upgrade in service is needed and wanted byCrawleypeople.
Upgrade is a word of our times. We can upgrade anything from an airline ticket to a hamburger and with these two examples we are not downgrading anyone else at the same time. This is an issue for the NHS. Too often a reconfiguration of healthcare services, with its reference to catchment areas, means that one area’s upgrade is another area’s downgrade. The process has been complicated by a reticence to look at provision issues that cross local authority political boundaries even when a large proportion ofEastSurreyHospital’s custom comes fromWest Sussex.
The difficulties faced by the NHS in service reconfiguration suggest that other avenues must now be more fully explored. These will include a more active role for the private sector in developing secondary services, perhaps bundled with other infrastructure improvements forCrawley. We cannot be dogmatic about who builds new healthcare facilities. What matters is the free and open access to allCrawleyresidents. The campaign for a newCrawleyhospital is alive and well and recognises the need to look for new solutions to our continuing issues.
Councillor Bob Lanzer, Leader of Crawley Borough Council
18th February 2009