NORTH Hampshire Primary Care Trust (PCT) has allowed itself a modest "pat on the back" following the release last week of the government white paper on health and care. Heralded as a U-turn by Health Secretary Patricia Hewitt, the paper has served to endorse North Hampshire PCT as a policy trail-blazer working towards the provision of more community-based health care. Setting out a vision of care and treatment provided outside the costly setting of traditional acute hospitals and nearer to patients' homes, according to Tony Blair the white paper advocates "a service fitted round the patient, not the patient fitted round the service". GPs would be encouraged to stay open longer and provide evening and weekend surgeries, specialist clinics, health MOTs and local screening facilities. There would be more help for carers with the provision of a respite service to give people a break. And key to these services would be the retention of local cottage and community hospitals. Miss Hewitt said that over the next 10 years she wants to see five per cent of resources shifted from major hospitals to more locally- based primary care. That would amount to around £2.5 million from the health service budget. With up to 100 hospitals under threat in England alone - Alton Community Hospital having come very close to the knife - primary care trusts are being urged to rethink their closure plans, particularly when they are being put forward as a cost-saving measure. It is positive news for the people of Alton, many of whom fought hard but failed to retain the former Treloar Hospital and were preparing to do battle once again to save Alton Community Hospital. Thanks to the stakeholder group, set up to look at the future of the hospital, and to the PCT, the crisis appears to have been diverted with plans to re-open Inwood Ward. While the proposal has been given the "thumbs up" by local GPs it will come before a public meeting, due to take place at the Alton Maltings at 7 pm on Wednesday, February 22. North Hampshire PCT chairman Dr Tony Ludlow is delighted with the white paper, pointing out that it does indeed endorse the PCT's policy over the last four years. "As the white paper says, we want to develop health services that are safe, high quality and closer to home." To do this, the PCT has set up a Community Intensive Support Scheme (CISS) which enables community nurses to look after patients in their own homes and use "procedures that could once only take place in hospital". North Hampshire was the first PCT in the country to open a diagnosis and treatment centre, based at Chase Hospital, Bordon, which is able to deliver services that used to be available only at the acute hospital (in this case North Hampshire Hospital at Basingstoke). And now the stakeholder group has recommended new ways of using Alton Community Hospital so that it becomes a "centre of excellence" in rehabilitation which, says Dr Ludlow, "coincides perfectly with the white paper's plans to introduce 'a new generation of community hospitals'. "We have shown that these developments work and now the government policy is fully behind us," he added. Dr Ludlow's message was clear: "An important part of government policy is to remove barriers between health services and social services so that we can provide local services for local people." Richard Samuel, director of patient outcomes and performance at North Hampshire PCT, points out that the Department of Health has undertaken an "extensive listening exercise" involving people from different sectors of the community, all of which have informed the white paper on health and care. The title alone, he said, enforces the message that the two are inextricably linked, endorsing the direction of travel put in place both by the PCT, local GPs and the stakeholder group whose aim is to strengthen and increase the range of services provided at Alton Community Hospital and in the community surrounding the hospital. "It sends a very positive message to the people of Alton," pointed out Mr Samuel, who believes the paper goes a long way to identifying how to move the issue of health services from being identified as "illness services" to being focused on improving health care. "With GPs encouraged to provide health MOTs and screening in the community, it is a way of tackling and identifying risks of disease at an earlier stage which will enable people to live healthier lives for longer," said Mr Samuel. The PCT, he added, would be looking to treat more people at the community hospital, in their own houses and in GP surgeries. "People don't want to go into hospital unless absolutely necessary - they would prefer to be treated nearer to home and to get home as quickly as possible but with the right level of support." l East Hampshire MP Michael Mates has called on the government and health service managers to ensure that community hospitals survive the current NHS funding crisis. "This week the Health Secretary published a White Paper promoting better health services in the community but was unable to guarantee that the current wave of community hospital closures would come to an end," said Mr Mates. "We cannot have better community health services without adequately funded community hospitals. It is no good ministers wishing there to be better community services but not providing the means to ensure that they can be delivered. "Ministers constantly boast of all the extra money they are putting into the health service. If this is true, why is there is not enough money to fund popular and effective community hospitals? It is important that ministers issue a clear message to Hampshire NHS managers that the hospitals in Alton and Petersfield are just the sort the government is going to need to deliver their ambitious plans."
