Hard decisions on the cards

RE: Darley Birth Centre

We write in response to the various comments that have been printed in the Matlock Mercury concerning the perceived lack of support for the Darley Birth Centre from local general practitioners which have also been linked with the suggestion of a lack of support for the Whitworth Hospital in general (“Conspiracy of Silence?” Matlock Mercury, June 30, 2011). We wish to reassure your readers that we are committed to the Whitworth Hospital.

It is true that no one was available for comment when the Mercury called to speak to the doctors, but that was because they were all out on visits. The Mercury called close to their print deadline and did not ring back as invited to, despite a comment being prepared at Lime Grove Medical Centre.

With regard to your analysis “that £300,000 a year for 100 births is quite expensive” (editorial, May 27, 2011). We want to point out that this figure refers only to the block payment made by the Primary Care Trust towards running costs, and does not include the additional £1236 per birth cost for the 100 births at Darley (ie and additional £123600 per year). Chesterfield Royal would only receive £1236 per birth - no block payment is made to run that unit. The £300,000 (ie roughly £820 per day) would still need to be paid however many births occurred at Darley. The financial issue here is the £820 per day ‘top up’ it costs to keep the unit open, not the cost of a birth which would be the same at Chesterfield or Darley.

We do agree with your statement that “What those figures aren’t revealing though is all the other services going on at the centre - which receive nothing but praise from all quarters.” We agree with the fact that Darly Birth Centre is a quality unit.

The NHS has to rationalise because of the current harsh economic circumstances and unfortunately some hard decisions will have to be taken across a wide range of health services where the health needs of the general population have to be balanced against the desires of the local people. We think that the issues of Darley Birth Centre is only the first of these difficult issues. The sad fact is that money spent in one part of the NHS means a cut in money for somewhere else, as there is no spare money in the system.

The full picture of what may or may not have to be done to balance the books by the local Commissioning Consortium is not yet known, but to balance the books will be a statutory obligation, and the Government states that there will be no bail out. Given that, no commitment can be made to any individual service until the full picture is understood and funding levels known.

Having said that, we hear what local people are saying and wish to be their advocate in this difficult situation as far as we can, but we also hope that local people will hear the reality of the situation that if Darley is kept open, some other service will not receive money and therefore not be provided.

It is rare for the GPs to see a mother in pregnancy if all is going smoothly, as the service is mainly midwife led. This means that contrary to previous comments in the Mercury that the GPs should do more to publicise and promote Darley, we will do the best we can, but this is difficult if we don’t see a mother until after she has delivered.

There is no conspiracy of silence. The PCT are obliged to follow due process as described by government in the conducting of an engagement process. The public phase will begin on August 1, when the facts above can be openly debated and the local people will be able to consider in depth the issues we have outlined.

The Doctors

Imperial Road Surgery and Lime Grove Medical Centre.