A Petition Is Launched Against The Downgrade Of Louth Hospital

September 28th 2018

There's no way to dress it up: 20 is less than 50, and so is 16. So why were representatives of Lincolnshire East CCG talking about the proposed reduction of beds in Manby and Carlton wards at County Hospital, Louth, as "an opportunity"?

LTC meeting

On 17th September Louth Town Council held a single-issue meeting, inviting S. Williamson and Dr Yvonne Owen as representatives of Lincolnshire East CCG to talk about the planned changes at Louth Hospital. Those changes involve two "options": either 16 beds and 6 chairs on Carlton ward; or 20 beds on Carlton ward plus 6 chairs on Manby ward. The chairs would be for day therapy such as intravenous drips.

Public interest was high. The Sessions House can only hold 50 people due to fire regulations, and it was over capacity so a number of people were unable to attend who wanted to be there.

Tempers ran high. I've never been to a more emotional meeting at the Sessions House.

Part of the outrage began once the two CCG representatives started talking, because they were justifying the reduction in beds with arguments you could drive a bus through.

Although Dr Owen said she "totally 100% supports the hospital", it doesn't follow that these changes are for the benefit of local people.

The CCG argued that health needs have changed, justifying greater centralisation of services in centres of excellence such as Lincoln. For instance, heart attacks, where outcomes can be improved by "revascularisation" which improves long term outcomes.

However, this argument ignores the many, many types of routine hospital care that don't require surgeons who are at the top of their game. It also ignores the steady growth in Louth's population, and that of the surrounding district. Louth is due to see a minimum of 1204 new homes built in the next 15 years, and most likely far more than that, whilst the district as a whole is set for housing growth of 7819 homes. In other words, the district could grow by as much as a town the size of Louth, and because there's a restriction on the number of homes allowed to be built on the coast, many of those new homes will be in the catchment area of Louth Hospital.

Those new residents will need jobs. Manby and Carlton wards employ 90 people. It makes absolutely no sense to reduce the number of beds in Louth when there will be both an increase in the population's need and in the need for jobs locally.

The link between poverty and ill health is well-established. Should beds be closed, patients will inevitably have to travel further away, and in rural East Lindsey the buses are both rare and dear. Sometimes that means you can't get a bus and either are forced to rely on more expensive taxis, or on an overnight stay. So by attempting to save money, the CCG will be shifting the cost of ill health onto patients. This will lead, in the long term, to worse outcomes as the stress of having to pay for travel takes its toll on those least able to afford it.

The centralisation model also depends on other hospitals and other health authorities having the capacity to take the slack. Yet they can't always do this. They may have recruitment problems of their own, or trouble coping with variable demand, or simply financial issues. Although in the NHS the money follows the patient, that may not always be enough if the receiving hospital needs to open a whole new ward in short order.

The CCG argued that there would be a greater emphasis on Neighbourhood Working, "a key programme within Lincolnshire's Sustainability and Transformation Partnership (STP) which sees professionals from different organisations working together to deliver patient-centred care".

However, this emphasis on preventative care in the community fails to take account of a mammoth in the room: care in the community is in crisis. According to the Local Government Association, adult social care faces a funding gap of £3.5 billion by 2025 just to maintain the existing levels of service. So it's madness to rely on services that councils will struggle to provide.

Horncastle hospital was downgraded to a cottage hospital and closed in 1999, a precedent which mustn't be forgotten.

"We are in the middle of a health care crisis," Dr Owen said at the meeting, referring to the funding issues faced locally by the NHS. It was a telling moment. Would the CCG be insisting on the tenuous clinical case for losing these beds, if money was available to keep them open?

Petition

Dominic Sivell has launched a petition to "prevent the downgrade of services to County Hospital, Louth in Lincolnshire." The petition makes particular reference to the proposals to withdraw beds, and to the effect on patients of long travel times, and the impact on neighbouring health providers.

On the day of its launch this became the petition with the second most signatures in an hour on the government's petitions website. There's no doubt that this issue means a lot to people. At the time of writing it has over 450 signatures. You can view the petition here.

Pending public meeting

Due to the interest in this topic, the town council resolved to hold a public meeting about the issue. However, getting the CCG to agree dates for another meeting has so far proven problematic.

Consultation

The consultation runs until 10th October, and can be accessed at this link.

As consultations go, it bites. The two options aren't meaningfully different, and neither of them will satisfy people who want a return to the provision available in Louth only two years previously. Consultation is supposed to be done when the public have a choice, and that choice can realistically affect the outcome.

Scaremongering?

Just over a year ago campaigners took to the streets around Louth to demand the preservation of Louth Hospital. They were branded as "scaremongers" by local Tory politicians. Yet, one year on, the feared downgrade is exactly what's being proposed.

It's not scaremongering if someone warns about a thing that actually happens. It's truthmongering.

I have still not had a response from Mr Andrew Morgan of LCHS about which services currently exist at Louth, which services have been lost in the last couple of years, and which services might be at risk, over a year since I first asked. It's been difficult to find out exactly what's happening with the hospital in any detail, and this lack of transparency doesn't fill me with confidence about the future of Louth Hospital. The CCG need to be more accountable to the public and they need to tell people what's happening to local services on a regular basis.