At the 20th January Greater Huddersfield and Calderdale Clinical Commissioning Groups meeting, the governing bodies’ unanimous decision to go ahead with a public consultation on plans to cut hospital and close hospital services was immediately denounced by a member of the public, who said:

“This is like North Korea”.

Amid general outcry, someone called out, to a round of applause.

“Shame on all of you”,

While another calmly said,

“You’re a cabal preparing for privatisation. That new hospital will be wrapped up in a pink ribbon and sold off.”

Before the governing bodies’ vote, members of the public were left baffled by the announcement by one member of the governing bodies that:

“I’d like to clarify that this is a very different new model of urgent and emergency care than is currently in place.

There will be an urgent care centre in the planned care site and an urgent care centre in the unplanned care site, along with an emergency care centre that will function quite differently from A&E.”

Dr Brook, the Chair, refused a plea from the floor (by me), to explain how an ECC functions differently from our current blue light A&E.

(Update:  An A&E Consultant has now kindly taken the time to explain what the Governing Body refused to. Please see info at the end of this report.)

Banners, placards and fury

Members of the public who were not at work at 1.30pm on Wednesday 20th Jan turned up with banners, placards, and fury at the Clinical Commissioning Groups’ plans to:

• knock down HRI, and sell off the site for development,
• build a 119 bed planned care clinic plus outpatients and and urgent care centre on Acre Mill,
• take services out of the hospital and put them in the community (so-called Care Closer to Home)
• expand CRH from 400-ish beds to 615 and make it the unplanned care hospital and emergency care centre for both Kirklees and Calderdale

Except when you read the pre consultation business case, you find that Kirklees patients will be sent to the nearest A&E, not necessarily to Halifax.

And as already mentioned, members of the public heard a “clarification” at the meeting that Halifax will have:

“an emergency care centre, that will function quite differently from A&E.”

Which was a bit of a shock.

Standing room only

It was standing room only at the NHS commissioners’ meeting to rubber stamp the decision that they were ready to consult the public on their plans to cut hospital services and replace them by care in the community; scores more people were unable to get into the 100-ish seater room at Briar Court Hotel.

Waiting for the meeting to start, a bald member of Calderdale CCG governing body repeatedly mopped his pate with a large handkerchief.

Dr Alan Brook, true to form in previous CCG meetings, swiftly infuriated the public by telling us this was not a public meeting but a meeting in public.

A member of the public twice raised a point of order that people had been denied access to the room. Dr Brook said:

“We don’t take points of order from the floor.”

Summarising the categories of questions the public had sent in before the meeting, that the CCGs had decided not to answer any of in the meeting, Dr Ollerton slipped up by saying,

“There were questions about other services, not just A&E. Many other services are going to be affected when we change it.”

A member of the public mocked:



“ ‘When we change it’ – you’ve already decided.”

At which there was a general outcry.

Strong public challenges to the CCGs’ “Readiness for consultation” presentation

This was provoked again when the Right Care Right Time Right Place programme manager Jen Mulcahy, putting forward reasons why the CCGs were ready to go to public consultation on their NHS cuts plans, told the Governing Body that the ‘future model of care’ included:

“…enhanced community services – taking service out of the hospital into the community – Care Closer to Home – which is what people have told us they want.”

Incredulous protests were met by Dr Alan Brook calling the meeting to order.

M Mulcahy proceeded to explain that Phase 1 of Care Closer to Home had been done, and in Kirklees the CCG had awarded the contract for this to Locala.

At the mention of Locala there were boos and shouts of

“Rubbish.”

There were further cries of “Rubbish” when Ms Mulcahy explained that the financial implications of having CRH rather than HRI as the unplanned/emergency care site were:

“ most favourable for the Trust’s income and expenditure and cash position.”

Amid the public outcry Katherine Horner, who has been campaigning for the last two years to keep both A&Es open, called out:

“It’s about PFI.”

Undeterred, Ms Mulcahy ploughed on through her presentation about how the CCGs were ready to consult the public about their proposals for hospital cuts.

Outlining issues to do with access to care, she was interrupted by a member of the public who pointed out:

“On page 36 of the Pre Consultation Business Case, it says that Calderdale people don’t want to lose their A&E. It doesn’t mention that Huddersfield people don’t either.”

Ms Mulcahy said,

“There’s no difference in the quality of care, regardless of either site.”

There was a public outburst of:

“Rubbish!”

“Where’s the evidence?”

Dr Brook tried to get a word in edgeways.

Ms Mulcahy said, to public dissent,

“The evidence is in the Pre Consultation Business Case engagement section.”

Dr Brook said to the dissenters:

“Please be quiet and let her proceed. We’re not taking questions from the floor.”

Ms Mulcahy continued,

“There are no differences in any of the criteria for any site except the financial sustainability criteria.”

She went on to outline key messages in the Pre Consultation Business Case, punctuated with cries of

“Rubbish.”

“You’ve decided, haven’t you.”

“It’s already been decided.”

“Rubbish.”

“No it won’t.”

“It’s just words, it doesn’t mean anything.”

Dr Brook said,

“This meeting is to decide if we’re ready for consultation.”

Someone answered,

“You’re not, the pre-consultation is flawed.”

Dr Brook said,

“You have failed to take note of the preceding statement. Both towns will have urgent care centres.”

What about emergency care?

Someone asked,

“What about emergency care?”

After Ms Mulcahy ended her presentation, as already reported one of the CCGs’ governing body members said:

“I’d like to clarify that this is a very different new model of urgent and emergency care than is currently in place.

There will be an urgent care centre in the planned care site and an urgent care centre in the unplanned care site, along with an emergency care centre that will function quite differently from A&E.”

I stood up and asked for an explanation of how an ECC would function differently from A&E. Applause from most of the people in the room showed they wanted an answer to this question too.

But the chair Dr Brook refused.

(So after the meeting I ploughed through the Pre Consultation Business Case (PCBC) trying to find out how the Emergency Care Centre differs from an A&E. I also sent out an appeal for info from anyone in the know. This led to an A&E Consultant kindly taking the time to provide an explanation – see update at the end of this report.

And although it’s not clear from the PCBC how the “emergency care centre will function quite differently from A&E”, the PCBC does state that:

“The single unified Emergency Care centre… would provide Emergency/Acute medicine and Accident and Emergency services.”)

PFI

The Finance Officer Julie Lawreniuk turned to the subject of PFI, and said:

“The Trust have explored all options around PFI. They’ve taken all reasonable steps to manage the PFI.”

A member of the public retorted,

“The PFI has usurious rates of interest, it’s a disgrace”

Which was met with loud applause.

Unanimous governing bodies’ vote to consult the public in early February

And after a few more rehearsed, spineless comments and questions from Governing Body members, both Governing Bodies unanimously agreed to consult the public on the so-called Right Care Right Time Right Place NHS cuts scheme.

As already reported, this did not go down at all well with the public.

A Kirklees Councillor stood up and protested at the Governing Bodies’ refusal to take public questions and to use the 10 Minutes on the agenda allotted for answering public questions.

Dr Brook said the next steps would be to produce the detailed consultation proposal and the consultation plan and to launch the consultation in early February, to run for 12 weeks followed by 7 weeks’ reflection by the CCGs.

A member of the public asked,

“Will it be couched in the same management gobbledygook as the rest of the documents?”

And then the Governing Bodies were off to lunch, leaving members of the public to exchange emails addresses, phone numbers, cards, information and protest arrangements.

Demonstration Sat 23rd Jan and public meeting Wed 27th Jan

There is a demonstration at 1pm in St George’s Square on Saturday 23rd January and a public meeting on Wednesday 27th Jan, 7pm at The Methodist Mission, Lord St, Huddersfield.

Save Lewisham Hospital has emailed to offer their support in our campaign to keep both A&Es open and to stop the hospital cuts.

Joint Scrutiny Committee 29th Jan has power to stop consultation

The evil empire run by Simon Stevens, previously Vice President of global American health insurance company United Health, is setting about Calderdale, Kirklees and North Kirklees. The proposed “Right Care Right Time Right Place”  hospital cuts will irreparably damage the NHS in all 3 areas if we let them happen.

There is a joint scrutiny committee meeting in Huddersfield on 29th Jan. 10.30am, Council chamber, town hall. The committee have the power to stop the consultation on the grounds that the proposals will damage the NHS in both Calderdale & Kirklees, and since both Councils have rejected these Right Care plans as unfit for the people in their areas, the committee won’t have a leg to stand on if they don’t stop the consultation and refer the plans to the Sec of State for Health.

Everyone who can, needs to go to that meeting and email councillors beforehand too.

Info here about Calderdale Council’s rejection of the “Right Care” plans

Last night Kirklees Council also rejected the “Right Care” plans.

Update: Info about Emergency Care Centres from kind A&E consultant

The first version of this report suggested that there would be no A&E at Calderdale Royal Hospital if these changes go ahead. This was an inference from a statement at the meeting by a member of one of the CCG Governing Bodies, who said:

“There will be an urgent care centre in the planned care site and an urgent care centre in the unplanned care site, along with an emergency care centre that will function quite differently from A&E.”

An A&E Consultant has kindly taken the time to explain what the Clinical Commissioning Groups Governing Bodies refused to at the meeting. He says:

“I’m unfamiliar with the term “Emergency Care Centre” as are those of my colleagues I have asked about it, in addition the Royal College of Emergency Medicine make no reference to it as a recognised entity. What I have found so far are centres bearing this name in Wigan, Gateshead and Cambridgeshire.

What they all share in common are the presence of an Emergency department (A&E) and an Acute or Medical Assessment Unit (AAU or MAU) with the variable inclusion of GP services, an Urgent Care Centre (UCC) or Walk In Centre, Urgent Children’s services and a Surgical Assessment Unit. I suspect that these are in fact what the Keogh Urgent and Emergency Care Review refers to as “Emergency Centres” in their Safer. Faster. Better document. If so then the CCG should be pressured into confirming that their Emergency Care Centre will have at its core an Emergency department; any other configuration would be something so far unknown and I suspect unlikely to receive the approval of the Royal College of Emergency Medicine.”

I have found that the Pre-Consultation Business Case states (p 55)

“The single unified Emergency Care centre…would provide Acute/Emergency Medicine and Accident and Emergency Services.”

So as long as that is the same as an Emergency department, then I guess that would meet the approval of the Royal College of Emergency Medicine. But the PCBC doesn’t seem to  specify the opening hours of Emergency Care Centre. It says there would be a 24 hour operating theatre, and it says the urgent care centres would be 24/7, but can’t anything about ECC opening hours.

There are still questions that need answers from the CCGs.