Hospital: why Cameron was right
Updated on 23 August 2007
David Cameron claimed services at 29 hospitals were 'under threat'. Labour said nonsense in at least eight cases. The truth? FactCheck goes digging.
How did the Tories get into this NHS mess?
The idea was simple: come back from holiday with all guns blazing, campaigning on a centre-ground issue where Labour are known to be vulnerable - the NHS.
Hospital closures are a particularly sensitive topic. Health economists say they are important and necessary; larger hospitals with more specialised surgeons mean better results for patients.
In fact, it's absurd to suggest that despite changes in medical practice, no hospital department should ever close.
Nonetheless, any change to health services can be political dynamite at the local level, as no-one wants their local district hospital to shut.
Even government ministers, fearful of their own seats, have campaigned against local closures whilst supporting the policy at national level.
So this week, when the Tories published a list of 29 hostipals where they said services were "under threat", it caused a national outcry. Many of the threatened hospitals went on the record to say that they were not facing any threat whatsoever.
It seemed like an appalling series of blunders, and has certainly turned into a PR disaster. But does the list have any basis in fact?
Although Labour has challenged eight of the 29 claims, most of them do have a ring of truth.
King's Lynn
One of the hospitals on the list is the Queen Elizabeth Hospital in King's Lynn, where the Tories say maternity services are under threat.
Even local MP Henry Bellingham has attacked Conservative Central Office for saying that the hospital was under threat.
The Conservatives source for their claims has been identified as a document from the local East of England Strategic Health Authority.
But the local Strategic Health Authority issued a statement said: "There are absolutely no plans to downgrade services at the Queen Elizabeth Hospital in King's Lynn."
However, we traced one of the documents where the SHA discusses the future of service provision. You can view the PDF here.
It notes that for a maternity unit "to be efficient, therefore, a unit should be carrying out about 3,000 births."
Further on, it notes: "If it is not possible for smaller units to cover their costs under the current tariff system, PCTs and their local communities will have to decide whether they wish to continue to support the continuing provision of consultant led services in smaller units or not. If they do, then they will have to find savings from other budgets to pay for the additional costs."
It's not conclusive, but it does suggest that the closure of this facility is being discussed within the SHA.
Interestingly, the document notes that there are in fact four hospitals with fewer than 3,000 live births in the East of England SHA region.
King's Lynn is one, and the others are West Suffolk Hospitals NHS Trust, James Paget University Hospitals NHS Foundation Trust, and Hinchingbrooke Healthcare NHS Trust.
The East of England healthcare project admitted that the review had been considering the future of the maternity services in the region, but that "any proposed service changes will be the subject of full public consultation".
Horton, Radcliffe
The Tories claim that the decision on the future of this hospital has been "referred to the secretary of state". The department of health pointed us in the direction of this letter.
It is from the Oxford Radcliffe Trust, signifying their intention to ask the Secretary of State for Health to review the future of the Horton General Hospital. It does appear to entertain the possibility of a reduction of services:
"The need to consider changes at the Horton General Hospital reflects our growing concern that we could not continue to run some services safely or to the highest current standard. We have a duty to our patients to do both.
"The decision of the Board to accept these changes is based on extensive evidence and advice from clinical experts, including staff running the services, and national clinical leaders in their fields.
"Changes in medical education, restrictions on the hours which doctors can work, and best practice guidance which indicates the need for fewer more specialist centres to provide services such as paediatric s and obstetrics, have all been factors which have been taken into account."
For more click here.
The Department of Health told Channel 4 FactCheck that the terms of the review had not yet been set, so it was not possible to say whether the review would consider closing A&E or maternity services.
Nuneaton, Rugby, Warwick
These three hospitals were all subject to the Acute Services Review for Conventry and Warwickshire.
Somewhat prophetically, the executive summary of this report notes that:
"Given the timing of the review, it was almost inevitable that there would be misconceptions about its purpose. It should be emphasised, therefore, that at no stage [their bold] did the Proposals, or the Recommendations in this Final Report, suggest:
- the closure of any of the existing acute hospitals
- the closure of Accident and Emergency services at any of the existing acute hospitals
- the complete closure of any other major service at any of the acute hospitals
- immediate major changes to Maternity services at Warwick Hospital"
However, there are some changes to maternity services being discussed, including the closure of the special care baby unit at St George Hospital, Nuneaton, and the West Midlands SHA is undertaking a region-wide review of maternity services.
Read the PDF here.
City Hospital, Birmingham
Accident and emergency services are facing some changes here, which have raised serious opposition at a local level.
Some of the surgery services at City Hospital are due to be moved to the nearby Sandwell hospital, leaving only the accident and emergency department and the emergency surgery departments at City.
Accident and emergency patients requiring further surgery would face an ambulance journey to Sandwell.
The proposals are currently subject to an independent review panel (as the Tories claim) and Ken Taylor, a part-time consultant and chair of the City Hospital Supporters Group, says that the plans could "drastically undermine the City hospital".
Meanwhile, the consultant-led maternity unit at Sandwell faces being downgraded to a midwife-led unit.
Telford
This was the hospital which received an apology from the Conservatives, which was later retracted.
At the Princess Royal Hospital, Telford's maternity care has been under review, but this ended in July, and changes were rejected.
Altrincham
The Conservatives have already issued a mea culpa on this one. David Cameron admitted that they meant to say Trafford General Hospital, rather than Altrincham hospital, which is in Trafford.
Although the Tory list says that both A&E and maternity units are under threat, the hospital in fact has neither.
However, the Altrincham Hospital has been at the centre of a row about ward closures. The last two in-patient wards at the hospital closed last year, on safety as well as cost grounds, despite a public campaign to keep them open.
Verdict
Given the sensitivity of the issue of local hospital closures, anything less than a completely watertight list was guaranteed to cause disaster.
The furore about hospital closures raises more questions about the Tories' competence than it does about the health service.
However, the list itself is not as inaccurate as the Conservatives' opponents would have us imagine.
Many of the hospitals they mention do have question marks over their future, or have done in the very recent past. The vague and emotive phrase "under threat" does, however, exaggerate the extent of the risk.
