Centralising health services away from the QE2 Hospital is being done on medical grounds

SIR - It was my intention to write a simple letter of appreciation for the surgery and subsequent excellent nursing care I have recently received at QE2 but I have been overtaken by Grant Shapps full page reply to my previous letter in which I complained

SIR - It was my intention to write a simple letter of appreciation for the surgery and subsequent excellent nursing care I have recently received at QE2 but I have been overtaken by Grant Shapps' full page reply to my previous letter in which I complained of his negative campaigning.

As his reply is so personally addressed I hope I may be allowed the space to respond.

My recent treatment is but one of many reasons why I have a fondness for the place and loyalty to it. Two of my grandchildren were born there - the first when her parents were living in Stevenage but the Lister had no maternity unit so they had to negotiate the A1M in a southerly direction!: two of my children had appendixectomies there and one a tonsillectomy: and last, but not least, I spent a large part of my working career (20 years) working at the QEII and attempting to ensure that appropriate social services were available to its patients. It is this long personal experience that has led me to keep myself well informed about recent developments in the local health service and it is therefore only on this subject that I feel confident to challenge our admittedly popular MP.

I am not, however, quite as politically na�ve as he assumes and I can see that it would be possible that decisions about which of the three hospital sites (Hatfield, QE2 or the Lister) should be chosen for development could have been influenced by central government for political as well as practical considerations.

What Grant misses, however, as a result of wearing his political spectacles, is the underlying reasons for the re-configuration of hospital services and the need to concentrate specialised acute services in one centre for a wider area with a bigger total population.

These reasons were clearly outlined in June 2007 in one of your newspapers in a letter written by senior consultants in the East and North Herts NHS Trust.

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They explained that, in order to maximise the benefit of recent rapid advances in medical and surgical practice it is necessary to centralise acute services in larger hospitals serving a population of 500,000 or more. In addition to the need for special equipment, there has to be a 'critical mass' of patients with the rarer conditions for staff in a centre of excellence to gain sufficient specialised skills.

Some papers are available on the NHS website in which medical experts explain this in more detail, for their particular speciality, although still in plain English that can be understood by any intelligent layman.

A good example of this is a paper by professor Roger Boyle, the National Director for Heart Disease and Stroke. In his paper, entitled 'Mending Hearts and Brains', he both advises the public about what action to take if they suspect a heart attack or a stroke and explains the need to centralise the acute services for these conditions.

Strokes have two different immediate causes, a blockage in an artery, or a haemmorrhage. It is essential to ascertain which is the cause before treatment can be safely applied, what is needed for one being obviously potentially fatal for the other. What is required, therefore is a brain scan by expensive equipment with 24-hour, 365 days a year skilled staffing that can be provided only in a few centres, not in every small hospital.

Similarly the treatment for heart attack has now changed (as discovered by councillor Jon Beckerman - see his apology on Page 11 of last week's Welwyn & Hatfield Times). The initial emergency assessment and treatment is now given by the paramedics at the patient's home or in the ambulance and the length of time taken to travel to the hospital, while important, is less crucial than the availability of specialist care on arrival.

The other major change in health policy has again been driven by advances in medical and surgical practice rather than by political considerations - the shift from prolonged hospital care to care at home.

A case in point was my own recent surgery, that not long ago would have entailed a hospital stay of ten days or more and a prolonged period of inactivity. Advances in surgery and anaesthetics enabled me to be in hospital and out again in three days and, already, three weeks later, I am almost back to normal.

At the same time, a dear friend and relative of mine living in a neighbouring authority who had been diagnosed with bone cancer 18 months earlier, was able to fulfil her wish to remain in her own home (although living alone) until three days before her death in a hospice, so excellent were the domiciliary services both from the NHS and from her (Conservative) local authority. I was fortunate in requiring no help from social services but I understand from neighbours and friends that such excellent care by social services is sometimes lacking in Hertfordshire so perhaps Grant could turn his attention to persuading his friends in County Hall to ensure that our domiciliary services are improved to an equally high standard.

The shift from hospital to home care has, of course, placed additional responsibility upon the GP surgeries. In the 2007/8 Patient Survey of patient satisfaction with GP services, while Welwyn/Hatfield residents showed a generally high level of satisfaction with their GPs their chief complaint was of the difficulty they experienced in obtaining appointments, with blocked phone lines exacerbating the problem.

It is this deficit that Spring House is designed to address and is now addressing without undermining the patient's relationship with the GP with whom they are registered. The anticipated increase in population will ensure that there will

be plenty of patients who remain registered with their present GPs and use Spring House only occasionally as well as those who choose to register at Spring House.

A recent national survey reveals that our local GP surgeries continued in 2008/9 to have difficulty in providing sufficient appointments to meet the demand from their patients.

I repeat my original plea for a less negative and more informed attitude towards the development plans for the QE2 site and now have in mind, not only the detrimental effects of such negativity on local services but it seems that the negative comments of some Conservative MPs and in the media is being used as ammunition to prevent President Obama from developing a more freely accessible health service in the USA I should be sorry to think that our MP's comments could be used for such a purpose.

Betty Saunders,

Birchall Wood, Welwyn Garden City.