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Lib Dems urge hospital to think again on ward for elderly
Mike Hancock, MP and his Lib Dem colleague Darren Sanders, the party's General Election candidate for Portsmouth North have joined forces to say that Queen Alexandra Hospital Trust should think again on closing its G5 ward. The ward provides specialist "end of life" palliative care for older patients.
Darren and Mike are also concerned that the unit is already being down-sized and patients moved out even before it is closed to facilitate staff training. They want the hospital to issue a written apology to these patients and their relatives for the distress caused by this.
The Lib Dems have written to the Chief Executive of Portsmouth Hospital NHS Trust urging a change of heart. They are also saying that, at the very least, the Trust should listen to the people of Portsmouth and South Hampshire and hold a meeting under the auspices of the City Council's Health Scrutiny Panel. They are also raising the issue with the Secretary of State for Health and Portsmouth PCT.
Darren Sanders said: "People living out their last days in hospital need as much respect and dignity as possible. For them to be moved to accommodate "training" goes against that. The Trust should apologise in writing to the families of the people affected; it's the decent thing to do.
"A dedicated ward like G5 provides the dignity and respect the dying deserve. The hospital trust say their plans are better but many people in Portsmouth do not believe them. The lack of debate with the wider public is shocking. That is why I have called for a public meeting under the auspices of the Council's Health Scrutiny panel so this can be talked about in the open, not behind closed doors."
Mike Hancock added: "The problems and lack of dignity that older patients can have on general wards have been widely highlighted. Nurses and medical staff can have little time to attend to their particular needs on busy wards. This can be very distressing to both the patients and to their relatives. I believe that closing the ward flies in the face of the direction that the NHS is moving in generally. This is to provide more specialist care for older people in more community hospital type setting. Medical staff, independent researchers, patients and relatives alike have praised the environment and care that the G5 ward offers. Given this, I am frankly at a loss as to why the hospital is closing it.
"There can be only three alternatives. If funding for palliative care is underfunded in Portsmouth then we and the trust should be taking up the issue with the Government and other relevant bodies. If funding is not an issue then it is difficult to see why they are axing this much valued facility. Or if they believe their plans are better overall then I have to say I believe the public in Portsmouth who pays for the NHS are not convinced at the moment. Whatever the situation, the Hospital Trust should put the closure of the ward on hold and have a meeting under the auspices of the City Council's Health Scrutiny Panel to listen to the people of Portsmouth and put to the test the issues of funding and the medical benefits of their plans and closing the ward."
Notes: Darren Sanders' and Mike Hancock's letters are below:
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Letter from Darren Sanders:
Ms Ursula Ward
Chief Executive, Portsmouth Hospitals NHS Trust
c/o Queen Alexandra Hospital
Southwick Hill Park
Portsmouth PO6 3LY
15 August 2010
Dear Ms Ward
CLOSURE OF G5 'END-OF'LIFE-UNIT
I am writing to you to express my concern both at the proposed closure of this unit and at the report in yesterday's News that claimed that people in there had been moved to facilitate training.
People in their dying days must be treated with the utmost respect and dignity. Moving people before they have passed away is the height of insensitivity. I therefore formally request that letters of apology are sent from you to the relatives of those affected.
On the main plans, I urge you to give everyone who pays for the NHS in our city to have the chance to comment before this takes place. Many of them, including me, are finding it hard to understand why a unit is being closed, not because there is no demand for it, but because there is not enough. In any other walk of life, if only 25% of people accessed something, those responsible would do everything they could to attract more people to it, not scrap it at the first opportunity.
I understand the Trust is in a hole financially, not least because of the previous Government's wasteful Private Finance Initiative. However, people should not be allowed to think that looking after people through their final days should suffer as a result.
I therefore ask that, before the project is enacted, a meeting is held in public to discuss your plans with the people who pay for the NHS in our city. I note with concern that the Council's Health Scrutiny Panel has not had this topic as a dedicated item on its agenda.
Having spoken with the Committee Chair, I know she is amenable to such a meeting, held under the Panel's auspices, so this plan can be discussed in public. In this 'Age of Austerity', it is important that decisions such as this are done with the utmost debate and thought. Only then can public support for our NHS continue during these tough times.
I understand my colleague Mike Hancock MP will be writing to you soon as a result of the many complaints he has received on this matter. He and I look forward to hearing from you soon.
Yours sincerely,
Darren Sanders
Lib Dem Parliamentary Spokesman, Portsmouth North
CC: Cllr Mike Hancock MP, Cllr Gerald Vernon-Jackson, Cllr Lynne Stagg, Health Scrutiny team, Portsmouth City Council
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Letters from Mike Hancock:
Ursula Ward
Chief Executive
Portsmouth Hospital NHS Trust
PHT Headquarters
F Level, Queen Alexandra Hospital
Southwick Hill Road, Cosham
PORTSMOUTH PO6 3LY
16 August 2010
Dear Chief Executive
CLOSURE OF G5 "END OF LIFE" UNIT
I am writing to you about the closure of the G5 "end of life" ward at Queen Alexandra Hospital. There are a number of things about this that concern me. The first is the lack of public scrutiny and consultation there has been over this. I understand that this has not gone before the City Council's Health Scrutiny Panel. It seems that it is particularly important that end of life palliative care does go before the democratic processes as this is an issue that I believe the community as a whole and their democratic representatives should consider.
I have to say that I remain a little confused about the situation about the ward itself. It seems to be well used and extremely well thought of. The Portsmouth News wrote on 28th July "Chris Ash, general manager of the department, said: 'G5 is a lovely ward... Sometimes... the ward is full and so patients can't always be transferred there.'" If anything this suggest there should be an expansion of the G5 ward.
I appreciate that there are issues surrounding the best place for people to be in their last days. And surveys show that people would prefer to be at home or in a hospice or care home setting. However a great many people will end their days in hospital. There have been, as you will be aware, many issues surrounding the care of older people on general wards which care for all ages. It can be that older people need more attention and assistance to help with eating of food and caring for their particular needs. Older people may be reluctant or have difficulties summoning and asking for help. You will no doubt be aware of the Patients' Association report on this and the "Dignity in care" campaign for which Sir Michael Parkinson has been the national "ambassador" for and which has highlighted the failings of care of the elderly in general wards.
One hospital worker is quoted in the Portsmouth News as saying: "We are all dreading it. Staff from G5 are not looking forward to this and nor are staff on other wards, who say they are so stretched already and won't have time to provide palliative care on top of their existing jobs. Staff from G5 have already left because of this. I think most of the palliative nurses will leave eventually. Not in a million years will this new plan work." This rather backs up the feeling from the Patients' Association and Sir Michael Parkinson that caring for older patients and providing high quality palliative care on general wards is very problematic. As I say unfortunately older patients, for a whole variety of reasons, may be because there are frailer or suffering, may be mildly, from dementia, find it difficult to ask for help and get ignored. A specialist unit helps tackle this problem as well as providing a better environment.
There is also the issue of having a more suitable and better atmosphere for older patients at the end of their life and this, I understand, is provided at the G5 ward and is greatly appreciated - especially by relatives. Indeed I understand that the trend in care for the elderly at the end of their lives is towards care in a less medical, community hospital type setting. I also understand that the work of the dedicated "end of life" palliative care ward for the elderly at Queen Alexandra Hospital was the subject of a study in the British Medical Journal and the conclusion of the authors was that it was "successful". It seems therefore a crying shame to shut such a successful, well-liked and needed ward. It is throwing the baby out with the bathwater. I hope that you will, therefore look at this again and especially hold a meeting so this can be discussed in public under the auspices of the health scrutiny panel and I understand that my colleague, Darren Sanders, the Liberal Democrat Parliamentary spokesman for Portsmouth North is also writing to you with such a request.
There seem to be three alternatives. If funding is the issue then we should be taking this up with the relevant authorities - the Government and Portsmouth PCT etc. If funding is not the issue then it is difficult to understand why you are closing such a well-liked and appreciated facility. If, though, you feel that money and additional money can be better spent overall then you should take the public with you on this and consult them on it and explain how, with medical evidence, it will be better. You should not be ignoring, particularly on issues such as this the public and the democratic processes of oversight of the NHS. Although I am somewhat as to loss as how it can be an improvement to close a unit which is praised by its manager, by medical staff and by relatives and patients, has been independently assessed as successful and is the direction that care of the elderly is moving towards in the NHS.
I hope therefore, at the very least, that a public meeting can be organised under the auspices of the Health Scrutiny Committee and I would very strongly urge you not to close the G5 ward.
Thank you for your help and time in this matter. I look forward to hearing from you, if possible, very quickly.
Best wishes
MIKE HANCOCK CBE MP
CC: Secretary of State for Health; Portsmouth PCT; Cllr Gerald Vernon-Jackson, Leader, Portsmouth City Council; Cllr Lynne Stagg, Chair, Health Scrutiny Panel
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Rt Hon Andrew Lansley CBE MP
Secretary of State for Health
Department of Health
Richmond House
79 Whitehall
LONDON SW1A 2NS
16 August 2010
Dear Secretary of State
I am writing to you about the closure of the G5 ward at Queen Alexandra Hospital which serves my constituents. This ward provides "end of life" palliative care for older patients. I enclose a letter that I have sent to the Hospital Trust about this which sets out the background. I am writing to you to ask you to look at a couple of aspects of this.
The first is whether it is the right way forward to close the ward. I am concerned that this is a greatly valued facility by local people. As I write in my letter to the hospital, there has been much comment about the wonderful atmosphere and environment of the ward. Of course no-one wants to consider their final days and if possible people want to end them outside hospital in their own home or in a hospice setting. But for various reasons many people do spend their final days in hospital and this will continue to be the case. I have great concerns that too often, even if they are well-run, older patients in general wards suffer from lack of dignity and not enough attention to their particular needs. Indeed closing such wards as G5 seems in general to run counter to the guidance given by the Department of Health which is for the setting up of more such wards in community hospital type settings. Therefore, I would ask you and your department to raise with the hospital trust whether they should be closing this ward.
The second issue is the way that the Trust have gone about this as they don't seem to have done much consultation with the public in Portsmouth and South Hamsphire. As you can see, I am urging that they hold a public meeting under the auspices of the City Council's Health Scrutiny Panel. Indeed I am disappointed that they haven't brought this is before the Panel already. I understand that the Coalition Government is setting great store by local involvement and consultation on the NHS. It seems that palliative care and "end of life" care is one of the most important areas to have such consultation on.
I would urge you to raise this with the hospital and see whether they are complying with Department guidance and best practice in closing this ward in the first place. And secondly if you could investigate the lack of consultation on this and get the hospital to consult properly on this. I would be grateful if you could do this as quickly as possible as I understand that the hospital plans to close the ward in September.
Thank you for your and your department's time and help on this. I look forward to hearing back from you very shortly.
Best wishes
MIKE HANCOCK CBE MP
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