24th September 2000

"We in West Cornwall HealthWatch wish to see a totally honest and genuinely open debate, in the public arena, about options for the future of West Cornwall Hospital. We have been told little about what other choices there might be for the future, and are simply being told that we cannot keep what we currently have. We have heard from the physicians that they wish their patients to receive better care (described as "outcomes"), and we appreciate the current difficulties of delivering the full range of emergency services in Penzance. However, there is no evidence that transferring all emergencies to Treliske will result in better outcomes for the patient; indeed, there are many who fear that the outcomes will be worse. We are aware that Treliske cannot cope with its workload, as evidenced by the "diverts" of all emergencies to West Cornwall Hospital several times a week, and the unacceptable waits on the Treliske site in A&E and Admissions Departments.

We identified four key issues to be addressed, back in July:

	We are concerned about "putting all our eggs in one basket" as would be the case if all emergencies throughout Cornwall were concentrated on the one site in Truro. The implications for residents in the far west are grave -when Treliske becomes overloaded, our options become Plymouth, Exeter or beyond. This cannot be acceptable.
	We are anxious about the adequacy of the service offered at Treliske and will be unwilling to sacrifice local provision unless we can be assured the highest quality of care and treatment "up the road". We are continually reminded of earlier losses - maternity services, the children's Rainbow Ward, and Bolitho Hospital. In the first, we were promised a replacement maternity ward within two years, in the others we were told there would be no changes until the alternatives were in place; in none of these cases were the promises fulfilled. Now, for the fourth time in recent years, we are being told that improvements will be in place before changes are made in Penzance -do we really think this will happen?
	We are insistent that there must be evidence which points to the need for change. So far it seems that no one has audited emergency admissions at West Cornwall to ascertain whether the clinicians' fears are justified. If the evidence proves that we'll be better off in Truro, then we'll probably want to go there; if it doesn't, then we'll most definitely want to stay in Penzance. We have been told that it is sufficient to know that specialisation and centralisation of services is happening elsewhere; but we contend that West Cornwall is not like "elsewhere". Surrounded by sea and miles from anywhere, we must find the solution that is right for US.
	We are conscious that the problem of transport and distance is one that will not go away. Whatever improvements may be made to public transport, Truro will always be nearly forty miles away from parts of west Cornwall, and will always prove stressful, costly, time-consuming and difficult to access for many members of this community. The recent fuel crisis, and growing pressures on society to reduce travel in the interests of the environment, have highlighted the inconsistency between the demands to travel less and the desire to centralise services. It is surely better to bring services to where the patients are, rather than expect patients to travel to the services. Choosing to provide all of West Cornwall's emergency health services on a centralised site in Truro does not therefore seem an appropriate environmental decision for the 21st century.