Closing community hospitals in a pandemic – the CCG hasn’t learnt, and Health Scrutiny lets down another local community
Yesterday’s Devon Health Scrutiny Committee faced a decision on the Devon Clinical Commissioning Group’s proposals for Teignmouth and Dawlish. These involved 3 key proposals to move services from Teignmouth Community Hospital (TCH) to either Dawlish Community Hospital or a new health hub in Teignmouth which will include one of the GP practices. A 12-bed rehabilitation ward which the CCG previously promised for TCH would be scrapped. The plan would leave TCH empty and ripe for its owners, an NHS Trust, to re-develop the site.
Health Scrutiny received strong representations against the plan from the local community in November, and in December held a Spotlight Review at which it was agreed that the CCG’s consultation – held during the pandemic – had been flawed. Even despite a skewed questionnaire, none of the 3 proposals to move services had majority support among respondents – most were opposed or unsure. Even on its own terms, the CCG had failed to convince the local community.
What is more, it had failed to produce evidence that community care was an adequate replacement for, rather than complement to, bedded intermediate care in community hospitals, evidence for whose benefits had been provided by Dr Helen Tucker, chair of the Community Hospitals Association, and others. The Committee’s Labour Vice-Chair, Cllr Hilary Ackland, strongly emphasised this point, and was the main author of a paper Health Scrutiny sent to the CCG explaining its reservations.
The CCG then met, but ignored the Committee’s views – the only point in its recommendations which addressed them was a plea for the district council to look into parking for the new hub, a serious issue (as anyone who’s driven around Teignmouth town centre will know), but a secondary one.
Health Scrutiny therefore had to decide whether to follow through and use its key statutory power to refer the proposals to the Independent Reconfiguration Panel (IRP) which reports to the Secretary of State for Health, Matt Hancock – who incidentally has said that he’s a fan of community hospitals. However 7 Tories including East Devon councillors Sara Randall-Johnson (Chair), Phil Twiss, Richard Scott and Jeff Trail, plus (disappointingly) Hilary Ackland, voted against my proposal to do this. I got the support of Independent Claire Wright (of course), Lib Dem Nick Way, and Tories Sylvia Russell (Teignmouth) and Andrew Saywell, so this was lost 8-5. (For Claire and me, this was all very deja vu.)
Instead the Committee voted to try to monitor the development and have informal discussions with the IRP. Given the advanced stage of these proposals and the CCG’s dismissal of the Committee’s views, I’m afraid this will be taken as a green light. I find it astounding that in the midst of a pandemic which has exposed the beds crisis in the NHS, in Devon as across the country, the CCG should continue mechanically with this pre-pandemic scheme and Health Scrutiny should fail to stand up for the need to keep our community hospitals – or at least insist on postponing a decision until we can look properly at what the needs will be – in the post-pandemic world.
CCG Chair Dr Paul Johnson even referred to Long Covid, believed to affect up many Covid sufferers, the full scale of which is very much unknown. Yet at a time when the NHS in Devon and elsewhere is turning patients out of hospitals and in many cases into care homes (which continue to suffer more outbreaks), a possible role for the rehabilitation ward in Teignmouth was dismissed out of hand.
Perhaps the most depressing thing about this meeting, indeed, was that Dr Johnson suggested that as soon as the pandemic declines, the extra money for the NHS will be turned off, and Devon NHS will be back in the world of endless cost-cutting in which it was a year ago, when the pandemic hit. Either he has learned nothing, or he’s expecting the Government to have learnt nothing, or both.