Can we expect a healthy 2008?

Argus health reporter Siobhan Ryan looks at what lies ahead for the NHS, its staff and patients.

What a year it was. Over the past 12 months there were some of the biggest demonstrations Sussex had seen as thousands of people took to the streets, united in a common cause.

It was a cause affecting major hospitals from The Conquest in St Leonards across to St Richard's Hospital in Chichester, taking in Eastbourne, Brighton, Haywards Heath and Worthing on the way.

It was all down to two public consultations under the banner Fit For The Future.

All four Sussex primary care trusts (PCTs) have been involved in drawing up proposals for changes in the way services are provided in the main hospitals and developing more facilities in the community.

The long-term aim, according to the PCTs, is to ensure safe, sustainable services well into the future.

There has been no argument that more services should be provided in the community and closer to people's homes.

Going to your local GP for a blood test or an X-ray instead of travelling further afield to a hospital makes a lot of sense.

Ensuring there are enough support services for people at home, such as regular visits by community nurses, so they can avoid hospital in the first place is also welcome.

The sticking point though, is the future of basic services at hospitals such as consultant-led maternity, intensive care and basic accident and emergency services.

What people cannot accept and have shown they cannot accept, is the suggestion that reducing A&E and maternity services at one hospital and transferring them to another is a good idea.

Quite rightly, they point to the length of time it takes to get from one town to another in a county where roads are often congested.

There may be only 12 miles or so between Worthing and Brighton but anyone who has travelled along the A27 or the A259 coast road will know just how long it can take.

The Royal Sussex County Hospital in Brighton is, through no fault of its own, in a location that is awkward to reach and where parking is scarce. It is looking to expand and develop its services so it can meet the extra demand from patients across the county but managing to get to the place is always going to be an issue.

Maternity units across Sussex are constantly busy. There have been many occasions when smaller units such as Eastbourne have had to step in and take mothers and babies because larger sites such as the Royal Sussex were full.

Despite this, East Sussex Downs and Weald PCT and Hastings and Rother PCT decided just before Christmas to push ahead with controversial plans. They will mean the only consultant-led maternity unit in East Sussex, excluding Brighton, will be at the Conquest in St Leonards.

Eastbourne District General Hospital will become a midwife-led unit.

Emergency cases will have to travel 20 miles between the two towns for urgent treatment.

Unsurprisingly, campaigners are not happy and have vowed to fight the proposals all the way.

Over in West Sussex, the public consultation on the future of A&E, maternity and other services at Worthing Hospital, St Richard's and the Princess Royal Hospital in Haywards Heath, has also finished. Tens of thousands of people attended mass demonstrations, signed petitions and attended meetings over the summer.

All they can do now is wait for a decision.

West Sussex PCT and Brighton and Hove City PCT have said this is expected in the spring but campaigners are not holding their breath.

Local elections are coming up in May and if the decision is going to be unpopular then there is a good chance we will not hear anything until after then.

For now, the best campaigners in West Sussex can do is wait and hope.

They have warned, however, that like the people in East Sussex, they will not take any bad news lying down.

There has been one glimmer of hope. West Sussex PCT has indicated it is interested in alternative proposals that could lead to A&E services being kept as they are in Worthing, Chichester and Haywards Heath but the future of their maternity services is still uncertain.

The problem is partly down to some of the units, such as the Princess Royal, not having enough births a year to ensure doctors are getting the right training and keeping their skills up to scratch.

If more women use the hospital, the greater its chance of keeping full consultant-led services. If they do not, then its future is certainly not guaranteed.

Whatever happens over the coming months, the clearest message gained from the past year is that people do care.

They may grumble about the occasional cancelled operation or how long they have had to wait in A&E but they want their hospitals to have the basics.

They understand you cannot have a high-level specialist heart unit in every hospital. Of course you can't.

There are not enough specialists around and not enough cases to merit it. But this specialisation should not come at the expense of the basics.

The three West Sussex towns affected - and Worthing in particular - have large, growing populations.

They want to be reassured they will have full A&E, intensive care and maternity services available.

Eastbourne is a large town and wants a complete maternity service.

Campaigners there fear that once one service like that goes, others will follow.

They have a point. You only need to look to Crawley to see that.

A few years ago, Crawley Hospital had an A&E department and children's inpatient services. It carried out emergency operations and had a maternity unit.

These have now all gone to East Surrey Hospital in Redhill, despite the fact Crawley has a population of about 100,000 that is still increasing and a major international airport on its doorstep.

It's no wonder people elsewhere in Sussex are worried when they see what is happening now.

Last year was a tough one for PCT managers as they tried to explain why these unpopular decisions and consultations had to happen.

Judging from the mood in the camps of the campaign groups, 2008 is not going to be much better.

It is certainly going to be another interesting year.

siobhan.ryan@theargus.co.uk

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