No crumbs of comfort from Ms Hewitt

EADT Political Editor Graham Dines joined Tony Blair's NHS reform seminar in Downing Street yesterday and afterwards spoke to health secretary Patricia Hewitt about the crisis in the debt ridden Suffolk health service.

EADT Political Editor Graham Dines joined Tony Blair's NHS reform seminar in Downing Street yesterday and afterwards spoke to health secretary Patricia Hewitt about the crisis in the debt ridden Suffolk health service.

IF Patricia Hewitt knew she was delivering an understatement, she did it with the straightest of all faces. There were, she acknowledged, “some extremely controversial proposals” being put forward to reform the NHS in Suffolk and to balance its books.

If she'd attended the previous day's meeting of the Suffolk West Primary Care Trust, she would have seen the anger of campaigners after the decision was made to close St Leonard's Hospital in Sudbury and to remove all inpatient beds in Newmarket Hospital and the Walnuttree in Sudbury.

But in the rarefied atmosphere of one of the conference rooms at 10 Downing Street, such local dismay was best kept at a distance as the need to push through the Prime Minister's cherished reform of public services became the order of the day.

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Under the heading “Financial Recovery in the NHS,” Mr Blair sat and listened as chief executives, chairmen, and clinical directors lined up to wear the hair shirt and tell him what local sacrifices and painful decisions are having to be made for the common good.

To give Ms Hewitt her due, there was no attempting to duck out of answering a local question on Suffolk when she talked to the EADT after the seminar.

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Much emphasis in the seminar had been placed on improving community facilities and providing new cottage-type hospitals as one way of reducing bed blocking and routine admissions to the country's top tier acute hospitals.

How, I asked her, did this square with the deeply unpopular decisions of Suffolk trusts to close hospitals and axe beds all over the county to overcome a £70m overspending crisis.

“I am very aware, of course, that in Suffolk there are some extremely controversial proposals to close or reduce the size of local or community hospitals,” said Ms Hewitt.

“We set out very clearly in the White Paper in January, the expectation that in future much more care is going to be delivered much closer to people's home - sometimes in their own homes, in local health centres, and in community hospitals.”

New community hospitals are to be built, but if any are coming to Suffolk, she wasn't saying.

“Against that background, we asked all PCTs which are planning to close community hospitals to look again at these proposals and see whether they were really right in terms of the new direction of travel we need to go in and the reforms that modern medical technology makes possible.”

Ms Hewitt added: “I also made clear that there are places - for instance, a cottage hospital in very old buildings, in some cases a workhouse building - that are simply unfit for 21st century care.

“Or where you have very small units providing community care that could be better provided in people's own homes or in slightly larger, more modern community hospital settings.”

Although Suffolk's health scrutiny committee has referred to Ms Hewitt closures in the east of the county - Hartismere hospital in Eye, the Bartlet in Felixstowe, and a reduction in beds at Aldeburgh - asking her to intervene, the tone of the Secretary of State's comments, and those earlier by the Prime Minister, do not seem to offer much hope.

“These are decisions which are best made by the local NHS, and in particular by the PCTs. They are reviewing those plans at the moment and these will consult on them, and that is in Suffolk and in other parts of the country.”

Ms Hewitt said the Government would not bail out overspent trusts. “We are not sitting on a secret pot of money. The money is all out there with the NHS, and there has been a very substantial increase, over 9% in cash terms, of money being given this year.”

She said most over spent trusts were in the south and east of the country. They had to sort the problem out themselves because it was simply “unacceptable” to continue with the present system of using the surpluses of trusts in the comparatively disadvantaged north and midlands to better off parts of England.

The acting chief executive of the NHS Sir Ian Carruthers made a telling intervention when he said it was amazing how hospitals “in the worst possible workhouse conditions” suddenly became “the best loved in the community” when they were threatened with closure.

Ms Hewitt denied my suggestion that millions of pounds had drained from front line NHS services when area health authorities had been replaced by primary care trusts which were now to merge and become AHAs in all but name, involving huge redundancy costs. In Suffolk, the county's five PCTs - Ipswich, Coastal, Central, West and Waveney - are being recommended by the strategic health authority for merger into one county-wide body, and Waveney is objecting and wants to form an alliance with Great Yarmouth.

“I do not believe we have wasted money at all,” Ms Hewitt insisted. “All over the country, we've seen PCTs really responding to the needs of their local communities, being much more innovative in the way they deliver care, working particularly closely with GPs and community nurses to do more in the community. But what we have also seen is a number of PCTs really struggling to recruit the excellent leadership they need.”

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