Thursday, 24 April 2014

Dr Tiz North tells why she stands for St Helier Hospital

The KOSHH Party Sutton candidates at St Helier Hospital. 
L to R: Frances Cornford, David Murray, Dave Ash and Dr Tiz North

Dr Tiz North, a consultant radiologist at St Helier Hospital shares her statement of purpose about why she is running on the KOSHH Party ticket in the May 22 local elections.

I believe that the population surrounding Epsom and St Helier Hospitals deserve to be treated by a local hospital trust which has all the secondary services of an Acute District General Hospital.

First, some background to the current situation facing St Helier Hospital... Over the past 30 years, there have been constant attempts by politicians to close St Helier, an excellent hospital with a good reputation. This has sprung out of the belief that there are too many hospital beds in London and therefore several of the outer London District General Hospitals should close.

Indeed, there has been an overall reduction in the number of beds throughout the capital thanks mainly to modern technology which allows day case surgery and intervention by minimal techniques. These advances result in shorter hospital stays. This shift has been led by the clinicians performing these services. It has not been led by politicians. Likewise, the shift of tertiary services, such as transplantation, cardiac and vascular surgery, major trauma, neurosurgery, acute stroke services and paediatric surgery, have all been shifted out of Epsom and St Helier Hospitals. These services are now performed at St George's in Tooting. Again, this was all with the agreement of grassroots physicians.

But what about the present situation? Our two local hospitals, Epsom and St Helier, have been pared down to the essential core services. This includes busy A&E departments, Paediatrics, Maternity, General Surgery (including cancer surgery), Eye Surgery, Urology, Orthopaedics, General Medicine (including diabetes, renal services, palliative care, care of the elderly and dermatology). Because of this wide spread of specialties, both hospitals can cater for the majority of common surgical and medical conditions. This attracts high calibre junior doctors into the surgical and medical rotation schemes as well as students from St George's Medical School.

What could happen in the future? If any of the specialties, especially A&E, Paediatrics or Maternity, were removed from either Epsom or St Helier, a domino situation would arise. If there are no patients admitted to the wards for acute medical or surgical treatment via A&E, this means the hospital loses training recognition by the Royal Colleges and the withdrawal of junior doctors. These doctors would be replaced by doctors in non-training posts, mostly from abroad. A lack of patients means a lack of teaching cases and this would have a negative effect on the presence of medical students. The general downgrading of the hospital means it would not attract top quality consultants and overall patient care could suffer.

Where would the patients be treated if St Helier Hospital was downgraded? The Better Service, Better Value (BSBV) programme may be defunct in name but the SW London Collaborative Commissioning Groups (SWLCCG) is simply the programme's latest incarnation. This group believes that much of the work can be done locally in patients' homes and by GPs. This is despite the fact that GPs are already under too much pressure and more than 50% of GPs are women, many of whom want to work part-time. On top of this, there is not the back-up in the community because there is a shortage of district nurses. 

So, what would be the new reality for patients in our community? In reality, what would happen is that more patients than ever would descend on St George's A&E in Tooting. The physicians there have been quite vocal about not wanting this to happen. This is understandable as they would like to concentrate on the tertiary services they already provide, as well as providing secondary services to their own local population. Like the area surrounding St Helier Hospital, the population around St George's Hospital is increasing.

Are there any solutions? Epsom and St Helier Hospitals should not be subject to any further reconfigurations. Doctors should work with local Clinical Commissioning Groups (CCGs) to ensure that across the patch every attempt is made to reduce hospital admissions and shorten hospital stays by improving health and social care outside the hospital. In turn, CCGs should support their local hospitals and not reduce funding by such an amount that they become unviable.

Both hospitals should look at their own practice to see how treatments can be improved by rapid investigation and timely intervention.

About Dr Tiz North: Dr North moved from Epsom to Sutton in 1982 and has lived in the same house in South Sutton since then. Both her children went to schools in the local area. She has been a consultant radiologist at St Helier Hospital since 1977 and was previously the Clinical Director of Diagnostic Imaging for Epsom and St Helier. Dr North was also chair of the Local Negotiating Committee. Currently, she is the Honorary Secretary of the SW London Division of the BMA and a member of Keep Our NHS Public.

Photography by Paul McMillan 

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