Horton - home

Please take a few minutes to write to them explaining why it is so important to keep our services in Banbury.

The IRP have set up a dedicated Horton email address: irpreview@southcentral.nhs.uk

Or, you can write to the IRP at:

Independent Reconfiguration Panel
Kierran Cross
First Floor
11 The Strand
London WC2N 5HR

Or call them on 0800 023 4680

They have to report to the Health Secretary on 18 February 2008 so please write well before then to give them time to take your views into account.

We're not doing a standard letter this time because individual letters, however short, count so much more. Common sense tells us that the new proposals will result in tragically unnecessary deaths; and we're sure everyone will have a personal reason why they believe services should be maintained. We'd love you to tell the IRP your reasons.

Here are some thoughts which may add weight to your letter:

Letters to the IRP and government

Stakeholder Group's report published

After many months of meetings, reviewing and questioning reams of complicated evidence, the stakeholder group has published its response to the working groups' recommendations. Our representative on the panel, and Banbury Town Council's representative, worked extremely hard to ensure that the views of the Keep the Horton General Campaign - and by extension, the views of the general public - were properly represented in the final report, and they have done a superb job.

It must be remembered that the report reflects the views of a diverse group, not all of whom remain as opposed to the proposals as we do. However we are pleased that the majority of those on the panel remain against the proposals on the basis that the Trust has not done all that it can to look at alternative ways of sustaining the current pattern of services at the Horton.

The group states "We have found ourselves being asked to choose between the lesser of two evils - on the one hand there are the clinical risks inherent in the current service arrangements;" (*) "on the other there are the proposals that by addressing the clinical risk will worsen access to services for local people" (*due to changes in national policy on medical training and the European Working Time Directive)

The report goes on, "The proposals that the clinical working groups have put forward may be a ‘least worst’ scenario but they represent a significant downgrading of access to services and a worsening of choice for women and children in the Banbury area. We expect the Trust Board to take note of our comments to this effect before making their decision.

We are aware, however, that the Trust Board may decide anyway to go ahead with the proposals from the clinical working groups. For this reason we have made recommendations about how we think the proposals could be enhanced and improved.

It is important to note this should not be taken to mean that we support them and that our comments and recommendations should only be read in this context"

The report then lists 21 recommendations that the group considers should be implemented to strengthen the proposals, if the Trust ignores the stakeholders' opinion and goes ahead with the changes.

The stakeholder group recognises that the reasons for the changes are national changes in medical education and the implementation of the European Working Time Directive. However, as the report states "(this) seems to us to be missing the point – health services must be designed in the best interests of patients and education and training should support that objective. Instead in Oxfordshire and other parts of England educational concerns are leading decisions about the pattern of healthcare with patient needs coming second." The report goes on to say that the "ORHT has a duty to raise this matter at a national level and challenge the rationale for these policies."

The report is also highly critical of the way in which the working groups and trust undertook the review, and raises concerns about the potential for the "domino effect" damaging other vital services at the Horton, such as A&E.

You can read the full report here.

______________________________________________________

Please send this letter to your GP

There is a “new” set of draft proposals on the table.
As a member of the Stakeholder Panel, we’ve seen them – and we can tell you they are not substantially different to those put forward last time.

The local GPs met on June 13, but as yet have been unable to decide their response due to the inherently complex nature of the problem. The GPs are probably the most influential body in the eyes of the ORH Trust, so their opinion matters a great deal. Last year, 85 of them described the Trust’s proposals as “unsafe and inhumane”, and this is one of the main reasons that the Trust were forced to go back and review their position.

It is vital to the success of the campaign that the GPs maintain their solidarity, and ensure that the Trust know how bitterly opposed the people of Banbury are to any paring down or withdrawal of services at the Horton General Hospital.

So – if you think the children in the Banbury area deserve round-the-clock care; if you think our women deserve a safe, consultant led maternity service; and if you are worried that the paring down of these services might have a knock on effect on other services such as A&E – we need you to send a letter to your GP telling them so.

We’ve drafted a letter for you which you can download here.
Of course, if you are able to write a personal letter to your GP that would be even bettere.

Please pass the letter onto anyone that you know who might send it, or copy it and hand it out at school, work or church.

But above all – please sign and send it RIGHT NOW! Most GPs surgery addresses are listed on our sample letters page

The Trust's proposals have now been condemned by all the local stakeholders in the consultation process. Medical professionals, the scrutiny committee, politicians, civic leaders, religious groups, business groups and of course the general public are UNITED in rejecting the proposed cuts.

The Keep the Horton General Campaign response and appendices
You will not be surprised to learn that we believe the proposals will have a significant detrimental effect on the services provided to the people of North Oxfordshire and surrounding areas. We reject the Trust’s proposals in their current form, but would welcome the chance to work with them openly and honestly to find a solution that provides a safe, sustainable service for the people of the Banbury area.

(The appendices form an integral part of the report and must be read in conjunction with it.
The response has been split for ease of downloading)

The Oxfordshire Joint Health Overview and Scrutiny Committee (149K)
This is the only stakeholder with the authority to refer the proposals to the Secretary of State for Health. Their response is highly critical of the changes to paediatric and maternity services, among other areas.

General Practitioners response (167k)
The GPs of North Oxfordshire & South Northamptonshire describe the proposals as unsafe and inhumane, and accuse the Trust of intransigence, lack of imagination or vision, misinformation, and more.The GPs opinion carries a lot of weight, so this should be a big blow to the Trust!

Cherwell District Council's response (2.7mb)
Comprehensive and damning, Cherwell District Council's report is well supported by figures disproving some of the fundamentals of the Trust's consultation document

Horton Midwives (letter below)
The Horton Midwives have spoken out with great courage against the Trust's proposals for the Horton's maternity service.

MPs response
Tony Baldry MP has joined with neighbouring MPs including David Cameron to submit a joint response.

Support from South Northants District Council
We welcome the response from SNDC, who represent the 30,000 South Northants residents in the Horton's catchment area.

________________________________________________________

The Oxford Radcliffe Hospital Trust's Consultation Document
This is what it's all about, and there's a summary on page 20 of Part 2. You should read it because you need to comment on it to be part of the consultation exercise. But read between the lines - and remember the source.

Whatever they are saying about "improvements" to services - they are talking about improvements for Oxfordshire as a whole, not the Banbury area. With the exception of elder care, there is no way any of these proposals are improvements to people in North Oxfordshire, South Warks or South Northants. You WILL see a reduction in the way YOUR heath care is delivered.

There are many errors in the report, some of which are listed below. Please note that claims that womens' and childrens' services are not clinically sustainable are highly suspect as there are reports that refute this - but the ORH Trust will not recognise them in this consultation.

AS GENERAL practitioners working in the area served by the Horton Hospital, we are writing to express our grave concern at the proposals being put forward by the Oxford Radcliffe Hospitals Trust to downgrade the range of services at the Horton Hospital.

The immediate threat is to round-the-clock paediatric services, which in turn will mean that the maternity hospital can no longer continue to provide consultant-led obstetric care.

This would entail the transfer of most maternity work to the already overcrowded John Radcliffe Hospital, with a minority of births – currently estimated at 600 out of 1,600 – taking place in a midwife-only unit in Banbury. There would be no medical cover for this unit closer than the John Radcliffe Hospital.

Our present midwifery service at the Horton has been described by ORT as an award-winning service. It provides choices for women to either deliver in a unit run by midwives and supported by obstetricians, paediatricians and neonatal nurses on site, or to deliver at home with the knowledge that help is very close by.

The proposed new system will reduce choices for women and runs counter to the spirit of increased choice.

A similar scheme was put in place at Kidderminster when the local hospital was downgraded in a similar way. "Low-risk" births continued at the Wyre Forest Birth Centre with frequent transfers of mothers in labour to the consultant-led service at Worcester, about 15 miles away. In less than two years, there were six unexpected neo-natal deaths and the unit was subsequently closed following a public enquiry. Similar problems occurred within months at Bishop Auckland when a consultant-led obstetric was closed down.

The risk to and distress of mothers undergoing an ambulance transfer taking over an hour in the late stages of labour is unacceptable. Still worse is the scenario of a baby delivered at Banbury who is in need of immediate medical attention and who has to be rushed to Oxford with only the most elementary resuscitation en route, and who dies or suffers brain damage as a result.

This is the most serious threat to health services that Banbury has faced. Only a few years ago, the Davidson Inquiry carried out a comprehensive review of local health needs and concluded that the Banbury locality needs its general hospital, including 24-hour paediatrics.

We cannot support the ORHT proposals, which would remove or severely undermine services essential to the residents of our community, particularly the vulnerable. They are unsafe.

The North Oxford and South Northants GP Forum
(A group representing local GP Practices)

Full 24 hour childrens' services were ruled essential in Banbury after the tragic death of a young child in 1974. The letter that follows is from his parents to Trevor Campbell Davis, chief executive of Oxford Radcliffe Hospitals Trust.

THIRTY-TWO years may seem a long time to some people, but we as a family can assure you that time does not heal quickly.

We refer, of course, to the loss of our son, Ian, through actions at the Horton General Hospital on February 25, 1974.

As you will be aware or advised, his loss – along with other factors – directly attributed to the lack of paediatric facilities at that time at the Horton. You will also have been advised that Ian’s was not the only child death at the hospital at that time; another had occured a few months previously.

Part of the recommendations of a public inquiry set up after Ian’s death was that there should be full 24-hour paediatric facilities at the Horton – and common sense prevailed at that time, with this recommendation being implemented. What has now changed that you consider these facililties are no longer required?

It now appears that with an ever-increasing population in the Banbury area that the decision is that a reduced paediatric facility is acceptable at our local hospital.

Well, we believe that you should never revert to a system that is able to allow history to repeat itself.

We appeal to you not to proceed with the transfer of any paediatric service or even any service from this hospital to any of the Oxford hospitals.

Letter from the Horton midwives

Some of the Horton midwives have bravely spoken out in protest at the cuts. Their letter, published in the Banbury Guardian on 8 June, really brings home the full extent of women who will be forced to go to the JR. There is also a cleverly worded letter from the Midwife Managers in the following week's paper which emphasises that of course the midwives will continue to provide the best care they possibly can - and that's the point. The midwives, not the consultants, will provide the care, and that means all the reductions outlined in the original letter by the midwives.

Letter from the Horton midwives to the Banbury Guardian, 8th June 2006

"WE WISH to make it known to the people of Banbury that the overwhelming majority of midwives working at the Horton Maternity Unit adamantly oppose the changes being proposed by the Oxford Radcliffe NHS Trust regarding the provision of maternity services in the Banbury area.

We are dismayed at the lack of consultation with staff and service users that has taken place in the planning of these changes and believe that if the changes being put forward are fully implemented, the safety of mothers and their babies in the Banbury area will be compromised.

Limited details of the proposed changes, including the possible use of ‘alternative’ therapies and provision of single rooms, have recently been published. While these suggestions may seem appealing to many women the reality is that a midwife led unit would only provide care for a select group of low risk women. This would mean that a very large number of pregnant women in the Banbury area who were not considered low risk would be excluded from using the service and be left with no choice but to travel to the John Radcliffe Women’s Centre in Oxford for their maternity care.

The following are just a few of the reasons why a pregnant women would not be allowed to use the birth centre:

- A previous difficult delivery or pregnancy
- A previous caesarean section.
- A slow growing baby
- A suspected large baby
- Twin pregnancy
- Diabetes
- High blood pressure in pregnancy
- Low blood iron levels in pregnancy
- Premature labour (before 37 weeks)

In addition, women who did use the birth centre would not have access to the following procedures:

- No caesarean sections, emergency or planned
- No doctors available to carry out forceps or ventouse deliveries
- No paediatrics available to resuscitate and treat babies.
- No epidurals
- No blood transfusions
- No induction of labour
- No Special Care Baby Unit.

Women in labour requiring any of the procedures or services would have to endure an ambulance journey of more than 30 minutes to the John Radcliffe, with no guarantee that an ambulance would be immediately available to transfer them.

The John Radcliffe Women’s Centre is already operating at full capacity and no extra provision of facilities for the increased numbers of women who will need to be transferred from the Horton have yet been put into place.

Pregnant women in the Banbury area who wish to give birth in a midwife led unit already have the choice of using the excellent birth centre facility at Chipping Norton Hospital. We feel that an additional midwife led unit in Banbury is unnecessary and greatly limits the amount of choice for pregnant women in the area.

We need a safe, caring, appropriately funded obstetric unit in Banbury to provide local women with the level of choice and care they deserve.

We hope that the people of Banbury will support us and speak out against the proposed changes"

The midwives at the Horton Maternity Unit

KEEP THE HORTON GENERAL

Our hospital provides vital services to Banbury's growing population.

We're about to lose those services.

This is what people have to say about it.
______________________________________________

Write to the Independent Reconfiguration Panel

Letters to the IRP and government

Stakeholder Group's report published

Please send this letter to your GP

KEEP THE HORTON GENERAL

Our hospital provides vital services to Banbury's growing population.

We're about to lose those services.

This is what people have to say about it. ______________________________________________

Write to the Independent Reconfiguration Panel

Letters to the IRP and government

Stakeholder Group's report published

Please send this letter to your GP

This is what people have to say about it.
______________________________________________