1.1 CHEK was established in January 1999 in the wake of the Secretary of State's qualified endorsement of the East Kent Health Authority's proposal to reconfigure East Kent's acute facilities on two sites. Our constitution expresses an unambiguous commitment to fight for the retention of A&E departments on three sites, the retention of full Cancer services at K&CH and to monitor and fight for high quality services throughout the entire East Kent region. We believe we have honoured that commitment.
1.2 It is thus impossible for CHEK to endorse or even give qualified support for any of the four options.
1.3 We fully accept that in expressing this view our comments fall outside the scope of the consultation, but hope that if the Trust is truly committed to identifying the best way forward for healthcare in East Kent, our views will be registered and our voice heard.
1.4 This issue is too big and too important to be bogged down by political dogma, entrenched positions, and individual careers. For the Trust to ignore very widely held and very deeply felt opinions is a betrayal of the very people who they serve.
1.5 Our reasons for rejecting all four options are laid out in some detail in this document, but in summary they are:
* That the scale of the changes proposed is massively disproportionate to the so-called 'drivers for change'.
* That none of the options (and Option D in particular) is affordable. That the unitary payments would be so crippling that bed, staff and service cuts would be inevitable.
* That East Kent needs and fully justifies 3 acute sites with 3 A&E departments.
* That East Kent must retain its Cancer Centre including all current specialisms and adjacent services. These include (as a minimum): Oncology, Radiotherapy, Chemotherapy, Haematology, Surgery for the 3 common cancers, acute Renal and HDU.
* The quality and equality of access to emergency services will be diminished for almost 40% of East Kent patients. And further:
* That the Trust has drastically and dangerously underestimated the likely level of future demand on its services.
* That the Trust has over-estimated its ability to recruit the necessary staff (of all levels) to service what would be two of the biggest DGHs in the country. QEQMH is a particular concern.
* That the Trust has given insufficient consideration to the impact that the reconfiguration would have on outpatient consultancies and clinics at K&CH.
* That the option appraisal process has not been conducted objectively.
* That patients would have to travel around 2,000,000 extra journey miles per year, most of them along the A28, with the consequent implications on congestion and the environment.
* That the clinical placements for courses for nursing students at Christchurch University College would be compromised by the absence of many necessary disciplines at K&CH. And that the close relationship between K&CH and UKC's KIMHS (with its prized Cancer Research Unit) would be much diminished.
* That the Trust management lacks the necessary skills to implement change on the scale proposed whilst maintaining services to a safe and acceptable level. It has conspicuously failed to do so even during the limited change which has already occurred.
* That change should be undertaken from a position of stability and strength. The current dire situation would inevitably worsen if massive change was attempted under such circumstances.
1. 6 This option represents what health campaigners believe is needed in the centre of East Kent.
It is not one of the options put forward by the Trust. We are making it possible for you to choose this one if you believe that it offers the best healthcare for all residents in the area.
OPTION E
Keep at K&CH a full 24hr emergency service, including an intensive care unit, renal medicine and paediatrics, general medicine, general surgery, services for older people, trauma and orthopaedics, vascular surgery, cardiology, consultant-led obstetrics, a full Cancer Centre (including oncology, haemotology, in-patient radiotherapy, high dose and complex chemotherapy for rare tumours), and neurology.
Also keep medical emergency admissions, a coronary care unit, critical care unit, acute rehabilitation of older people, planned hip/knee replacements and breast and urology surgery for all East Kent.
Under Option E, K&CH would have a minimum of 315 beds.