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24 March 2003

The Horton Hospital

A continuing concern for the Horton General Hospital (HGH) has always been that critical services will be lost to the hospital on a bit by bit basis, either by being consolidated with or transferred to services in Oxford.

Given the comparatively small size of the Horton as a general hospital, the loss of any service or facility inevitably has a knock on effect on the range and capacity of remaining services at the hospital.

I understand that your predecessor had decided to initiate a review of the path lab services at the Horton and the provision of mortuary services.

Having seen various of the papers relating to this "option appraisal" I cannot help but conclude that this was an option appraisal where the conclusion was already decided before the appraisal commenced which was to seek to transfer path lab services (Cellular Pathology Services) and mortuary services in their entirety to Oxford, transferring autopsy and laboratory processing from the Horton to Oxford, so that all the consultant pathologists will henceforth be based at Oxford with consultant pathologists only coming to the Horton " ... as necessary, e.g. for one-stop clinics".

Apart from the fact that this was a review which clearly started with the conclusions already written, so far as I can see, it is a review which at no time involved the effective consultation of local user groups, whether it be the Community Health Council, which whilst now in the process of being wound up, at the start of this process was still in existence. I would be interested to know how much consultation there was with local GPs and it is clear to me that even from a cursory reading of local Press reports, there was absolutely no consultation with local undertakers who, if these proposals are going to go through, are going to have to go to Oxford on a regular basis, to collect bodies that have been moved there for post mortems from the Horton � adding not insignificantly to the undertakers� costs.

No coherent explanation has been given for this consolidation at Oxford. There has been no explanation as to why the consultant pathologists cannot continue to do their work at the Horton. There is a perfectly good mortuary at the Horton, with first-class mortuary technicians.

The transfer of "autopsy and laboratory processing of tissue from the Horton" to Oxford is inevitably going to have an effect on other medical and clinical services delivered at the Horton. This strikes me as being yet another instance where the Oxford Radcliffe NHS Trust is looking simply to save costs, largely because of the enormous overspend at the John Radcliffe, and as has happened so often in the past, it is the Horton Hospital and the community which it serves, who will see a reduction in services. I would be extremely interested to hear any arguments that this is going to enhance the services for my constituents and the idea that if a patient dies in the Horton and requires a post mortem, they are going to have to be trundled all the way down to Oxford and back after they have died, I think many people will simply find macabre. The argument put forward by management at the Oxford Radcliffe NHS Trust that "it is our view that this option will serve best the needs of the users of the service, fitting it better to meet the demands of quality, clinical governance, accreditation of the laboratories and modernisation of pathology" I think is positively Orwellian in its "double-speak" use of language.

All of this may well be to the convenience to the management of the Oxford Radcliffe NHS Trust, and I am sure will be greatly to the convenience of those working at the John Radcliffe, and those who wish to protect and enhance medical services in central Oxford. It will, however, in no way enhance services at the Horton.

Given that there appears to have been no proper consultation on this exercise, I am copying this letter to the local press.

I should be grateful for your comments.

Tony Baldry