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Public Meeting - Observations

The following comments refer to the public meeting held in Louth on October 5th, called by Victoria Atkins MP (Cons) and incorporating members of Lincolnshire East Clinical Commissioning Group.

Post by Dominic Hinkins of Horncastle:

"Thanks to all who attended the public meeting in Louth this evening regarding the downgrade of the hospital there from 50 beds to 20 or 16. I attended in a *personal capacity*, not as a councillor.

I took copious notes, but I've tried to precis them as best I can - frankly, the panel we were presented with contradicted themselves so often, and spoke in such corporate waffle, it was difficult to get them all straight.

Here it is, anyway:

The main thrust of Dr Parks’ arguments were that ‘care is changing’, and emphasis is now on care received at home, rather than admission to hospital. His statement that “we all have beds” was met with derision. He stated that beds and the capacity for inpatient services were no longer a relevant measure because of this change in ways of working, and thus the removal of beds from Louth should not be a concern for residents who simply “did not understand this”. Dr Parks at one point said that patients should “look after themselves”.

Dr Parks cited the example of an elderly person who is admitted to hospital, where they might then pick up pneumonia or MRSA, despite going in only because they had had a fall. He asserted they were better off at home, where therapists could visit them. However, people were quick to point out that appropriate levels of home care, equivalent to that received in hospital, do not currently exist. There is currently a staffing crisis, and it is questionable whether medical staff are best used travelling between patients’ homes, rather than having patients centralised in one place. When pressed, the CCG representatives admitted they were aware there were issues with community provision, and how difficult it was for people.

Apparently contradicting himself, Dr Parks later talked about how it was better for a patient to travel from Coningsby to Louth, than have the specialist travel to them. This seems at odds with a policy of caring for people in their own homes, as it is surely an argument for retaining services at the hospital. With regard to admissions, he talked about “holistic care” and assessment being provided by social workers and nurses, rather than a doctor, using the six chairs to be provided on the ward in place of beds.

Dr Parks also initially praised the current practice of post-operative patients being dismissed more quickly to recover at home, rather than prolonging hospital stays. However, when residents highlighted cases they were aware of where people had been returned home too early, and without appropriate care, he agreed he had seen many such cases at his surgery, which put increasing pressure on him, and admitted that he usually ended up sending them to A&E, because he did not have the resources to deal with them.

Dr Parks spoke about the ease with which patients could be transferred to other hospitals with “modern ambulances”, negating the need for care to be located closer to home. It is well known, however, that ambulances are increasingly obsolete and unreliable, and the service under growing pressure. Parks later said that this was the way things were going whether he liked it or not, and he would rather patients stayed in hospital for longer to recover (formerly a function of the beds at Louth...).

Dr Parks noted that GPs were increasingly overworked because more people were surviving into old age, when they needed more attention. A resident pointed out that the number of GPs in Louth had been reduced. The Chairman of ELDC and the Mayor of Louth both noted the local plan recommended many more homes be built in the area, and the difficulty the council had overseeing such a large rural area, which would also challenge the provision of care at home.

Questions were also raised about outpatient care. A resident spoke of how she now had to make four round trips to Grimsby for these appointments, which was obviously causing her distress.

Dr Parks spoke enthusiastically and revealingly about why outpatient services would be better provided at the GP practices he owns, runs and in which he has a financial interest – the soon to be “East Lindsey Medical Group” – than at Louth Hospital. He talked about how his colleagues could work alongside staff at the hospital, apparently confirming speculation that it is to become a GP hub.

The CCG representatives appeared to deny that there had already been a substantive change at the hospital requiring a full public consultation, stating they were engaging with the community. A healthcare support worker from the hospital explained to the meeting that there is no longer a doctor on duty at the hospital, and nurses are no longer permitted to use many of their skills. They are no longer allowed to give IV drips, or perform transfusions. The pharmacy at the hospital has been removed, meaning nurses have to leave the site and walk to the co-op to access prescription drugs. Staff cannot resuscitate, and now have to dial 999 for an ambulance if this is needed.

There was some comment about the coincidence that the exact number of beds to be removed under the proposal, should have had to be removed from the hospital for 'fire safety reasons', at a time when the CCG was seeking to 'change the way the hospital worked' by removing beds.

None of the representatives were able to explain adequately how the number of beds (20 or 16) in the consultation had been arrived at, nor the admission criteria, except to explain their models were based on the idea of increased care at home. The beds have already been removed, however, before the Home First care team has been created.

A councillor noted that a reduction to 20 beds would mean there was one bed per 7,500 people in the catchment, 24% of whom are over 65. The hospital had capacity in 1953 for over 138 beds, and additional wards have been built since then. Dr Parks implied that 20 beds represented an "increase". Tellingly, he at one point referred to the reduction in beds last year as a “pilot”, before hastily correcting this to “proposal”.

I was not encouraged by the behaviour of our MP during the meeting, who did not act as an impartial chair, but more like a rather condescending and patronising primary school teacher. She was several times quite rude to members of the public, giving a severe telling off to elderly questioners who did not give their name and address before speaking. She spent a good deal of time talking about her party’s policies, rather than allowing the Q&A to proceed. She then attempted to shut the meeting down after 90 minutes, despite there being many questions waiting, and had to be asked to allow it to continue by the Chair of ELDC.

In summary, while there is something to be said, in an ideal world, for people being able to be cared for increasingly at home, the resources simply do not exist, and are not likely to exist in the future, short of the discovery of a Magic Money Tree. Every rationale given for reducing the use of beds in hospitals in general, and at Louth in particular, was undermined or completely contradicted by other things said by the experts at the meeting.

Finally, the presentation of Dr Parks as an impartial advisor of the public, when he apparently has a financial interest in the change in health provision in the area was slightly concerning."

Admin Notes:

Dominic's observations were originally posted on the "Fighting 4 Louth Hospital" Facebook page. You may comment on this Forum (FREE basic registration required), or follow the link below to the original post.

F4LH Facebook (original post)