Hospitals!

Here in Epsom, in the far north of Surrey, we are lucky enough to have our own general hospital, in our case about half an hour's walk away. My guess is that by current standards it is quite a small hospital, making provision of a full range of services expensive. A lot of the buildings are quite old and also expensive. Against this background it seems inevitable that provision is kept under review.

Hospitals are a subject which brings the good people of Epsom out to meetings. Is it the density of people in suits? Is it an aging population? Do we feel threatened by reviews of provision? Some of these people don't seem to understand that provision has to be paid for and that the public purse is not a money tree - with the screen shot included above coming from that neck of the woods. A product of a time when everybody can try to make a splash on the Internet. Twenty years ago, there would not have been a home for this sort of thing.

A major exercise is presently under way to look at the future of both Epsom Hospital and the St. Helier Hospital with which it is brigaded for these purposes - and they are now running a series of consultative public meetings at which they tell us where they have got to and we tell them what we think. I think the responsible body is the consortium of the NHS Surrey Downs, Sutton and Merton Clinical Commissioning Groups. They look to be responsible for references 2 and 3.

Partly because we are old enough to be actively interested in the provision of health services, we thought we would go to one of these meetings, and ended up at one actually put on by Epsom & Ewell council - and, luckily, our car service had concluded in time for us to be able to get there under our own steam. A meeting in the large underground theatre at Bourne Hall, formally a public meeting of a health flavoured committee of the council. Quite a lot of councillors and Residents' Association people there, with Epsom & Ewell, oddly, being more or less in the pocket of said Residents' Associations. Not as many members of the public as I was expecting. Probably less than a hundred of us altogether.

The format was that the health team, three or four of them, gave a presentation. That was followed by their tackling questions which had been taken in advance and sorted into groups. That was followed by questions from the floor. A format which I thought worked well. And well managed by a lady whom I assumed was the chairman of the committee in question - a lady who did not feel the need for the meeting to be about her.

I also thought that the health team had struck the right balance with their preferred option. The right balance between not having made their minds up, being open to comment and coming clean about where their thinking was going. The preferred option being one of three options, all of which were thought to be viable.

All three options involve pulling out acute services into a new acute care hospital. Both the existing hospitals would retain their A&E facilities and would retain more than three quarters of that business, but the expensive part of that business, the top end, would be concentrated in a new hospital, in what they call a specialist emergency care hospital. The big choice was where to put that hospital. We were convinced by the expert view that the best value for money was to be obtained not by building on either the Epsom or the St. Helier sites, rather by going for a site at Sutton, next to the Royal Marsden outpost there.

As members of the public not spending much time on the matter, we are taking this mainly on trust. But we felt that the team, as represented at this meeting, deserved that trust. And there seem to be plenty of others with the time and skills needed to test their thinking.

Maybe I will fill in one of their online questionnaires - although I don't think I have anything to contribute apart from assent: saying that it would jolly handy to have a full-on hospital up the road from me does not add anything of value to the debate.

One of the problems which I did not feel was addressed, and perhaps this is not a problem which can be addressed locally, was the excessive dependence on expensive agency staff at all levels. Surely we have to push up the supply of health care staff and their salaries to a level where supply matches demand? Paying agency staff for ever and ever is not a good answer at all: to meet short term changes in need yes, but not more than that.

PS: we did wonder how many evenings the experts were giving to meetings of this sort. Did they get some time off, in lieu as we used to say in my part of the Civil Service?

Reference 1: https://www.epsom-sthelier.nhs.uk/. Our hospitals.

Reference 2: https://improvinghealthcaretogether.org.uk/consultation-on-500m-epsom-st-helier-proposals-now-live/. The experts.

Reference 3: https://improvinghealthcaretogether.org.uk/consultation/key-documents/. Their documents.

Reference 4: http://koshh.org/. The splash.

Reference 5: https://psmv3.blogspot.com/2016/06/pianos.html. Our first visit to the underground theatre.