The Horton General Hospital Banbury.
Banbury needs the Horton General Hospital.
There is a common misconception that managers in Oxford want to 'close the Horton down' but that has never been the case. The Horton is far too important to them. They could not accommodate all the Horton's patients in Oxford and they could not afford to lose the Horton's potential to help them. What they are looking for is concentration of 'acute' care at the centres of excellence in Oxford, they say for 'safety' reasons, while campaigners in Banbury say it is to save money.
"Banbury people (and members of the 2008 Independent Reconfiguration Panel) feel Oxford is too far away to have mass emergency transfers and that a core for necessary acute services should continue to be provided locally."
Population Increase
Banbury is set to build 23,000 new homes in the next 16 years. Bicester has recently been chosen as the location for a new Garden City and is set to increase its housing stock by 13,000 in that time.
With each dwelling estimated to house an average of three individuals, that is another 108,000 patients in the area looking to the Horton General Hospital - in addition to the existing catchment of some 170,000 people.
So the Horton alone may have a catchment area of some 300,000. Oxford's John Radcliffe Hospital catchment will also be increased as tens of thousands of new homes are built in the south and west of the county, imposing still more pressure on hard-pressed services.
With both hospitals near capacity, the JR being difficult to get to, and Oxfordshire's population soaring, does it make sense to reduce services in a fully equipped general hospital, 25 miles from its base? The majority of Banbury patients thinks not.
However managers and a number of specialists at Oxford's over-run, space limited, badly located John Radcliffe Hospital wish to turn the Horton General Hospital into a busy community hospital, confined to a vastly expanding day case surgery unit with care of the sick elderly and lots of outpatients' clinics to deal with thousands of patients, funnelled annually to the Oxford centres for highly specialised acute care.
They believe the patient will get the best treatment and outcome at the JR because it is a centre of excellence, despite a 25-mile journey described in several reviews as too far from Banbury to be 'humane' or 'safe' to transfer very sick patients. Without the Horton there is a gaping chasm of some 50 miles between Oxford and Birmingham, with a huge population contained within it.
Two years ago the Oxford University Hospitals Trust (OUHT), which runs the JR, Horton and Churchill hospitals, used less-than-satisfactory excuses to abruptly remove emergency general surgery from the Horton, meaning patients with excruciating conditions (e.g. gall bladder emergencies, twisted guts, ruptured hernias) could no longer be admitted.
The result was chaos for patients as desperately overworked staff at the JR in Headington tried to accommodate an extra stream of sick and painridden individuals, brought to them by completely overstretched ambulance teams or taken by relatives. Many deemed insufficiently acute for immediate surgery were simply told to find their own way home, some numbed with morphine, expected to make their own way back within hours for a scan for further diagnosis.
The system simply cannot cope in that way and patients should not be treated in that fashion. Stories I dealt with at the time included a rash of incredible cases of patient mis-management - not the fault of doctors but of over zealous managers.
How NHS Underfunding is Affecting Our Services
The Horton General Hospital does not deal with the most highly specialised medicine or surgery such as cancer, heart or stroke care. Orthopaedics and trauma have long since been removed, orthopaedics as a consequence of the Orthopaedics Treatment Centre (the Ramsay Centre) opening, and trauma because orthopaedics was unavailable.
The dedicated special care baby unit has been under review and inpatient care for the elderly with dementia has been removed from the Horton site leaving families and friends to travel to Oxford to visit relatives for months on end.
Cuts to Oxfordshire County Council's budget, necessitated by 'austerity' to pay the bankers' debts have resulted in long delays in social care packages being created for the elderly who are sufficiently recovered to go home with support. This 'bed blocking' is causing severe log jams at both the Horton and JR accident and emergency (A&E) units, since there are no available beds for new admissions.
Target times are then missed and once again, the NHS is blamed as a 'failing institution' when it is not failing - it is being underfunded and denied the tools to do the job efficiently.
Doctors who should be operating are unable to perform procedures because there are no beds for patients to recover in.
In terms of A&E, the Horton traditionally outperforms the JR, although the OUHT insists on banding the two sets of statistics together, giving the Trust overall a better performance rating than the JR deserves. But from the figures, the statistics paint an unnecessarily bleaker picture of the Horton than its performance warrants.
In this context, the population of Banbury led by George Parish and the Keep the Horton General Campaign (KTHG) were (and still are) right to say it is crazy to downgrade the Horton or reduce any of its services.
Only after a long and heroic battle by the united Banbury community, led by George Parish and Keep the Horton General Campaign, with the Banbury Guardian, district councils, civic leaders, GPs, MPs, parish councils and others, was a full downgrade of the Horton averted in 2008.
PLANS by Oxford hospital bosses to remove women's and children's services from the Horton Hospital to the John Radcliffe site were not in patients' interests, the chairman of the Independent Reconfiguration Panel said.
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OPPOSITION leader and Chipping Norton MP David Cameron has given his thoughts on key Horton services being saved.
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Hands off our Horton
Press Release - Campaign History and Services Saved.
PDF Document.
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The future of a struggling district hospital in Oxfordshire has been secured by the Health Secretary.
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The Secretary of State for Health, Rt Hon Alan Johnson, accepted the recommendation of the Independent Reconfiguration Panel that it was too far to send sick patients, ill children or mothers in labour to Oxford for admission. (See History of the Horton).
Threats the Horton General Hospital still faces
A number of issues continues to cause the Horton survival problems:
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A lack of 'middle grade' doctors (specialists in training)
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A perception that a small hospital with many fewer patients than the JR does not give trainee doctors enough breadth of experience
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The loss of 'training recognition' by the Royal Colleges as a suitable place for doctors to train as consultants
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A constant drain on resources and cuts in staff caused by underfunding of the NHS by the government.
Campaigners in Banbury argue that trainee doctors working in Banbury get general hospital experience, an advantage lacking in modern training programmes, but advocated as a benefit to medical students.
(See http://careers.bmj.com/careers/advice/bmj.331.7519.s137.xml)
They also ask the Trust to rotate trainees between work at the JR and the Horton - as the IRP recommended - allowing the Horton to continue treating patients and giving young doctors invaluable experience of varied practice in a small, district general hospital setting, as well as the intense throughput of a giant hospital like the JR.
The benefits of a district general hospital are declared by none other than Prime Minister David Cameron, whose constituents use the Horton as their preferred acute hospital. His betrayal - that he is now presiding over savage cuts to hospitals including the Horton - is not lost on the Banbury National Health Action Party. Indeed this is one of the reasons the National Health Action Party was created - to save all NHS services Mr Cameron alludes to in the Link Here:
The solution adopted to allow acute services to continue after 2008 was the formation of paediatric (children's) and obstetric (maternity) services as fully, consultant-led wards. This is more expensive than the old mixed method of consultants and middle grade doctors, but it relieves Oxford of added patient numbers and allows the vastly expanding population of Banburyshire to enjoy the right to continued service within reasonable distance of their homes.
The Domino Effect
It has been accepted that if one critical service is taken from the Horton, others cannot survive. This is why it is essential that we do not allow any further erosion of services at the Horton. We have to be extremely alert to moves, or excuses, being made to discontinue or downgrade any departments.
The Domino Effect goes as follows. If you remove paediatrics, you do not have paediatricians available to be on hand for difficult births; therefore you cannot have an acute maternity unit and any birth with any chance of complication must be booked in to Oxford.
If the maternity department, which conducts planned and emergency caesarian section operations, were to go, there would be no economic justification for keeping 24-hour anaesthetics - and if anaesthetics went, you could not have a critical care unit (intensive care) and therefore accident and emergency (A&E) could not continue as a major service.
We are in a dangerous position because some departmental heads in Oxford are irritated with the continuing cost and strategic implications that maintaining a small hospital poses.
They are used to a very elevated academic medical atmosphere in the university hospital environment of Oxford and they believe, in spite of the practical chaos patients sometimes face at the supercentre, that treatment is better in the care of highly qualified, sub specialist Oxford consultants, concentrating on very limited areas of the body, than multi-tasking consultants in Banbury.
We believe rapidly-expanding Banbury needs its own acute district general hospital for all the reasons it ever did. If the way to do that is to share consultants with Oxford here in Banbury, we welcome that. But we argue that the need for an acute, district general hospital will be even greater to embrace the 100,000 more adults and children who will be moving into the Banburyshire catchment.
To allow any erosion of services with this enlargement of the population in sight would be grossly negligent and unwise.
Please vote for the
National Health Action Party
at the General Election on May 7.
To ensure that politicians, the Government and the Oxford University Hospitals Trust know that Banbury means business in this critical area of our lives
Please vote for the
National Health Action Party
at the General Election on May 7.