Last night, our local MP Philip Dunne, who is the new Health Minister, gave a categorical assurance that Ludlow Hospital will not close. He told a crowded meeting of the hospital League of Friends that the hospital “is going to remain a hospital”.
Speaking after Philip, David Evans from the Clinical Commissioning Group confirmed that closure is not an option:
“Ludlow is not under threat of closure. Let me be absolutely clear about that.”
David thought there could be more services offered from Ludlow Hospital and for it to become a health and wellbeing centre, as well as a community hospital. But he also made it clear that, in his personal view, we might lose the midwifery-led unit.
The news that the hospital looks set to survive is very welcome. But although we have a political and policy commitment to keep Ludlow Hospital but I am not yet convinced the story stacks up. We had that level of political commitment with the ill-fated Eco Park hospital project.
That project was built on shifting financial sands and was sunk amidst yet another reorganisation of the NHS. Unless there is enough money to fund services at Ludlow Hospital, there will be no justification for the rent our local NHS pays to the shadowy PropCo. Philip Dunne last night described the workings of the NHS as “byzantine” but claimed that ways of working within the NHS are now more joined up. I hope that is the case.
We need much more information on what funding there will be to run Ludlow Hospital in the future. We also need to know what role it will have under Future Fit – the plan to reorganise hospital services in the county. Oddly enough, I can’t recall Future Fit being mentioned last night.
Philip is now health minister. He would not have given such a clear commitment to Ludlow Hospital if he felt it was going to be axed on his watch. He will have also learnt the lessons from the Eco Park calamity, when everything was promised but nothing was delivered.
The news last night was good news indeed. But we need firm commitments and we need them quickly so that we can stop talking about reorganisation and get on with it.
Philip Dunne on the future of Ludlow Hospital
Philip told the meeting:
“I think that the views that are being expressed today are out of frustration over 10 years at various times and in various forms in response to perceived threats to Ludlow Hospital… There have been some notable successes that go against the grain of that. The dialysis unit is foremost amongst these…
“I think there is a degree of frustration about how we make ideas, and try and put in time and effort and then nothing happens…
“In the past, we have been operating within individual entities in the NHS and trying to get them to make a big change of their own. So all the efforts that we make to get a new hospital for Ludlow, described variously as a white elephant, was directed through ShropCom without the proper joined up work that is required across the NHS as it now is.
“I can absolutely assure you that from my perspective Ludlow Hospital is an essential asset for the south of the county. It is going to remain a hospital. It is not going to be a volunteer run wellbeing centre. Let’s not let that hare get running. It’s going to frighten people.
“The reality here is we have got a hospital here providing good services, better than you get in community hospitals in many other parts of the county. We need to fight to keep that… and improve services rather than reduce them.”
David Evans on future hospital services in Ludlow
David Evans, accountable officer for NHS Shropshire and NHS Telford & Wrekin Clinical Commissioning Groups gave his thoughts on the future of health provision. He told the meeting:
“I am responsible for buying health services for this area as well as the rest of Shropshire. I am absolutely clear that in the future we need to provide, I need to buy a comprehensive range of health services for this population – that includes primary care, community nursing, etc., etc.
“I think there is significant scope to change the way services are delivered that sees an increased rate of services offered in Ludlow and other community hospitals in Shropshire, not a reduction in services.
“I am absolutely committed to providing as wide a range of services as we possibly can within Ludlow and the Ludlow area, including the community hospital, but we have to make sure that they are the right services, that they are cost effective and that they are value for money.
“It is absolutely clear that given the financial circumstances of where Shropshire CCG finds itself and Shrewsbury and Telford Hospitals finds itself is that we need to have transition funding to help us make changes…
“What is absolutely clear is we can’t use these to these [funds] to pay off our current deficit. We have got to use the these [funds] to change the way that we deliver services…
“We have got to think about it differently. We have got to think about it much more radically…
“What should we be doing now is putting for more emphasis on primary care services and re-examine how we deliver care closer to home…
“I can think that in general terms community hospitals are a really important asset. What I don’t think we do in the NHS generally is use them to the best we can. There is scope for us to change the way that we use them, to enable them to look after a much wider group of patients, to provide care for a wider group of patients in the future.
“So let us talk about the community hospital here in Ludlow… There is a potential in the future for the hospital not to become owned by NHS Property but become a local asset.
“Ludlow is not under threat of closure. Let me absolutely clear about that. I think there is real potential for Ludlow to become a health and wellbeing centre as well as a community hospital moving into the future.”
David Evans on the midwifery-led unit
David gave his views on the future of the maternity unit at Ludlow Hospital:
“I do think there may have to be some areas we have to make difficult choices. Gill George talked about the midwifery-led unit… The risk assessment for a woman who is pregnant on whether they should give birth in a midwifery-led unit or not is the same you would use for a home birth. So actually what we have is a difficult choice there…
“We have not started a discussion about this… At some point in the future, we may have to look at can we afford that level of choice given that the CCG has a deficit. This is not to say we have made a decision because we definitely haven’t…
“We may be faced with a choice of do we have births locally or do we have a midwifery-led unit locally because we may not be able to afford both in the future…
“That was my personal view. It was not the view of the CCG.”
Philip Dunne on his new ministerial role
I have gone into the Department of Health, effectively as Jeremy Hunt’s deputy. They have reshuffled the portfolio so I am the only minister of state in the Commons… I have got most of the stuff that you see on the front pages. Note all of it…
It is a very new rich environment that has its challenges… I have financial and clinical performance across the NHS. I have hospitals, which is about two-thirds of the NHS. I have workforce that is about 75% of the costs of running the NHS. And I have, for some reason I don’t understand, maternity. So I have quite a broad portfolio, mostly to do with NHS England but there are some UK-wide responsibilities…
One of the first questions I had to my officials was how what does this mean in terms of how I involve myself in health matters locally. The conclusion we quickly came to was it would be much better for me as minister to absent myself from any decisions about anything that happens in Shropshire. So I can continue to advocate for whatever seems to be the best things for Shropshire without being asked to personally rubber stamp it at the end. I hope that is a good thing because otherwise I wouldn’t be able to stand up at a meeting like this.”
Andy thank you for the information.A unique and hard rep. for your electorate. Thank you.
Good news indeed
Sounds more hopeful!
There is more than a degree of ‘politician speak’ in Mr. Dunne’s observations. For example, the phrase ‘from my perspective’ covers him should the CCG, or the mysterious and unaccountable team putting together the Sustainability and Transformation Plan decide to downgrade/close Ludlow Hospital. He even states when describing his new health related role that he will NOT be involved in decisions concerning Shropshire. So, it doesn’t matter what he says by way of reassurance.
In any case, the effectiveness of the individual community hospitals is ultimately limited by the overall state of health provision as a whole in Shropshire, which is in a very poor state. Shropshire CCG is the worst performing CCG in the country – see page 49 of this report, http://offlinehbpl.hbpl.co.uk/NewsAttachments/PGH/Strengthening.pdf – and is being told what to do by NHS England. The proposal called Future Fit, which has already been rejected once by NHS England on financial grounds, is being done before any of the services away from the central hospitals – claimed to be able to cover currently ‘centralised’ services taken away by Future Fit – have been designed or sorted out. And, above all, the limiting factor is money, which is controlled by the Treasury. Mr Dunne should be asked about the whole picture and not just Ludlow.