THE closure of the Royal Surrey County Hospital or of A&E departments at the Royal Surrey or Frimley Park Hospital is neither being ruled out, nor ruled in at the moment. That was the message from the first board meeting of the new Surrey Primary Care Trust, held on Monday, a week after 6,500 people took to Guildford's streets in support of the Royal Surrey. The board made clear that more than 30 options have been reviewed. A range will be put forward for public consultation and the full closure of an acute hospital could be among them. But those options, being driven by the national agenda for change in the NHS, are currently very much "a work in progress", with no facility on or off the safe list, it was stressed. The board faced questions from the public about whether it really understood the real fear felt by tens of thousands of people about their health services. "If you believe that what you are going to do is going to be for the benefit of your customers, how exactly do you plan to get that across when at the moment the agenda is completely driven by closures?" they were asked. PCT chief executive Chris Butler acknowledged it as "clearly an issue that is causing immense concern among the public". But he said it was important that it should be seen in the context of national policy, with Surrey "probably at the vanguard of that policy". The PCT has inherited projected financial deficits from four of the five former PCTs that it has superseded and without changes to the pattern of services commissioned could be facing a deficit of £119m by 2008/9. This situation, although a factor, is not the driving force behind the changes ahead, Mr Butler insisted. Jill King, programme director of the Fit for the Future programme for change in Surrey, said the aim over the next 10 years would be to shift services to local communities, better meeting the needs of individuals and shifting the emphasis to prevention. "Wherever you live in Surrey, you will have equal access to services, depending on what your need is," she asserted. Less need for acute hospital beds and a reassessment of the services provided by community hospitals will be among the consequences. The proposals will also aim to ease the load of A&E departments through the use of urgent care centres staffed by GPs and emergency nurse practitioners, coalesced with community hospitals to share diagnostic facilities. "For a large number of people, going to an A&E is not what you need. An A&E is a critical care centre. Sixty per cent of people who go to an A&E do not need the highly technical, very intensive care at an A&E," it was explained. "The whole point is for the establishment of centres of excellence for people to get the best possible treatment," said Douglas Robertson, chairman of the PCT. He said the background had been absent from the public discussions so far. "We are hoping we are preparing the way for the most modern and affective NHS that we can." • South West Surrey MP Jeremy Hunt said this week that answers to parliamentary questions he had tabled revealed the true cost to the NHS of McKinsey & Co, the management consultants who have been tasked with developing hospital closure proposals in Surrey. So far in 2006-7 the Department of Health had spent £9,964,000 on McKinsey. Said Mr Hunt: "Patricia Hewitt is gambling that spending ever increasing amounts of money on them will somehow help her justify unpopular hospital closures. "McKinsey's bill for this financial year alone would have paid for nearly 2,000 hip replacements. Perhaps if she sacked the management consultants, then the doctors and nurses at hospitals such as the Royal Surrey would not find their jobs under threat." Mr Hunt has also claimed that while the future of the Milford Hospital site still hangs in the balance, bids are already being submitted by developers who wish to build on the site if the closure finally gets passed. He said: "Health bosses may be hoping that given the threat to Royal Surrey, we may all forget about Milford. If they believe this, they are quite wrong. "It is quite unacceptable for developers to be sniffing around the site when the final decision to proceed with the implementation of the closure plans has not been made. I will be raising the matter with the new Surrey PCT and ask it to look into the matter immediately."
