Supertrust idea to revamp health care

One option health managers keen to slash bureaucracy are looking at is to bring all five of the county's main hospitals - including York District Hospital - together under a single management board.

Medical staff and facilities could also be shared, with "flying consultants" and specialists travelling from one hospital to another rather than being based in one place.

As well as York District Hospital, the proposals could affect Harrogate District Hospital, Northallerton's Friarage Hospital, and Scarborough and Airedale hospitals.

York MP Hugh Bayley today gave the moves, being proposed partly in response to the recent health White Paper, a cautious welcome.

But he said changes should be for the sake of patients, not of managers, and local people should be fully consulted before anything definite went ahead.

He said: "I would welcome change that cuts bureaucracy, but I wouldn't want anything that looked like a takeover because people should see local control of their hospitals.

"The change should go ahead if doctors are satisfied it will improve the quality of care for patients, but only for that reason and not because of saving money or for bureaucratic reasons."

Barrie Fisher, chief executive of North Yorkshire health authority, said there was a need to change the way hospital services in the county were run.

Hospitals like Northallerton's Friarage and Scarborough District Hospital were too small to keep pace with the latest developments such as new drugs and hi-tech treatments like keyhole surgery, he said.

Sharing specialist medical staff was the best way of ensuring quality care for patients across the county, while sharing managers would save resources that could be ploughed into front-line care.

But he pledged: "These proposals would not be about closing down hospitals, and they would not be about centralising everything at one point.

"They would be about trying to make sure we maintain local accountability for services, but also that we can ensure the right quality services are being given."

The changes are being considered as health managers gear up to implement the health White Paper, published late last year, which calls for a radical review of the way health services are managed.

One feature of that will be that responsibility for "community" services, such as district nurses and health visitors, will be hived off from hospitals and moved to new "primary care groups" of GPs and nurses.

They would also manage community hospitals like Easingwold's St Monicas and Selby's War Memorial Hospital.

The changes would strip smaller hospital trusts which previously handled community health care such as Northallerton of a big part of their function.

Graham Saunders, chief executive of Harrogate District hospital which is currently undergoing a £30m refurbishment, said it made sense for some management and clinical overheads to be shared.

But he stressed: "That's not the same as saying it will all be York-based. It's not the same as saying everybody in Harrogate is going to have to go to York to get their treatment."

Valerie Stangoe, chief officer of the Northallerton branch of health watchdog the Community Health Council, added: "We understand what's being said about specialisms, and how not every hospital can afford to have specialist doctors. Our concern is we want to make sure all patients have access to equal services, particularly in rural areas."

Dr Peter Kennedy, chief executive of York Health Services Trust, which runs York District Hospital, admitted he had been in talks with other senior health managers.

He said: "I do think it is time for being open, although nothing has been decided yet. The important thing that everyone agrees on is that we have to look at the needs of the patient first, and only then at the needs of managers."

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