The proximity of North Devon district hospital to Anne-marie Wiles’ home – it is less than five minutes away – is crucial.
Her twin sons, Jed and Peirce, were given just six months to live after being born with multiple complex health needs. They are now doing well, aged 16, thanks in large part to the efforts of a loving family, but also the dedicated staff at the hospital in Barnstaple.
“I intentionally live opposite the hospital because when the boys stop breathing there is not enough time to call an ambulance,” said Wiles. Jed has been resuscitated three times at the NDDH and both have been nursed countless times at the Caroline Thorpe children’s ward.
“If these services end then my boys will for certain die once they become ill,” said Wiles. “I am fearful of losing my children.”
She is one of thousands who have joined marches, written to local MPs, organised benefit gigs, signed petitions over the Wider Devon STP – sustainability and transformation plan – which is proposing radical changes to healthcare in the county.
If the plan comes to fruition in its present form, 600 community and acute beds across this sprawling, largely rural county will be gone within five years.
Cherished community hospitals at Honiton in the east – nicknamed the Honiton Hilton because it so beloved – Okehampton in central Devon and Paignton and Dartmouth in the south would go. There have been howls of protest everywhere – but nowhere more than in and around Barnstaple.
Here there is deep alarm that the plan may lead to the shutting down of maternity, neonatology and paediatric services as well as triggering the loss of other departments, including A&E. The Royal Devon and Exeter hospital is 50 miles away – an hour and 10 minutes by car down a winding road if conditions are good, much more if not.
Tina Day’s son, Jaiden-Lee, was born at the NDDH with a collapsed lung and spent a week in the special care baby unit for a week before developing type 1 diabetes. “It terrifies me if services like maternity and A&E are re-located. People will die, guaranteed,” said Day.
John Tate claimed his wife and daughter would both have died had the NDDH not been near. “My daughter had her umbilical cord wrapped around her neck. She had breathing problems and was trapped head down. This caused my wife life-threatening problems. An emergency cesarean saved their lives. Both would have died if Barnstaple was not there.”
Crystal Steinberg said the closure of the maternity department would make her think twice about having a second child. She underwent an emergency caesarean section because her unborn baby, Dylan, was in distress. “I do not want to be stranded at the side of the road while my uterus ruptures and my baby and I die.”
It is not just mums who are worried. Tracy, 46, suffers from a mental health condition that leaves her suicidal. “I have been to A&E three times this month after being picked up by police.” Should the A&E close she believes she would be held in a cell or have to head to Exeter. “I’d have no way of getting there but to walk or hitch. Both are a scary.”
Jacob Egan, seven, was so concerned when he got wind of the proposals that he dictated a letter to Theresa May. He has brittle asthma, which can result in severe attacks, and has been admitted to the NDDH around 10 times.
“Dear prime minister,” he said. “Just think about it, every time any child in our area of north Devon needed to go to hospital they would have to go to Exeter. Exeter is a long distance away and if your heartbeat stopped you couldn’t just wait for a train or car to get you there.”
At the heart of the plan is a “new model of integrated care” that will “reduce reliance on bed-based care and enable people to live healthy independent lives for longer, closer to where they live”. In other words the idea is to look after people at home rather than in hospital.
According to the latest draft of the report, which is up for consultation, every day more than 600 people in Devon are medically fit to leave hospital beds but do not.
The plans argues change must take place. Health and social care services in Devon are likely to be £557m in deficit in 2020/21 if nothing is done, the plan says. It also says the system as it stands isn’t working. The 95% standard for patients being seen in A&E within four hours is not being met – the Devon system is currently achieving 91.6%.
Devon’s demographics also have to be taken into account. There are more elderly people here than in other parts of the UK – in one area of Torquay almost one in 10 are aged over 85. Some need a lot of care – in north, east and west Devon, 40% of people use almost 80% of health and social care.
Angela Pedder, lead chief executive for the plan, said she understood people’s concerns. “But if we sit back and say let’s just let things happen, that’s a much bigger risk not just for the whole of Devon.
“We have to be pro-active. We have responsibilities to make sure the service is safe and sustainable two, five, 10 years down the line. That’s what we’ve got to plan for. That’s the framework we are trying to put in place.”
Politicians, activists and patients are not impressed.
The East Devon Tory MP Hugo Swire said: “We are in danger of putting the cart before the horse. Until we can absolutely ensure that we have got social care right, we should not look at unnecessarily closing community beds.”
Jan Goffey, the mayor of Okehampton, called the proposals cruel and claimed the NHS was being “dismembered”. If the people who actually live in Barnstaple are worried, those that live even further north – and so even further from Exeter – are even more concerned.
Sarah Vander, who runs a shop in the cliff-top village of Lynton, 20 miles north-east of Barnstaple, said her mother had been saved from a stroke and her husband from a diabetic hypo – a drop in blood glucose level – because they got to the NDDH quickly. “We are incredibly remote and we must be able to rely on the excellent services of NDDH otherwise the simple fact is, people will die unnecessarily.”
The seaside town of Ilfracombe, 12 miles north of Barnstaple, suffers a double whammy. The town is isolated and some areas are deprived: life expectancy in central Ilfracombe is 75 compared with 90 in parts of east Devon.
Rebecca McGarry, from Ilfracombe, the mother of daughters aged two and three, said she felt sick thinking about the prospect of losing services. Both her children have received excellent treatment in Barnstaple including for severe croup, which makes it difficult for them to breathe.
McGarry’s husband is a carer and needs the car for work so she often has to take her children to the hospital on the bus. “I honestly don’t know how we would manage if these appointments were moved even further away. The idea that such a remote region should lose these vital services is totally absurd. People will lose their lives if these closures do happen.”
NHS cuts in Devon: "If these services end my boys will for certain die"
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