Hospital clings on to A&E in face of growing public anger

Scarborough Hospital is clinging on to its A&E department in the face of mounting public fear over NHS cutbacks.

A petition opposing cuts attracted about 25,000 signatures within a week.

The NHS’s Humber Coast and Vale area, which includes York and Scarborough, has been told by government to find savings to plug a massive £420m funding gap by 2021.

Anger greeted NHS representatives at two public meetings called at short notice by the health trust and attended by hundreds of people.

After a period of uncertainty, the trust is now saying it will protect and enhance the A&E department, although it isn’t known if other services might be reduced or lost in exchange.

Dr Becky Chandler, who lives in Scarborough and practises in Whitby, said: “The review [of acute services] is a significant public consultation on what we, as Scarborough residents, think about the future models that are proposed for the hospital.

“A private company has come to review just Scarborough Hospital”, Dr Chandler said. “They are not looking at York Hospital, despite them having merged. Yet senior York-based personnel are having a say on our future services and what should be reduced here and possibly expanded in York”.

Dr Chandler said the dangers include:

* Reducing or stopping emergency surgery and moving some routine elective surgery elsewhere, likely York, Hull or Middesbrough. This means, in an emergency, travelling far away from loved ones, even having the risk of travelling further to see a doctor, on roads that aren't even dual carriageways. Travelling for pre-op assessments, having surgery there and then post-op follow-ups.

* Reducing obstetric cover to a midwifery-led unit. “Any complications would be shipped to either York or Hull. “Midwives can't control bleeding, do Caesarean sections, even offer alternative pain relief such as an epidural. Imagine travelling in an ambulance or being stuck on the A64 while in labour and scared”, Dr Chandler said.

* Downgrading A&E to a minor-injuries unit (MIU) led by nurse practitioners. “We are a trauma unit as we are so far away from other hospitals. Therefore if we become an MIU we will lose this and our population will be at risk.

* “Pushing outpatient appointments into primary care when waiting for a GP appointment is already weeks away. Some local GPs are leaving due to the pressure and we have very few trainees coming to train in our area”.

* Closing the hospital’s paediatric ward. “Our children will be shipped to York and families will be split at times when they need to be together”, Dr Chandler said.

She added that about a third of Scarborough residents don’t have a car. “We are a poor area, over 40 miles from any other hospital. The number of attendees to A&E in the summer rises by 13.5%. We need Scarborough Hospital. Otherwise we won't get tourists, we won't get future employees or new businesses setting up”.

York NHS Foundation Trust chief executive Mike Procter says there are enormous pressures on NHS staffing in the area and that local NHS bodies have started a review on the delivery of health services.

He says no specific proposal had been made and that many scenarios have been suggested and are being considered. The public meetings were convened to “eliminate an awful lot of the scenarios”

He insisted that Scarborough’s A&E department would not be downgraded to a minor-injuries unit.

A firm of consultants, McKinsey, has been paid £150,000 to scrutinise the hospital with a view to cutting costs and achieving sustainability through centralisation, among other objectives.

A spokesperson said: “Healthcare is changing, people are living longer and there is a growing need for different types of health and care services, which are often provided outside of hospitals. This should mean that, with increased out-of-hospital care, fewer people will require the type of services that acute hospitals currently provide. Whilst this is good news for patients, it puts pressure on hospitals such as Scarborough where we are already seeing challenges in recruiting enough specialist staff or seeing enough patients to make services sustainable.

“We need to think about how we can do things differently to provide the best services for local people, not just finding a quick fix for the problems we face now, but finding longer term solutions that meet local needs.

“We have committed to retaining an emergency department in Scarborough”, the spokesperson said. “To do anything else would be unthinkable, not least due to the impact on other hospitals and the local population. Our efforts are focused on what we have to have at Scarborough and what innovative staffing models we can develop to safely deliver them if traditional staffing is not possible”.

Labour’s parliamentary candidate for Scarborough and Whitby, Hugo Fearnley, said: “Given the questionable outcomes of the recent review and redevelopment plans at Whitby Hospital, where all sorts of guarantees were made based on its proximity to Scarborough Hospital, any review that leads to a downgrading of services at Scarborough could be potentially disastrous for the people of Scarborough, Whitby and the surrounding villages.

“The enormous and spontaneous reaction online of thousands of local people rallying to the cause of their local hospital is commendable. In many ways, this issue is outside of narrow political affiliations and, as someone who has lived here all my life, I share people’s concerns and want to make sure there is the high-quality healthcare services available for everyone”.

* Scarborough Hospital staff recently took part in a 48-hour strike against private contractors taking over the catering and domestic departments of the York primary-care trust. The Unite union said the move was designed to avoid paying tax.