In an open letter to GPs today the editor of the Epsom Guardian has urged all GPs in the area to think very hard before voting next week on the Better Services Better Value proposals to downgrade Epsom Hospital.

With the local MP, consultants, GPs and nurses all criticising the plans, he argues that Epsom Hospital serves the needs of Surrey residents and it is vital to find a bespoke solution that puts their needs first, not the needs of London residents and NHS London:

Dear GPs,

In the next few days you will be asked to make one of the most important decisions of your life which will affect the health and well-being of your patients for decades to come.

Over the past fortnight Chris Grayling MP, who is also a cabinet minister in a government supporting major change across the NHS, senior consultants and doctors at Epsom Hospital and the Royal College of Nursing have all written to you expressing grave reservations about the current proposals for change being put forward by the Better Services Better Value team.

The issues they have raised about the proposals range from the huge financial uncertainties involved to the lack of real consultation and the challenge of an ever increasing, ever more frail and elderly population in this area having to fight its way into Tooting when they need urgent medical attention.

And there is no doubt whatsoever that the vast majority of residents in this area want you to fight to keep an A&E and maternity unit in Epsom Hospital. Over the past two years thousands have signed the Epsom Guardian's petition to protect Epsom Hospital and young and old are deeply worried by the impact of these proposals.

But, as BSBV has made clear, no change is not an option. The aim is to drive up standards and improve clinical outcomes - and who can argue with that?

A huge amount of money, time and expertise have gone into BSBV, trying to draw up the best options for hospitals in south west London.

And it may be that for those living there these proposals really are the best way forward.

But Epsom is different.

Unlike all the other hospitals involved in the process, Epsom Hospital is in Surrey, not London. 

And the hospital was only included in the process at the 11th hour after its proposed merger with Ashford and St Peter's fell apart. There remains a potential alternative future for Epsom Hospital and residents in this area as part of NHS Surrey which is not available for the other hospitals. On the other hand, because of geography, the impact of losing key services in this area is arguably much greater than in London areas where hospitals with a full range of services will be closer and more accessible on public transport.

So, while other GP commissioning groups in London will understandably vote for these proposals, it is vital that you are not swayed by the inevitable pressure, direct or indirect, to fall into line with them.

The key question has to be whether they really are in the best interest of your patients who live here in Surrey?

Let's not kid ourselves that if you vote in favour of these proposals the three month public consultation will provide a chance for radical change to these proposals. Barring government intervention, the only conceivable change might possibly be the adoption of proposal B or C - both of which involve Epsom losing its A&E and maternity unit.

I would urge you to approach this decision as if you were making it about a patient in your surgery (although of course it will actually affect hundreds of thousands of patients in the years to come).

Are you certain that what BSBV is recommending really is the best treatment for this particular patient? Are you convinced that the treatment has been robustly tested and planned? Are you confident that there are no significant contra indicators, or potentially harmful side effects that could undermine any positive benefits from this treatment? Is there no other potential treatment which should be further explored before you send the patient for irreversible surgery?

If you can confidently answer yes to all these questions then of course you must vote for the proposals.

But if you have any significant doubts, then you should reject them at this stage.

Doing that is not to reject all of the good work done by BSBV up to this point. It is just asking them to go back to the drawing board to find a solution that really works for the people of Surrey and for the future of Epsom Hospital.

Yours sincerely

Sean Duggan
Editor
Epsom Guardian