The Campaign & C.A.S.H 2007-2009
Click here to go directly to the Community Action for Savernake Hospital (C.A.S.H.) section (2007 – 2008)
Written by Val Compton.
The last campaign to save Savernake, started in 1990…
One of the wards
…In order to understand “how we reached this point” in Savernake Hospital, with a judicial review being sought over the decision to close the Minor Injuries Unit and Day Hospital, take a quick look back.
The re-build of a hospital and which departments are required within it, are not decisions taken lightly or without research. It took from 1990 to 2003 for the plan to be consulted on, drawn up and approved. The plan included a Day Hospital and Minor Injuries Unit.
The Primary Care Trust then decided that the Minor Injuries Unit was not required – the decision to close the Day Hospital took a little longer.
One might think that either the Kennet & North Wilts PCT along with the Strategic Health Authority (SHA) of the time got it very wrong or the current PCT and SHA have misjudged the need.
This is what happened:
In 1990 Savernake Hospital was under threat of closure, a group known as Savernake Hospital Inquiry Fund Trust (SHIFT) was set up and commissioned a report on the need (or otherwise) for a hospital in the area.
In 1992 HACAS – Management and financial consultants to the social housing, health and care sectors said;
“It is recommended that Savernake Hospital is developed as a Community Hospital”
They further recommended services to be included, one of which was “Casualty”
In 1999 The Welsh Institute for Health and Social Care produced a “Review of the Future of Savernake Hospital”, commissioned by SHIFT following much community fundraising. Amongst the Services recommended for inclusion was Minor Injuries Service
In 2003 Business Case for the redevelopment of Savernake Hospital was written by Kennet and North Wiltshire Primary Care Trust.
“The strategic context within which these proposals have been developed include:
Provision of local access to a wider range of services for the people of the locality, including diagnostics, outpatients, rehabilitation and minor injuries.”
In 2003 the Avon and Wiltshire Strategic Health Authority approved the plan for Savernake Hospital for PFI Redevelopment along with;
“full ICT cabling to facilitate “telemedicine” links with clinical centres (PACS radiology system already operational).” This is the digital X-ray link to Great Western Hospital (GWH)
In 2005, without any official opening ceremony, the 9.5million pound Savernake Hospital re-build was completed and it was once again fully functioning. It included a fully staffed MIU open from 8am -10pm 365 days per year run by highly qualified Nurse Practitioners who could prescribe drugs and request X-rays. The X-ray Unit was digitally linked with GWH allowing remote opinion to be sought.
Local GPs used the unit for minor surgery (with MIU nurses on hand) and nurses also triaged for Marlborough Medical Practice. In return the GPs supplied medical cover when required. The Out of Hours Service was run from the MIU and the nurses were integrated with this service, seeing and treating minor illnesses thus allowing Doctors to concentrate on patients with more acute needs.
On July 4th 2005 The Chief Executive of Kennet & North Wilts PCT, Carol Clark said
“I am delighted that, after 15 years of dedication and commitment to this scheme by the community, the local NHS is now able to provide a significant health care resource for the people of Marlborough and district.” ……….. then nine months later;
In April 2006 K & NW PCT produced a consultation document called “Pathways for Change”.
All three options involved the closure of the Minor Injuries Unit.
“Minor Injuries Unit: concentrating all Minor Injuries Unit activity onto two sites, we will be able to offer a more comprehensive Minor Injuries service.”
These existing “two sites” were in Chippenham (20.7 miles from Savernake) and Trowbridge (26.3 miles from Savernake). Neither are newly built and neither had digital X-ray link at the time Savernake MIU closed.
In December 2006 the “Impact of service change on patient journey” was published by Wiltshire PCT it acknowledged that;
“The closure of the minor Injuries unit (MIU) in all three options would mean that journeys to any other alternative provision for patients living in parts of the existing catchment area for Savernake would be the most significant in terms of mileage and time travelled. Patients needing the services of a Minor Injuries Unit would be more likely to attend an acute unit. Accident and Emergency department (A&E) which would be nearer than either of the MIUs in Trowbridge or Chippenham.”
The Clover Unit (“What’s that”? I hear you say!) was not even in the plan at this late stage.
In January 2007 the Wiltshire PCT Board Meeting took the decision to close Savernake MIU
In May 2007 the news came like a bolt from the blue that the Day Hospital (Dept that gave treatment and therapy to elderly people) was also to close.
In June 2007 action started to be taken and meetings called as we now realised that three departments within the brand new hospital were closing – Farmer Unit (Mental Health), MIU and Day Hospital.
In July 2007 we searched for someone to lead an action group, for a Solicitor to act pro bono should we need one and for possible sources of funding. We drew a complete blank on all three!!
However, Community Action for Savernake Hospital was born out of this – a group with no constitution, no chair, no committee, no meetings and no money!
The campaign
Click here (and enter Savernake Hospital into Search) for the Gazette & Herald pictures of Torchlight Rally on the evening Savernake MIU closed.
Click here to see the local news coverage from the Gazette & Herald
Click here for short video showing the start of the week long Vigil outside Savernake Hospital running up to the closure of the MIU
Community Action for Savernake Hospital (CASH)
October 2007 – 2008:
Over the last year or so a huge amount of progress has been made. In a nutshell permission has now been given for a Judicial Review of the decisions made by the PCT to close the Day Hospital and Minor Injuries Unit at Savernake Hospital. At the moment progress over the Judicial Review is halted pending a decision on the Protective Costs Orders.
CASH supporters demonstrating before Court of Appeal Hearing
The Court of Appeal ruled in July 2008 that Mrs Compton’s Protective Costs Order should remain at nil in the Day Hospital Case. This means that should Mrs Compton lose at the Judicial Review stage, she would not become liable for costs. The Minor Injuries Unit case is slightly different. The Court of Appeal ruled that Mrs Compton should retain the Cost Capping Order at £20,000. This would be the maximum she would be liable to pay should she lose. This is the amount the community was asked to pledge in order that Mrs Compton would actually be able to find the money if required! The support that she received from the community was overwhelming
However, the PCT decided to seek permission from the House of Lords against the decision in the Court of Appeal. Mrs Compton now waits to hear from the Law Lords as to whether this permission will be granted. There is as yet no date but any news will be posted on this website as soon as it is received. In order that you can be alerted to breaking news you only have to subscribe to the RSS Feed.
As most of you will know, the barrister Guy Opperman, who was born in Savernake Hospital, (indeed he and his Mother’s lives were saved that day), took up the cause. He has acted for free and one couldn’t even hazard a guess as to how many hundreds of hours of work have accumulated. Guy was joined by Mathew Gullick, also a barrister acting for free and in the Court of Appeal they were led by Neil Garnham QC – again acting for free! CASH is not short of enthusiastic and eminent friends! There was an intervention by the Public Law Project at this stage – once again a pro bono action – which was most helpful.
Further details of the cases can be found on the links below
- R (Compton) v Wiltshire Primary Care Trust [2008] EWCA Civ 749: leading test case on protective costs orders in judicial review claims, in which the Court of Appeal gave new guidance on the interpretation of the test of “general public importance”. Guy obtained two protective costs orders for Mrs Compton at first instance, see [2007] EWHC 2769 (Admin) (McCombe J) and [2008] EWHC 880 (Admin) (Holman J), both of which were upheld on appeal.
- The case has had multiple hearings in the High Court
Before Holman J: www.bailii.org/ew/cases/EWHC/Admin/2008/880.html
Before McCombe J: www.bailii.org/ew/cases/EWHC/Admin/2007/2769.htmlAnd in the Court of Appeal: www.bailii.org/ew/cases/EWCA/Civ/2008/749.html
For those wanting a shorter read there are a couple of summaries:
Case summary of Court of Appeal July 1st 2008:
R (Compton) v Wiltshire Primary Care Trust; [2008] WLR (D) 221
R (Compton) v Wiltshire Primary Care Trust; [2008] WLR (D) 123
The Royal Courts of Justice
October 18th 2008:
The PCT’s petition for leave to appeal was formally recorded as having been submitted to the House of Lords on 7th October (as it was lodged at the House of Lords on 28th July after Parliament rose for the summer recess it has not been formally dealt with until now) and has been referred to an Appeal Committee. This is a committee of three Law Lords who will grant or refuse leave to appeal on the papers alone.
This process should take six to eight weeks, so we should have decision one way or the other around the end of November. The latest we would expect to hear is by Christmas.
November 5th 2008:
The Court of Appeal judgment in Compton v Wiltshire PCT has now been highlighted, having been considered in detail by another Court of Appeal in a judgment delivered on Nov 4th by the Master of the Rolls (i.e. the top civil judge in the Court of Appeal), Sir Anthony Clarke. It would seem the Compton v Wiltshire PCT case is becoming famous! Click here to see the details.
November 27th 2008:
Wiltshire Primary Care Trust have been denied leave to Appeal to the House of Lords.
The PCT sought to appeal against the Protective Cost Order given to Val Compton, without which the case would be unable to proceed to Judicial Review.
The way is now clear for a Judicial Review of the PCT’s decisions to close the Minor Injuries Unit and Day Hospital to be hopefully be heard in the Spring 2009.
January 7th 2009:
The Directions Hearing, which was originally scheduled for July 2008, will now take place in The High Court on February 12th 2009. This is the last step before the Judicial Review, which is likely to take place in the Summer.
February 12th 2009:
The date for the Judicial Review is set for June 30th 2009.
February 20th 2009:
Following the setting of the date for a Judicial Review, the PCT have now issued an application for an order to strike out, and a summary judgement in respect of both claims. The decision of the court is awaited on this application.
March 18th 2009:
The Strike Out Hearing will take place on Wednesday April 1st in the High Court. See News Page.
April 2nd 2009:
The judgement in the High Court yesterday was in favour of C.A.S.H. and the case can now move forward to the Judicial Review in June. The work of the pro bono legal team was recognised and appreciated by Mr Justice Plender. He expressed his gratitude to Neil Garnham QC, Guy Opperman, Mathew Gullick and Caroline Stone who carry out this work for free.
April 7th 2009:
Caroline Stone recently joined our legal team – all of whom act for free. We are indeed fortunate to have four dedicated lawyers working on our behalf!
April 15th 2009:
“Victory for the lone crusader battling to save her local hospital” – Daily Mail article. Click here to read the whole story.
April 16th 2009:
The Telegraph: “A retired health worker has won a two-year legal battle to force a judicial review of the closure of vital services at her local hospital.” – Click here to read the whole article
April 19th 2009:
The Sunday Times: Columnist Rachel Johnson writes about the Campaign again, and names Val Compton as her “Woman of the Year”. Click here to read more (please note, the article is at the bottom of the page). “It is time NHS managers realised it’s not their money and it’s not their NHS – it’s ours”…
June 3rd 2009:
Friends of Savernake Hospital & the Community have organised coaches to take campaign supporters to Royal Courts of Justice in London to attend the Judicial Review on June 30th, July 1st, 2nd, 3rd
Reports from the Judicial Review courtesy of the Gazette & Herald
Savernake health campaigners await judge’s decision
Judgement reserved on Savernake High Court case
QC claims Savernake day hospital is not closed
Marlborough day hospital was closed by stealth
Health decision “tainted by bias”, court hears
Hospital campaigners arrive at High Court
Wednesday 22.7.09: – The verdict
Click here to download a PDF copy of the Judgment 1.8mb PDF
Click here to download Transcript of Post-Judgment Discussion
Before: MR JUSTICE CRANSTON
Mr Guy Opperman appeared on behalf of the Claimant
Miss Fenella Morris appeared on behalf of the Defendant
Marlborough loses hospital High Court action
We are all very disappointed with the outcome; we accept we got a fair hearing; albeit we do not understand how staff know that the day hospital is closed and the Judge finds that although closed, it is “alive and well”.
All of us know the MIU was closed to save money, but the Judge did not find so. Similarly, the Judge found that the appointment of Redbridge was “an error of judgement by the PCT” yet finds against us;
However, after two years of struggle, the time has come to accept the decision of the court and move on; we take much comfort that the PCT will know never to try and force such decisions on the Savernake area again, as they will be harried all the way.
We also take comfort that this case has changed law in this country – obtaining the Protective Costs Order – which was approved by the Court of Appeal and the House of Lords allows individual members of the public to bring actions where the state acts contrary to the local public interest;
For the first time ever the state is now accountable locally in the courts to individuals. We know the precedent is being used up and down the country to challenge other hospital closures and acts by the state generally.
On a personal note:
I would personally like to thank the team of lawyers who have worked incredibly hard and for free, over the past two years. Guy Opperman, who was born in Savernake Hospital, and who took on this case has been a source of inspiration and given more to the people in this area than they will ever realise. Mathew Gullick joined Guy, although he has no links with the area and again has worked tirelessly on our behalf. Neil Garnham QC led in the Court of Appeal and the Strike Out Hearing – where he was successful. Caroline Stone assisted first as a pupil barrister and then took on a greater load when she joined Guy and Mathew recently in Chambers. I am grateful to all of them and would reiterate the words of the Judge that “they have done an outstanding job of presenting Mrs Compton’s case”. They most certainly have.
There are local people – too numerous to mention to whom I owe a massive debt of gratitude. I must give special mention to Joan Davies, who has given me a huge amount of support, sharing her healthcare knowledge through work she has done supporting Savernake in different ways, over many years. Also to Janet Louth, who has taken up the cause from the outset and run all the way with it. The campaign could not have done without her or the support from Jonathan Conning and co who handled a massive amount of work for us with an unflappable attitude and always a smile. To them and to the many hundreds of other people who have worked and supported me in many different ways – I am truly grateful.
Val Compton 22.7.09
Friday 31st July 2009 If you would like know more about contributing to costs see Val’s letter
You can also join Friends of Savernake or make a donation online. Donations made between July 30th and September 30th will be added to the ring fenced fund mentioned in the letter.
August 14th 2009: FUNDS RAISED! See News Page
POST JR CAMPAIGN
Val’s still campaigning to try and have minor injuries treated in this area as are several others;
Ceased to function for a few weeks as I tried to get over the shock and disappointment of losing the Judicial Review. But come September, I re-commenced the battle. The PCT are as determined as ever to prevent progress;
Sept 21st 2009 emailed a question to the Board concerning the possibility of an Urgent Care Centre at Savernake and the use of Emergency Care Practitioners (ECPs) The full question can be seen here; Question for Board in September
Sept 23rd 09 Board Meeting of PCT – Jeff James (JJ) expressed a wish to understand further and take this forward
Sept 29th 09 letter to Gazette – full copy to JJ
Oct 28th 09 Requested by email how we could move forward on the question
Nov 9th 09 emailed JJ to remind him that Claire Perry was standing as Parliamentary Candidate and had nominated the treatment of minor injuries as her priority issue
Nov 9th 09 offer of a meeting with JJ on Nov 20th
Nov 20th 09 meeting with JJ in the yet to be made Friends Shop in Savernake Hospital
Nov 23rd 09 follow up to meeting - email to JJ with further thoughts arising from discussion and expressing an understanding that with Swine Flu being a priority nothing may happen very quickly – (JJ had said at meeting nothing was likely to happen till Spring)
2010
Jan 15th 2010 emailed Deborah (JJs Business Manager) to inform JJ of Radio interview about Friends Shop and expressing that it would be good to say something positive re a response to my question to the Board
Jan 18th 10 received email saying due to IT problems JJ had not seen my email until after the radio interview but was hoping to respond on Friday (22nd Jan)
Feb 4th 10 emailed to remind that no answer to my question to the Board
Feb 4th 10 reply from Deborah, saying she thought she had seen a reply but my have dreamt it – the subsequent silence proved she had, dreamt it that is!
Feb 12th 10 emailed to remind that no answer to my question to the Board
March 6th 10 emailed to remind that no answer to my question to the Board
March 13th 10 emailed an incident that had just happened, where a local person on Warfarin (anti-coagulant) was unable to access treatment. Suggested that using Emergency Care Practitioners (ECPs), as mentioned in my question to the Board in Sept could have helped. Asked for this to be taken into consideration when an answer is written. Copied in Claire Perry.
April 15th 10 LOST PATIENCE. Sent copy of my question to the Board to PALS asking them to let me know the correct procedure for a complaint when a question remains unanswered for just on 7 months.
April 15th 10 Immediate answer from PALS acknowledging my email and affirming a reply was on the way – from Rob Gittins.
April 16th 10 A reply to my question put to the Board Sept ’09 arrived. Bizarrely, the letter pre-dated my email to PALS by 3 days! Do they think I am really that stupid? In the third paragraph – quite breathtakingly, Jeff James said;
“ I had gained the impression that the answers I gave at this meeting (ie the one on Nov 20th) meant that a written response was not necessary…”
This was despite numerous emails requesting an answer after that meeting!
The reply totally disregarded, once again, the use of Emergency Care Practitioners who the PCT tell us can treat minor injuries in people’s homes. What they don’t tell you is that you cannot access them. You are clearly instructed not to dial 999 unless it is a very serious or life threatening situation. The only way to access an ECP is to dial 999 and be triaged by the ambulance service. People who have tried this find that an ambulance is automatically dispatched as soon as you dial 999, prior to the triage and there is no way to prevent it arriving. The ambulance service is obviously keen to hit targets, which is understandable.
April 20th 10 emailed a response to the JJs reply to my Sept Board meeting question, highlighting the inability to access ECPs and suggesting ways this might be done. Still trying to be polite and constructive!
May 25th 10 emailed a request for an acknowledgment of my letter on April 20th and asked if the contents were being considered.
The emails above are a very small part of the e-traffic that goes through my pc gaining information, making enquiries, keeping in touch and answering questions
I will continue to try to fight in order your minor injuries will be dealt with locally – but now we have Claire Perry taking this forward for us.
Good Luck Claire! Keep an eye on what your MP is doing at http://claireperry.org.uk/
