QE2 site should house a wide range of health facilities

SIR – We were at the Fielder Centre last month to witness the (inevitable) decision being made to select the Lister Hospital as one of two acute hospitals serving Hertfordshire – the other being in Watford. We believe that going for a judicial review (JR)

SIR - We were at the Fielder Centre last month to witness the (inevitable) decision being made to select the Lister Hospital as one of two acute hospitals serving Hertfordshire - the other being in Watford.

We believe that going for a judicial review (JR) will achieve nothing but undesirable delay, which will feed the uncertainty which has bedevilled our health planning for the past decade.

Further, a JR will look only at process and will not alter the basic decisions taken on December 19.

It occurs to us that many people, and their representatives, have not fully appreciated the extent to which two fundamental changes have occurred since 2003.

The first has been the change of rules concerning Private Finance Initiatives (PFI).

The second was the European Working Time Directive (EWTD).

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PFIs were introduced by the last Tory government - but actively utilised by the Labour party when it came to power. Several such schemes for building schools and hospitals have proved very expensive, even in the first years of the repayment period (usually 30 years) with very high annual rental costs and service charges.


The EWTD means that in order to provide a high quality service 24/7, there has to be more concentration and specialisation of hospital services to provide the necessary cover. District hospitals cannot afford to pay for this extra staffing, but specialist or 'acute' hospitals can. Just.

This means that in eastern and north Herts it came to a straight choice between the Lister and the QE2.

This was the basis of the consultation and it ended with the Lister considered by the primary care trust and hospital trust to be the most suitable site for the acute hospital.

Whether we agree with that decision or not, it is now an established fact.

What is needed now is a concerted effort by the whole Welwyn Hatfield community to ensure that all developments in health provision should be focussed on the suggestion by the health trusts that the QE2 site should become a 'health campus'.

In this way, a number of health and welfare services would operate in a fully co-ordinated fashion on the same site, thereby providing what we would describe as a 'centre of multiple expertise'.

This would ensure a high level of patient care across a whole range of clinical disciplines, backed up by social and welfare services.

The proposed Local General Hospital (LGH) will replace the District General Hospital - the QE2 - on the same site. [This is by no means certain; another smaller site could be chosen by the PCT - Editor]

While not offering blue light A&E or acute surgical services, it would concentrate on the provision of a range of core services, including rapid and effective diagnostics - essential in the early identification of cancers - plus a wide range of other specialisms which must be pulled together so that the sum of the parts is much greater than the whole.

The trusts suggest (Delivering Quality Health Care for Hertfordshire"; Final Report on the Outcome of the Public Consultation, pages 39 to 42) that in addition to the Local General Hospital, the Urgent Care Centre (minor A&E 'walking wounded'), and out-of hours GP services, there could be a number of important additional services such as mental health, social care and palliative (hospice) care on the same site.

We also see the provision of an intermediate bed unit (IBU) for patients not requiring acute facilities, as being a useful facility which would allow GPs to treat patients needing some medical care without sending them to the Lister.

It would also allow respite services for carers, who already have to cope with increasing age and infirmity, and conditions of their charges.

The surgicentre at the Lister will only have an allocation of beds based on a patient needing a bed for three days. After three days some patients will still be unable to cope at home and will require a longer stay with more continuing physiotherapy facilities.

We note that some of the modem facilities of the QE2 are located on the outer flanks of the site, so this plan could include linking the Isabel Hospice, and the Prince's Wing on one side, the Queen's Wing on the other, with other services situated in the centre of the site.

Such a design will enable patients to have minor surgery and endoscopy etc without having to go to the Lister.


This scheme will avoid losing these gems of the existing QE2 while adding to them so as to create a hospital campus which will, as a single entity, be totally fit for purpose in the 21st century and a great improvement on what we have currently.

The health trusts must ensure that the programme board sets up a New QE2 Health Campus working group to include local authorities, social care groups for adults and families and children, the Herts Partnership Trust (mental health), the voluntary sector and patients' representatives. Working together in partnership, the local community and the other organisations could produce a highly effective complex that would ensure that excellent professional health and welfare help and support was available 24/7 in Welwyn Hatfield.

We know that the hospital trust is very keen to achieve Foundation status.

Among other things, this will have the advantage of ensuring that at least some of the management decisions are taken locally. In order to do this effectively, we would propose that the Foundation Trust board should include at least three members elected onto it by the community, and that they have full voting rights.

We do not pretend that what we have described is the ideal answer to health problems in our area of Hertfordshire.

There are still serious difficulties to overcome, including provision of non-emergency transport, accessibility, car parking (a multi-storey car park is essential), continuity of services during the change-over period up to 2010/11.

However, we agree with Nick Carver's contention that "doing nothing is not an option".

What we are suggesting is doing something positive and constructive to get the very best health care in the East Anglia region.

We see little point in continuing to complain and to whinge, when the benefits and advantages of a fully co-ordinated 'health campus' on the QE2 site are so obvious.

Dr Dennis Lewis, The Links, WGC, member of PCT Patient Involvement Panel.

Dr Eric Sherrard, The Holdings, Hatfield, member of PCT Patient

Involvement Panel.