The future of Halton Hospital has reached a crucial turning point with proposals for the biggest upheaval in services since the formation of North Cheshire Hospitals Trust. But the proposals to centralise emergency medicine in Warrington have met with a backlash. ADRIAN SHORT reports.

HOSPITAL Trust bosses claim that 'doing nothing' is not an option and are trying to reassure patients that the restructuring is not the 'beginning of the end' for Halton Hospital.

They claim a bright future lies ahead and the changes envisaged so far would see Halton Hospital developed as a centre of excellence for planned low risk surgery.

Services including an expanded medical oncology unit, a programmed investigation unit and a daytime emergency assessment unit would be developed in Halton and outpatient services would be expanded.

But proposals to centralise many services at Warrington Hospital, including heart and stroke care and to develop a new critical care unit at Warrington have sparked outrage and concern - there are fears of an imbalance in services across the two areas which many fear would be to the detriment of Halton.

At a health policy and performance board meeting last week, hundreds of angry patients and staff marched on Runcorn Town Hall to voice their opposition.

Trust bosses including North Cheshire Hospitals Trust chief executive Ann Marr were put on the spot and councillors raised concerns on behalf of residents.

Questions were posed by campaigner's representative Steven Blakesley followed by a presentation by Ms Marr.

Cllr Stan Parker questioned the validity of the consultation process. He said: 'We see a lot of negatives for Halton - is the Trust prepared for a negative response?'

Cllr Eddie Jones asked Ms Marr whether she would be the one who drives forward the plan, but she said she would not be applying for the new chief executive's role.

Bob Bryant, chairman of the Let's Go stroke club, told Ms Marr: 'The stroke unit at Halton Hospital appears to be going but people in Halton have the highest number of strokes. We were promised a stroke unit and now we are being told that we are not having one.'

'We had a critical care unit and after 18 months we were told that it wasn't feasible.'

He added: 'We fall short in CT scanning. If you have a stroke in Halton at the weekend you're doomed until Monday.

'We are better off extending the stroke unit at Halton and finding a way to fund that.

'Whoever makes the decisions does not realise we have got a river between the two towns. I'd like it to stay the same way but with more money - I'll go rattling tins if I have to! I am not happy.'

Cllr Kath Loftus said: 'Is this the start or the end of the consultation process. I find the whole process flawed. The way the board has handled this is appalling.

'You've made people lose trust in the Trust. I advise you to buy a dictionary and look up 'consultation'.

'All you've done is raise anxiety and anger and leave people angry and confused.'

She suggested the results of public consultation would be ignored.

Cllr Diane Inch said: 'Can you confirm that this is the first step in the closure of Halton Hospital?'

Ms Marr said: 'We categorically and absolutely assure you that this is not the first step in the closure of Halton Hospital.'

And when asked by Bob Bryant how many staff would lose their jobs if they didn't wish to relocate to Warrington, she said: 'I don't know what the answer is, we have not yet got to the end of the operational plan.'

The Trust representatives said that the there would be uncertainty and an affect on staff morale until the situation was resolved and a secure base achieved.

Cllr Geoffrey Swift said: 'If staff morale sinks, patient morale sinks.'

Ms Marr said the cost of development would be around £15m for both sites and she hoped there would not be any redundancies and said the Trust was working to achieve that aim.

Cllr Tom McInerney said: 'Why should we transfer from a new hospital in Halton to an old building in Warrington?

'The other part that annoys me is that the mission statement for this joint venture was 'Two Sites, One Hospital'.

'People in this room don't feel like that - there are two hospitals and only one being used properly.'

Cllr Alan Lowe said: 'We, the people, demanded a hospital in the 1970s. If any hospital in this country can be called a people's hospital it is Halton Hospital.

'With the way you have run down Halton Hospital no-one will choose to use it. Then you will close it because you'll say no-one is using it.

'You keep referring to a 'hot unit' and 'cold unit' - when a patient goes cold, he's usually dead.'

Rota work puts staff off applying

THE Trust representatives said that they had to create a 'sustainable and viable organsiation which would deliver' and the Trust had to respond to pressure from central government, including the need to become a Foundation Trust by 2008 and to have balanced finances.

Ms Marr said spreading services across two sites was not the best way to use resources and did not provide the best deal for patients.

She said there were workforce pressures with retirements coming up and said Halton Hospital was not an attractive place to work because support services were not always available and rotas of one-night-in-four were a factor in a problem recruiting radiologists. Such rotas are 'not be found anywhere else'. She said radiologists jobs had been advertised but the trust had been unable to fill the posts.

The Trust 'had the machines but not the people to read them' and the radiology department was up to five people short.

She said Halton Hospital would have a 'clear and secure' future and £7m would be invested in it.

Ms Marr said: 'To do nothing isn't an option. It will bring us to the point where we can't run the hospital. If we do nothing that's where we'll be.'

She said she could not see how emergency medicine could be kept on the Halton site.

Ms Marr told the meeting that she would not be applying for the new chief executive's role because of her existing contractual commitments but the board was unanimously behind the restructuring plan.

She said the chief executive's role would be advertised and someone else appointed.

The creation of 'hot' and 'cold' sites had worked elsewhere such as Broadgreen and Liverpool hospitals which operated in a complementary fashion.

She said 'I think there is enough precedent and evidence to show what can be achieved.'

Future is safe - health chief

THE medical director of North Cheshire Hospitals Trust has pledged that Halton Hospital has a long future ahead.

Vascular surgeon Phil Wake said: 'Halton is absolutely crucial to the survival and future of the Trust.

'The services which we will be providing at Halton will ensure that the hospital is a vital part of the operation for many years to come.

'There is certainly no room for these services to be provided at Warrington.'

More than 20,000 signatures have been received in petitions.

And Halton Hospital heart surgeon and chairman of the British Medical Association (BMA), James Johnson, fears Halton won't survive unless it severs ties from the Trust.

Changes mean better healthcare, says Trust

NORTH Cheshire Hospitals Trust insists that the re-organisation of services will benefit Halton Hospital and claims there are many medical staff who are in favour of the proposals.

It cites Dr Steven Bentley, the Trust's clinical director for medicine, as a case in point and claims better healthcare, massive investment and a 'bright future' for both sites will result.

Dr Bentley said: 'Every consultant working in the NHS wants to offer their patients the highest standards of care. I, along with other physician colleagues, am convinced that centralising emergency medical care on our Warrington site will enable us to do that for patients in North Cheshire. That includes patients in Halton.

'Indeed, the sickest patients from Widnes and Runcorn are already being cared for at Warrington Hospital now.

'Under these proposals, the expertise and abilities of our highly qualified staff will be concentrated in one place, which is common practice at Trusts with two hospital sites. At the moment, by splitting our staff we are diluting that expertise. Re-arranging services will also help us to attract the highest calibre of doctors and nurses.

'These bold proposals frame an innovative vision of the future, one that we must work together on to realise - for the good of our hospitals, our staff and our patients. Standing still is not an option.

'The entire focus of these proposals is to ensure Halton and Warrington Hospitals complement each other to benefit patients, not running down one hospital in favour of another.

'Looking at the proposals, it is exciting to see the suggestions of what services could be developed at Halton. For instance, an expanded chemotherapy unit costing between £1-2m would make a big difference to cancer care locally.

'A new kidney dialysis unit will be on site with appropriate expertise. A new programmed investigations unit would provide rapid, one-stop diagnostic services. There would also be a consultant-led emergency assessment service.

'A wide range of services will be available at Halton, including services that are not provided there at the moment.

'I would also add that the vast majority of patients who attend Halton Hospital now will still be able to access the same services there if the proposals are implemented. Given that, these new developments should be warmly welcomed.'

He added: 'Clearly people in Halton are passionate about ensuring they continue to receive high quality healthcare. I share that passion, along with everyone else at the hospital Trust.'