Case for a review of a wasted year

Sir – Like your correspondents Dennis Lewis and Eric Sherrard I attended the Fielder Centre last month to hear the final decision of the Lister versus QE2 consultation . Like them, I want to see the development of a 21st century health service in Hertfor

Sir - Like your correspondents Dennis Lewis and Eric Sherrard I attended the Fielder Centre last month to hear the final decision of the Lister versus QE2 "consultation". Like them, I want to see the development of a 21st century health service in Hertfordshire, and I applaud their suggestions for what might be provided at the QE2 site.

Unfortunately it is far from clear at present that the PCT have the same vision for our local hospital, and many of us feel Hertfordshire is now sleepwalking into a reconfiguration of services that is poorly thought out and will not be fit for purpose.

And this despite the huge amount of work carried out by our highly paid professionals within the NHS, and also by our not-so-well-paid county councillors reviewing the process, not to mention those on the taskforce working on this in our spare time.

I am as reluctant as anyone to initiate a judicial review of the decision, but if this is what it takes to get what we need then we have a duty to look at this very seriously indeed.

It is clear that the consultation was deeply flawed by the exclusion of the Hatfield hospital as an option, and by the lack of proper financial analysis carried out prior to the decision to exclude Hatfield.

The choice that should have been examined was between centralisation at the Lister or the building of a new hospital at Hatfield. The QE2 option never had any chance of being chosen, due to the poor state of the buildings, and because of its higher staff costs - £3m a year extra due to London weighting being paid in Welwyn Hatfield, but not in Stevenage.

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By setting up this false consultation, we have wasted a year, and have been trapped into a "decision" on the location of the major hospital without any real consideration as to what might be needed elsewhere.

The consultation on the make-up of the Local General Hospital was pointless. The NHS asked us what we wanted - we all said we wanted whatever they could give us! - and they have ended up promising no more than a glorified outpatient clinic.

Having spent a large part of the past two years following these proceedings I believe that the decision not to go ahead with Hatfield was heavily influenced by the deep financial crisis faced by the NHS in 2006.

In such a context it is understandable that executives decided that no detailed financial examination was necessary. They only carried out this work after the close of the consultation in response to our criticism. That said, national rules do make it very difficult to conclude any major hospital is "affordable". Payment by results - which is the system by which the acute trusts are paid for the operations carried out - pays exactly the same regardless of the age of the facility, whether it is a brand new state-of-the-art hospital or a hut in a field.

And any new hospital has to meet modern standards - which in this case means that the Hatfield option had to provide 70 per cent more floor area than the Lister for the same number of beds. It is not surprising that across the country virtually no new hospitals have been approved for development recently.

If the facts were looked at again now, with trusts in surplus, and heading for foundation trust status, it is quite possible there would be a very different conclusion reached.

Many of the parameters which the trusts have had to use to determine affordability are likely to change again in the near future. It is quite likely that Hertfordshire will be granted a higher allocation of funds - it seems that the penny has finally dropped that we have been chronically underfunded for many years. The problems with the current system have been recognised and changes are afoot.

The county council health scrutiny committee has put huge effort into trying to understand the issues, and has produced a substantial report which makes some very good points and recommendations about the local NHS, but one suspects they have just had enough of this process - that certainly seems to have been the overwhelming mood of the committee.

"Too much time has already been wasted, what point is there in referring the decision to the Secretary of State if it won't change the decision" seems to be the general feeling.

So despite finding that the consultation was flawed they have shrugged their shoulders and said its time to move on. Of course, none of them lives in Welwyn Hatfield!

So, if the county council cannot or will not refer it, judicial review remains the only option, and we will be giving it very serious consideration. And before the shouts of "unnecessary delay" are thrown in our direction by the NHS - perhaps they should consider their own responsibility for causing delay by dint of wasting a year on a flawed consultation process.

Cllr Nigel Quinton, Liberal Democrat borough health champion, chair of evidence & judicial review, hospital SOS taskforce