HISTORY OF TOMORROW’S HEALTHCARE

There are many stories and rumours about how and when the whole ‘Tomorrow’s Healthcare’ saga actually began. It is a long time ago and really has very little relevance to the present so we are not going to speculate. However, we do know that it included a pretty eclectic cast of characters:
* Sir William Wells. The Thanet developer and builder who became Chairman of the NHS Regional Office, Chairman of the Royal Free Hospital and is now Chairman of the NHS Chief Executives' Appointments Committee.
* Jonathan Aitken. MP for South Thanet, Chief Secretary to the Treasury, friend of many in the Arab world, convicted of perjury and now released from prison.
* Virginia Bottomley. MP for Surrey. Secretary of State for Health. She backed the Tomlinson policy of ’fewer, larger centres of excellence’. Her local hospital is currently undergoing a very similar re-configuration to ours.

LOAN ARRANGER

At the same time as Jonathan Aitken was helping to raise the cash from the Treasury and the Royal Bank of Kuwait to build the new sections of QEQMH, EKHA undertook a review of Orthopaedic services, because the Sea Bathing Hospital in Margate had to close. Orthopaedic surgeons almost unanimously decided that a single central unit would be preferable and chose a site near Whitfield in Dover. However the general election was looming and suddenly EKHA was told to drop the Orthopaedic review because of ‘political sensibilities’. Folkestone, Canterbury, North and South Thanet might have been deemed to have ’lost’ their orthopaedic departments and all had conservative MPs.

A&E REVIEW

Instead, EKHA began a review of Accident and Emergency services. For reasons which have never been fully explained, around 1996-7 EKHA decided that East Kent could not sustain 3 A&E departments. This was in spite of the fact that only a couple of years before they had approved the building of a third A&E department, at QEQMH. One would have to go! KCH was chosen very early on, and everything that happened afterwards was engineered to fit that scenario. KCH was for the chop even though it was:
* The most geographically central
* Best managed
* Most cost-efficient
* Had most specialities

TOMORROW'S HEALTHCARE

The plan now had to be put out to public consultation. This became known as 'Tomorrow's Healthcare'. The document outlined three possible options and asked the public to endorse their preferred option - to downgrade KCH to a Cottage Hospital with just 65 beds, a minor injuries unit and low-risk maternity. The people of Canterbury took to the streets in their thousands and told EKHA what to do with their preferred option.
But it was no surprise when EKHA announced that the public had endorsed their preferred option. In fact the figures had been heavily weighted and the true result was a very substantial rejection. (see left) The Community Health Council had the power to ask that the decision be referred to the Secretary of State.

DOBBO DECIDES

Frank Dobson announced his decision on 23rd December 1998 when parliament was down and everyone had their minds on Christmas. It was only a partial endorsement. He made some very substantial changes. He said that KCH must:
* Have 232 beds instead of 65.
* Retain acute medical admissions
* Retain its Coronary Care unit
* Retain its Cancer Centre (in fact he approved the purchase of a new Linear Accelerator)
* Continue to treat 85% of the patients currently treated there. And that:
* Arrangements for emergency services (A&E etc) were unsatisfactory and must be improved;
* There must be further research into the future of Renal services and Haemophilia services. This was the worst possible outcome for EKHA. They have since spent three years desperately trying to make the Dobson plan work, but without success. They were probably right in suggesting that for KCH it had to be 'all or nothing'.

TOGETHERNESS

On 1st April the three Trusts (Ashford, Canterbury and Thanet) merged to become the East Kent NHS Hospitals Trust. On the same day, the Kent Cancer Network was born. This followed the recommendations of Dr Jill Bullimore of the Calman-Hine committee that Cancer services in Kent should be managed from one site and be treated as different departments of the same unit. Maidstone was chosen to manage the network.