Closure of Lowestoft Hospital – Health Watch

Lowestoft Coalition Against the Cuts

356 London Road South, Lowestoft, Suffolk, NR33 0BQ – Tel (01502) 563208

8th January 2014

Official Complaint by Lowestoft Coalition Against the Cuts to Healthwatch Suffolk concerning the proposed closure of Lowestoft Hospital by HealthEast CCG.

Dear Healthwatch Suffolk

On behalf of Lowestoft folk, Lowestoft Coalition Against the Cuts (LCAC) presents this official complaint to Healthwatch Suffolk being the authoritative monitoring body for health in the county.

LCAC attended the three official consultations on the matter by HealthEast and were so upset by the bias shown in the consultation document, organised a straw poll on HealthEast’s conclusions to gauge public reaction.

Following this a complaint was sent directly to Andy Evans, CEO HealthEast, for the attention of the Monitoring/Compliance Officer, because we felt the questions in HealthEast’s consultation document were so loaded in favour of its ‘preferred option’ as to cast serious doubts on the validity of their conclusions.

Furthermore, the CCG has not followed agreed democratic procedure in dealing with our complaint to them about the bias of their consultation document and in not openly consulting with Waveney District Council.

Yours faithfully,

Christopher J. Brooks,

Member of both LCAC and HealthWatch Suffolk.

Summary of Complaint

(referred to in detail on pages 2 and 3)

Part One – The Bias of the Consultation Document Gave a Prejudiced Conclusion

The bias shown in the document was of the positive spin put on options one and two and a negative spin put on option three. The full consequences of the loss of Lowestoft Hospital were not spelt out in option three and option one was not an option at all – it was already happening in practice making it difficult in the extreme not to vote for it – especially if you lived in South Lowestoft!

Part TwoHealthEast’s Response to Complaint One was Undemocratic and did not follow the Public Bodies Policy: A guide for Departments – Chapter 8 on Openness and Accountability.

Section 4.2.3 of that chapter 8 states: ‘Complaints relating to decisions or action taken by a body should be referred to that body for response. Complaints should firstly be subject to internal review, which should not involve staff involved in the initial decision or action.

This did not happen as Andy Evans, the CEO was the respondent to our complaint.

Part Three – Open democratic consultation with Local Government had not taken place before the decision to close Lowestoft Hospital.

There was a lack of full consultation with Waveney District Council before, during and after HealthEast’s consultation period before the decision to close Lowestoft hospital was taken.

It is known that members of HealthEast presented their decision to a closed session of WDC a few weeks after they voted on their final decision at their public meeting at Beccles.

It is our view that the closed session held at Town Hall Chamber in the High Street, Lowestoft is the exact opposite of open and transparent democracy in action and works against the good-will of the people being represented.

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Complaint in Detail

Part One – The Bias of the Consultation Document gave a prejudiced Conclusion

The bias shown in the document was of the positive spin put on options one and two and a negative spin put on option three. The full consequences of the loss of Lowestoft Hospital were not spelt out in option three and option one was not an option at all – it had already been decided upon with the start of a multi-million building operation at the Kirkley Rise ‘clinic’ months before the consultation was launched. In other words millions of pounds had already been ear-marked, budgeted for and some spent on a project in South Lowestoft. In a proper consultation to gauge the will of the people based on ‘a level playing field’ could well have shown a result to renovate and restore Lowestoft Hospital to its full modern potential as a bed and service base for clinical and minor injury treatments as has been the case of the excellent work done at Beccles Hospital.

Lowestoft hospital bed-based services have been reduced and it is clear that this has been official policy or practice driven by some people for several years, otherwise it would have been maintained to a proper standard and fully occupied by Lowestoft & District folk who have no desire to block beds in James Paget hospital after treatment but who maybe were not ready to be discharged to their own home for various reasons. We maintain the whole building could still be made basically sound and, with proper management, acceptably modernised and upgraded to present day standards to serve as a modern clinical centre of excellence in North Lowestoft.

In HealthEast’s reply to our complaint Andy Evans CEO states HealthEast is committed to having high quality community hospital level beds in Lowestoft. However when he said that their origin is not vaguely as important as their quality and the service to patients they provide, does he not imply that the beds service at Lowestoft hospital, for which HealthEast is currently responsible and accountable for, is not or cannot with due care and attention, get up to the standard he is seeking, under proper management?

The fundamental position in the ‘consultation’ document was that the options offered were prejudiced in favour of HealthEast’s preferred option 1 “to move services to Kirkley Rise and develop services in North Lowestoft, which rested upon the closure of Lowestoft Hospital and save seventeen million pounds needed to restore it to develop a new centre for clinical services in North Lowestoft ‘sometime’ for option one. Further questioning obtained the information that if Lowestoft hospital were to close, beds could be bought in the Residential Care or Nursing Home sector.

We say that unless these are already booked and reserved in advance, as is now the current plan by HealthEast, they cannot be guaranteed to be available in an already stretched market for such places. However, the reservation of such scarce beds in the residential home sector for the NHS has the impact of diminishing availability for those increasing numbers of elderly seeking a local home in which to reside in their final years. Not only is the proportion of elderly people rising in this area, so also is the general population through growth and net inward migration which is predicted to rise faster than previously according to statistics released in this New Year.

To avoid this raiding of scarce resources in this age of austerity surely it makes more sense to restore good management and guarantee of NHS beds with medical staff in place at an upgrading of Lowestoft Hospital and including other services like a minor injuries unit and such as is being proposed for Phlebotomy in the north wing to meet this growing demand and relieve Lowestoft’s demand on A&E services at the JP Hospital.

Given the choices in the consultation what was the likely result? Take HealthEast’s apparent offer to spend multi-millions on new premises and services or keep a hospital that is unsafe and have little or nothing left over from restoration to spend on services? It was a foregone conclusion but what is remarkable is that despite the bias, a sizeable minority of more than a third of respondents (35.7%), voted against HealthEast’s preferred option and voted for Option three. In our opinion many more would have voted for option three if options one and two were not so heavily biased by their positive spin and if no negative spin was put on option three.

No explanation was provided in the consultation document for what would happen to the property and land occupied by Lowestoft Hospital should the decision be made to close it. By implication of the negative spin in option three £17 million would be ‘saved’ for services etc in Option Two by not restoring the hospital to its full potential but nothing was explained about the conversion of assets of property and land that would be released if the hospital was not to be restored. Would new build take place after demolition for example, or the land sold for other development? During the consultation there was a distinct lack of open vision, clarity and timetable for the future of this NHS site in this regard, though recent publicity indicates ideas will be explored in the future.

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After we took a straw poll of the public’s views on the closure decision, LCAC submitted a complaint to HealthEast and asked for a new, independently produced questionnaire which would lead to the people of Lowestoft having greater confidence in the conclusions reached for the future of health care in Lowestoft and in the future of the NHS itself.

Part TwoHealthEast’s Response to Complaint One was undemocratic and did not follow the Public Bodies Policy: A guide for Departments – Chapter 8 on Openness and Accountability.

Section 4.2.3 of thatchapter 8 states: ‘Complaints relating to decisions or action taken by a body should be referred to that body for response. Complaints should firstly be subject to internal review, which should not involve staff involved in the initial decision or action. If the decision or action is upheld, the complainant may wish to ask their M.P. to refer the matter to the Parliamentary Ombudsman (if the body concerned is within the Ombudsman’s jurisdiction).

Patently this guidance was not followed so the same bias driving the consultation was reflected in the response by the same person heading HealthEast’s original decision to close the hospital ie Andy Evans, CEO HealthEast. He could not explain to us the extremely high opposition to the closure of the hospital we found in our poll. The result of our poll was virtually dismissed in his letter of response in which he said: “It would appear from what you write however that the rigour applied was not as comprehensive as the process we applied”… so the factual evidence we obtained was simply denied and ignored.

To explain our position, after the decision to close the hospital was made, we organised a simple and straightforward snap public poll for two hours on Saturdays 25th September and 5th October 2013 in London Road North, Lowestoft by simply asking one uncomplicated question to people in the street to which the answer was ‘Yes’ or ‘No’. “Do you agree with HealthEast’s decision to close Lowestoft Hospital?” Of the 197 people who stopped to answer by writing ‘Yes’ or ‘No’ on a blank ballot sheet and posting it in our ballot box, it was found 194 had answered ‘No’, a result of over 98% delivering a significant verdict against HealthEast’s decision.

Our conclusion was the vast majority of folk would like services to remain and be enhanced at Lowestoft Hospital, but this was not positively offered them in HealthEast’s biased document – hence our complaint.

Part Three – Open democratic consultation with Local Government had not taken place before the decision to close Lowestoft Hospital.

On 1st April 2013 the main provisions of the Health & Social Care Act came into effect, replacing a PCT with the CCG HealthEast. It appears HealthEast should have consulted Waveney District Council and Suffolk County Council on the framing of its consultation document, as in Option Two it states that a second phase building for a ‘centre for care’ would be developed at Kirkley Rise for benefits, housing, education, employment and young people’s services, something outside HealthEast’s own jurisdiction. However, we have not seen reference to this in any minutes of the meetings of the local authorities concerned so questions whether this is just HealthEast’s vision to bolster option one!

What is more concerning is the lack of full consultation with Waveney District Council before, during or after Healtheast’s consultation period before the decision to close Lowestoft hospital was taken. This could at least have taken the form of sharing the conclusions of the HealthEast consultation in open council before the final decision was made and to take on board serious questions that could have been posed then by those representing the people of Waveney District and Lowestoft in full view of the public who can attend such meetings.

However, it is known that members of HealthEast presented their decision to a closed session of WDC a few weeks after they voted on their final decision at their public meeting at Beccles.

It is our view that the closed session held at Town Hall Chamber in the High Street, Lowestoft is the exact opposite of open and transparent democracy in action and works against the good-will of the people being represented – hence our concern and complaint.

Healthwatch reply

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