Patients' anger at closure threat

A BITTER war is being fought in rural Kent which has pitted patients and hospital consultants against health authority managers over proposals to close the Kent and Canterbury hospital, one of three serving the east of the county.

One of the key players has received anonymous phone calls threatening his family. But it is mirrored - in its content if not in its bitterness - in arguments in health authorities across the country, as shown in our list of hospitals where change is threatened. The total is certain to be an underestimate as similar discussions are being held in almost every health authority. In Kent, pleas from Frank Dobson, the Secretary of State for Health, for collaboration in place of competition - the previous government's lever for change - have fallen on deaf ears. Local people are left frightened and confused.

Maureen Hoskins, 55, who comes from Birchington near Margate every day for treatment for pelvic cancer, said she was furious at the proposed closure of the cancer unit at the Kent and Canterbury and its transfer to Maidstone, a 60 mile, hour-long drive away. "It's obvious," she said. "If they move the cancer unit to Maidstone, I will die. How will I get there? Who will bring me? This isn't pleasant treatment. You get diarrhoea, cystitis, you are sick."

Her husband, Bill, already takes half a day off every day to drive her the 26 miles to Canterbury and Kent and would not be able to take her to Maidstone. He said: "At the moment, we just about get home after the treatment before Maureen's pain begins. She couldn't manage a longer drive."

East Kent Health Authority says that to provide safe, high quality medical care, resources must be concentrated in two of the three existing hospitals - the 500-bed William Harvey in Ashford, and the 460-bed Queen Elizabeth the Queen Mother in Thanet, which are in the major centres of population. A spokeswoman said: "This is not about money, it is about safe working. It is about making better use of manpower and getting the best health care for people."

Consultants in Canterbury insist that all three hospitals can be kept open, reneging - according to the health authority - on their earlier acceptance that one hospital must close.

Rob Easton, 39, stays at the Kent and Canterbury for five days every three weeks having chemotherapy for testicular and lung cancer. His wife Beverley, and 22-month-old son Raef, visit him every day. Mr Easton, who lives in Canterbury, says if the unit moves to Maidstone, it would be too far for his son to visit. He says: "I would miss the cuddles and his smile ... I would miss that so much."

Hospitals affected by change

NORTH WEST REGION

Morecambe Bay: Five hospitals - Furness General, Queen Victoria, Royal Lancaster Infirmary, Ulverston and Westmorland General - in three acute trusts to merge into one, Morecambe Bay Hospitals NHS Trust, from April. Two community trusts to merge.

South Lancashire: Southport and Ormskirk hospitals. One to become acute hospital and the other a community hospital but the health authorities cannot agree which should be which. Awaiting decision by Secretary of State.

Manchester: Withington and Wythenshawe hospitals. Wythenshawe to be rebuilt as main acute hospital and Withington to be community hospital. Negotiations in progress under the Private Finance Initiative. Manchester Royal Infirmary to be re-built under PFI scheme with specialist children's unit. Royal Manchester Children's Hospital and Booth Hall Children's Hospital will then close. Approved by former health secretary Stephen Dorrell in March 1997.

Bury: Consultation to start on plans to close Bury General Hospital and centralise services on Fairfield General.

Rochdale: some services at Burge Hill Hospital to move to Rochdale Infirmary.

NORTHERN AND YORKSHIRE

Newcastle: Freeman and Royal Victoria Infirmary to merge. Ministerial decision imminent.

Durham: Five trusts to merge into three from April. Darlington Memorial, Bishop Auckland, North and South Durham acute trusts to become two: North and South Durham Health Care Trusts. A third trust, Durham County Priority Services, will cover mental health and learning disabilities throughout the county.

Leeds: St James University Hospital and Leeds General Infirmary - major review of services.

Gateshead: Proposed merger of Queen Elizabeth Hospital and St Mary's Hospital, Morpeth, put on hold at request of health minister Alan Milburn. He asked the two trusts to look again at the options.

North Tyneside: Merger of North Tyneside Trust and two community trusts under discussion.

TRENT

Derby: Derbyshire Royal Infirmary and Derby City General to merge from April, with the City to become main acute site.

Lincolnshire: Service review with proposed closure of some community hospitals out to consultation. Also sharing of services among the eight trusts and the two main hospitals, the Boston Pilgrim and the Lincoln County.

Leicester: Review of services at Leicester Royal Infirmary, Leicester General and Glenfield hospitals.

South Humber: Review of services at Scunthorpe and Grimsby hospitals going out to consultation.

WEST MIDLANDS

Birmingham: Selly Oak and Queen Elizabeth hospitals to close and be replaced by new building on University Hospitals site. Consultation on reconfiguring services among City Hospital, Royal Orthopaedic, Heartlands and University Hospitals ended this month (2 March).

Worcestershire: Proposed new hospital in Worcester as main acute centre, Kidderminster General Hospital to become out-patient and day surgery centre, Alexandra Hospital, Redditch to specialise in urology and orthopaedics. Consultation opened this month.

Rugby: Consultation on proposed merger of Rugby and Walsgrave NHS Trusts ended last month. Main acute hospital at Walsgrave will share surgeons with St Cross Hospital. Awaiting decision by Secretary of State.

ANGLIA AND OXFORD REGION

Oxford: Plans to close Radcliffe Infirmary in town centre and move work to John Radcliffe Hospital on outskirts under discussion.

Ipswich: Ipswich General Hospital and West Suffolk General Hospital, Bury St Edmunds to share services.

NORTH THAMES

Stevenage: Lister Hospital in discussions on sharing services with Queen Elizabeth II Hospital at Welwyn Garden City.

Enfield: Chase Farm Hospital in discussion on sharing services with North Middlesex and New Barnet hospitals. Edgware to become a community hospital.

Essex - three maternity hospitals, in Braintree, Harwich and Clacton, to close.

North London: New building to bring together University College Hospital, the Middlesex, Hospital for Tropical Diseases and the Elizabeth Garrett Anderson.

East London: plans to save St Bartholomew's Hospital by making it a specialist cancer and heart hospital to go out to consultation. Royal London Hospital to be rebuilt. Proposal to build new hospital at Oldchurch and close Harold Wood to go out to consultation.

West London: Services to be shifted from Queen Charlotte's to Hammersmith.

SOUTH THAMES

South London: Plans to switch services from Guy's to St Thomas's to be re-evaluated.

Acute services to be switched from Queen Mary's, Roehampton, to Kingston and St George's hospital. Queen Mary's to become community hospital.

Services to be shifted between St George's and Atkinson Morley hospital.

New Queen Elizabeth Hospital to be built under PFI scheme at Greenwich.

East Kent: One of Canterbury, Thanet and Ashford hospitals to close and work to be transferred to remaining two. Consultation ends on 8 May.

West Kent: Hospitals in Maidstone, Tunbridge Wells and Dartford to share services.

Surrey: East Surrey and Crawley hospitals to merge. Ashford and St Peter's hospitals to merge.

SOUTH AND WEST

Bristol: Review of management at Frenchay and Southmead hospitals.

Cornwall: Proposed closure of four of ten community hospitals at Saltash, Fowey, St Ives and Poltair and changes to number of beds in the remainder.

Review of management at Royal Cornwall Hospitals Trust (Treliske hospital) to be completed later this year.