Rapid action urged to settle hospitals saga

NHS dilemma: Split over provision of services for children in Manchester
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Public Policy Editor

The NHS Executive was yesterday told by the Ashworth inquiry that it must sort out specialist children's services in Manchester - just as the latest attempt to do so in a 10-year saga bit the dust.

Three local health authorities finally withdrew a proposal that the Ashworth report says is needed to close the Booth Hall children's hospital in north Manchester and centre neurosurgery and other specialist services on the Royal Manchester Children's Hospital site at Salford.

This proposal foundered, however, in the face of intense local opposition to the Booth Hall closure and legal action by Manchester City Council, which argued successfully in preliminary judicial review hearings that the plan was not properly costed. Yesterday, the Manchester, Salford and Trafford health authorities formally accepted the argument in court, and agreed to meet Manchester council's costs.

Opponents of the plan - which had near universal medical backing - included Graham Stringer, the council leader, who was hoping to be adopted (as he has been) as prospective Labour candidate in Blackley, the constituency which houses Booth Hall.

Yesterday he said opposition across all political parties in three local authorities to the Booth Hall closure "gave the lie" to suggestions that the parliamentary nomination influenced his stand. The fault lay with the health authorities for getting procedures wrong and failing to justify their proposals.

They may, however, now be revived. Yesterday's report - which follows the death of 10-year-old Nicholas Geldard, who died of a brain haemorrhage while being ferried between four hospitals in an attempt to find a vacant intensive care bed - makes clear they would not have saved the boy's life.

But the report states bluntly that "the time for talk" over reorganising the services is "over", that continuing uncertainty is hitting recruitment and morale, and that action to end the present split of specialist children's services on different sites must be taken "as soon as possible".

However, Dr Ian Greatorex, chief executive of Salford Health Authority, said there remained "serious difficulties" in getting agreement on reorganising services between three health commissions (authorities), 10 NHS trusts whose services could be affected, five community health councils and three local authorities. "We felt the solution we were seeking may not have been the best possible solution, but that it was the only feasible way at the time of improving the services."

The saga - which began a decade ago, with the Booth Hall closure emerging as the favoured option last year - showed the difficulty of planning in the city, he said. Local opposition to loss of a service was understandable, he said, even though the change would improve services for all children in the region. "It is not easy to win the argument that a local hospital closure would be to the benefit of all children right across the region when local people still see it as a valued local hospital being taken away".

With so many players involved, the division between purchasers and providers had not helped, he added, although agreement had been no easier to reach when reorganisation was first proposed in 1985 before the NHS reforms.

Despite yesterday's report, a solution may remain elusive. Mr Stringer said some reorganisation of services was needed, but the council still rejected the idea of one "super hospital" for children or the closure of Booth Hall.