The following are partial transcripts of interviews carried out on BBC Radio Leicester on August 23, 2018.
Jo Hayward introduced the segment noting:
“Campaigners say that they are getting increasingly worried about changes proposed for Leicester’s hospitals. In fact, some claim that without clearer detail about these plans, patients could be put at risk. We’ve known for a while now that the main services which are currently carried out in three hospitals across the city are going to be reduced to two, effectively downgrading the General Hospital. And with the budget deficit for the NHS in Leicester, Leicestershire and Rutland predicted to rise to £400 million over the next five years, there is certainly an economic case for it. But Dr. Janet Underwood and her team based at the Health Policy Research Unit at DeMontfort University have big concerns about these changes. They say there hasn’t been a proper consultation; she’s been speaking to Tim Parker.”
Dr Underwood: “Probably one of our biggest concerns is the fact that a lot of the detail is in the appendices, not in the public domain, which stops us from evaluating, fully, the plans. What’s actually happening is that there are moving Level 3 intensive care beds from Leicester General to Glenfield Hospital. That means that major operations such as kidney transplants, liver operations that are currently taking place at Leicester General will also have to move to Glenfield. As part of national policy, the General will eventually become something like a community hub; the acute hospital status of the General will have been lost.
Tim Parker: “But three acute hospitals in one city is unprecedented elsewhere. But campaigners point out that these serve a growing city and two counties, not just Leicester.”
Dr Underwood: “The UK has far fewer beds per thousand of the population than in Europe. In Leicester, Leicestershire and Rutland, there is even less beds per thousand of the population, so we are actually in a state of needing to have more beds.”
Tim Parker: “Perhaps most worrying, our researchers claim that there will be medical risks for patients in making these changes.”
Dr Underwood: “They are going to split three clinical services across two sites: these are kidney transplant, liver operations, urology. For kidney transplants they are going to be removed from all the facilities at the Leicester General Hospital, including the dialysis machines, which are necessary for maintaining life. And it is not clear, and we need more information, as to where these patients are going to dialyse.”
Tim Parker: “Tonight, at a Health Committee meeting at Leicester City Council there will be public questions asking why the closure and transfer of Intensive Care Unit out of the General Hospital got approval in 2015 without public consultation because it was argued that it was needed for public safety reasons and yet the unit is still open.”
Dr Underwood: “This needs to be formally consulted upon in public with full information, and that way people can add their views, bring their own expertise and their own experiences to ensure that the people of Leicester, Leicestershire and Rutland end up with a hospital service that is fit for purpose.”
Speaking in the BBC Radio Leicester studio, Jo Hayward then talked live to Andrew Furlong, the Medical Director of University Hospitals of Leicester.
Although he didn’t properly respond to concerns about the need for a public consultation he repeated that he was adamant that the changes “will improve safety in Leicester actually for patients”. He then engaged in a little scaremonger when he said that the legacy of having three separate hospitals means that they do “not necessarily meet modern health care standards.” He then added that the “consequence of that means that we have duplication and in some cases triplication of services, to give you some examples … like having three Intensive Care Units”.
Furlong went on to state:
“What the Royal Colleges and others are telling us is that this is increasingly clinically unsustainable, and itself will create safety risks for patients in the longer term because we struggle, almost on a weekly basis, to meet the modern standards that are required for staffing some of those units. I would like to stress with people that there are no issues with safety at the moment, but it is a constant pressure for us. Now things came to a head for us in 2015 for Intensive Care when our senior consultants, our senior doctors, and our senior nurses came to speak to people like me to say that the situation at the Leicester General had reached a tipping point. And the four reasons for that were, the first was that the Intensive Care Unit at the General had been downgraded, so it had lost its training status, which meant that doctors-in-training could no longer go there to get training. We were also facing a number of senior consultants who were about to retire and despite multiple attempts to try to recruit, we were unable to recruit new consultants to work in the Unit, and that was partly as a consequence of the fact that the Unit had lost its training recognition.”
Jo Hayward then said: “But that was three years ago wasn’t it, so one of the concerns is that quite a lot of time has passed and that at that point it was deemed to be…”
To which Furlong replied:
“One of my frustrations is that it has taken this long to get to where we are. So, in 2015 we had to take those concerns very seriously because they weren’t made lightly and we quite rightly tested them. But we were clear that we had reached a tipping point with the Leicester General, so as a consequence we outlined a paper, in terms of some proposals, which essentially involved coalescing, moving the three units to two units in line with the longer term plan that you made reference to, that there would be a movement from three to two ultimately. So, we took that paper to the Health Oversight and Scrutiny Committees in Leicester and Leicestershire in the Spring of 2015 and the case we made was that we needed to get on and do this because there were significant concerns. The Health and Oversight Scrutiny Committees agreed and didn’t feel it was in the best interest of the public of Leicestershire to consult.”
Jo Hayward: “Why not though, because the public are going to be the ones who are treated and will have the consequences of any moves or decisions, it seems very curious that there isn’t wider public consultation on what is such a crucial service?”
Furlong: “Well because at the time, we felt that the situation was such that we needed to get on and do this relatively quickly. It is a great regret to me that it has taken this long to do that.”
Jo Hayward: “Maybe there could have been room for public consultation after all?”
Furlong: “Well with hindsight, but at the time we were convinced by the clinicians that things were at a tipping point. The reason it has taken this long is that it has simply taken this long to secure the Central [Government] funding. The reason we have been able to keep the Unit going, and we have not seen it fall over is because we have been able to, through essentially the good will and discretionary effort of staff that currently work there, and by recruiting people on the promise that we have a plan that is backed, that is going to involve new facilities, we have been able to recruit people to be able to keep that service going. But I strongly believe that if we hadn’t have had that plan, we would have been talking about closing that Unit, because we couldn’t keep it going.
Furlong: “The longer-term plan takes us from three to two [hospitals]. To be frank, if money were no object then what I think that Leicester needs is one hospital, a super hospital; but being pragmatic that is probably unaffordable for Leicester and Leicestershire, so the three to two is a pragmatic solution.”
Steve Score, who is part of the Save our NHS Leicestershire Campaign, was interviewed during the lobby of the Leicester City Council Health Scrutiny Committee meeting. He said:
“We are worried that the removal of the intensive care beds from the General Hospital will pre-empt the potential closure of this hospital as an acute hospital and that there has been no public consultation on that.”
“What we need is a public consultation and we are seeking the support of the [Health Scrutiny] Committee here for the idea of a public consultation on these proposals. If they refer it to a body that can make decisions, then all the good. We want to raise it everywhere we can. But the point that we are making is that if they take intensive care out of the General then it pre-empts a decision on whether to close the General as an acute hospital, and we feel that that is a way of circumventing genuine public discussion about whether it is right to go from three to two hospitals in Leicester.
“When it comes to a public consultation — that is a public one that the general public get to hear about and participate in — it could almost be presented [by the Hospital leadership] as a fait accompli, [with them potentially saying in the future] ‘we can’t sustain services because we don’t have intensive care’. That is what we are worried about. What Elly [Cutkelvin] said about a decision in 2015 — at that point they were told that this was a matter of urgency to close this intensive care unit for public safety, and on that basis they [the Health Scrutiny Committee] agreed to the issue without a public consultation. Yet three years later it is still there. It obviously hasn’t been an issue of public safety for three years and we think there should be a proper public consultation process to go through.”