SIR: Make no mistake about the reason behind the current proposals for a new hospital for central Hampshire. It is happening because central government has decided that this is the best way to make a politically advantageous investment in the NHS, whether it is the best use of resources or whether or not local people would have it as their first healthcare priority. It’s not quite such a photo opportunity when sexual health services receive funds for expansion or a dementia service in the community avoids closure for lack of resources.

Politicians tend to be fixated on hospitals although they are needed by much smaller number of people than pharmacists, GPs, therapists, community nurses, social workers, etc. For 20 years attempts to rebalance NHS spending from the majority being directed at the top of the ‘pyramid of need’ (i.e. secondary and tertiary care), whilst the primary, community and public health services which could reduce that demand for it remain under resourced, have failed.

When they are needed, often in emergency situations, hospitals should be able to offer the best evidence-based treatment. This can only happen in properly equipped and staffed departments that see a considerable number of cases. This militates against small hospitals where few patients requiring specialist skills and equipment will be admitted. It is very important for the training of doctors that they have access to a breath and spread of cases; hospital lose their training accreditation –and the work of junior doctors – if they cannot offer this. Departments viewed as ‘at risk’ by these criteria are not the most attractive to specialist staff. There is, and has been for many years, a national shortage of Emergency Care Consultants (and indeed many other specialities); they can choose where to deploy their expertise. Patient choice & access is less important when very serious, life-threatening conditions arise, than the best treatment at a centre of excellence. This is why Winchester does not take ‘blue light’ trauma cases.

However, there is a great deal of routine work that a District General Hospital can do to a high standard. The Treatment Centre at RHCH is only 15 years old and can still make a valuable contribution. I accept, however, that a lot of local NHS estate is not fit for purpose. Perhaps the plan to sell the old RHCH buildings for re-development, (to fund patient service improvements), on the lines of the Winchester Regiment Barracks site, will be revived, having foundered in the financial crash 12 years ago. I would also like to think that the previous extensive plans for a new hospital will not be entirely wasted, developed as they were at very great public expense when there was no finance available to build it or support from the local health economy.

Finally I would be interested to know about the future workforce plan, without which no re-organisation or re-engineering of healthcare can succeed. The NHS is not a set of buildings but a complex interdependent network of people, from cleaners to consultants and all those in between. Let’s hope that the ‘Clap for Carers’ really did mean something with not only thanks but real consideration and support – especially financial- for the men and women who make our NHS the inevitably flawed but hugely valued national treasure that it is.

Lynda Banister,

Pine Close,

Oliver’s Battery