The passionate concern of West Cumbrian people for the future of their health service is clearly matched by doctors, nurses and other health professionals. You only needed to come to the public meeting at Whitehaven Civic Hall on 14th January to find that out. There was standing room only fifteen minutes before the meeting started, and among those standing tightly packed at the back of the hall was a large gathering of doctors nad nurses, many of them from Egremont.
The meeting had been called by Cumbria Primary Care Trust to explain the health plans set out in their consultation document, "Closer to Home." Most of those present, and all of the speakers on the platform, came prepared to listen. The tone was established by the sensitive and good humoured chairmanship of Willie Slavin and taken up by Rev. John Bannister, invited to address the meeting before any of the platform speakers. He praised the strength of public support for the Save Our Services campaign and announced that the SOS group were now convinced that their concerns were being addressed by the health trusts. All of the main demands of the campaign had now been met.

Specifically, there will be a new acute hospital with at least 220 beds and a capacity for more if experience proved that more were needed. It will have a full Accident & Emergency Service, where all major trauma victims within its area could be stabilised and assessed. It will have a consultant led maternity service and a Special Care Baby Unit led by paediatricians. Specialist care and hospital beds will still be available for acutely ill elderly people, and though it remains the intention of the Trust to provide palliative care in people's homes if possible, there will remain five beds for this purpose at West Cumberland Hospital.
Why is it possible to give these assurances now? As a result of increased government investment the £28.4 million local health economy debt has been cancelled, saving the Trust £2 million a year in interest charges alone. An addition £19 million will be provided to improve community services and a further £8 million to cover the unavoidable cost of providing comprehensive health care in a rural setting. The political pressure that Jamie Reed, MP has asserted through an unremitting barrage of parliamentary questions has forced ministers to become aware of the unique needs of the West Cumbrian community, and the achievement should not be underestimated. Is there another acute hospital in England that serves a population of fewer than 160,000?

The concept of the Closer to Home strategy works in many ways. Wherever possible patients will be offered care in their own homes. At the same time, West Cumbrian patients should be able to attend an acute hospital near to home unless their condition required specialist care in Newcastle or Middlesborough, and patients who were recovering or less acutely ill should be accommodated in the community hospital nearest to their homes.
It is clear that the detail of these proposals is being closely watched by local doctors. Dr Charles Brett intervened when surgeon Simon Raimes appeared to imply that some acute trauma patients might be transferred to Carlisle for complex surgical treatment. His understanding was that only a very small number of patients would be transferred to Carlisle, and this was agreed by speakers on the platform.
Chris Nicholson, who retires as Senior Nurse later this year, also demanded attention to the fine detail. Will she be replaced by a nurse at the same level, she asked. She told of a patient whom she referred to Social Services for immediate care, only to be told that this could not be provided until February. Jill Stannard, Director of Adult Social Care for Cumbria County Council indignantly declared that such advice was totally unacceptable and promised to see that the care was indeed provided immediately.

Egremont Doctors Still Vigilant

Beech House doctor, Magdalena Rocha, intervened angrily to tell how one of her patients was obliged to travel to Carlisle for acute eye treatment simply because the department at West Cumberland Hospital had to close at 6pm. Her response prove how sensitive local doctors are to the needs of their patients and their concern to see their medical needs in the context of their whole domestic circumstances.

Her colleague, Dr Jan Den Bak, who had signed a letter from a group of GPs who were anxious about the way Closer to Home might impact on their patients and had told the meeting that he was "happier but still not thrilled yet" about the Closer to Home proposals told Egremont Today that he thought that a great deal had already been achieved at the time of the meeting. The decision to increase the number of beds to be provided to 220 was a vital factor and it had since been agreed to make provision for an additional 30 beds if experience prove d that they were needed. Crucially, it was necessary to keep an eye on the number of community, Step Up, Step Down Beds, that would be needed so that local patients could continue to receive care at West Cumberland Hospital rather than have to transfer to a community hospital at Keswick or Millom. The crucial question was whether there was enough money to make it possible to provide the right degree of community care closer to home. "If it works, we can afford to reduce the number of beds in the hospital."