IN an intensive session with senior doctors from Hinchingbrooke, David Cameron put most of the hospital s woes down to the size of the debt, one of the consultants said afterwards. Radiologist Catherine Hubbard – radiologists are the doctors who interpret

IN an intensive session with senior doctors from Hinchingbrooke, David Cameron put most of the hospital's woes down to the size of the debt, one of the consultants said afterwards.

Radiologist Catherine Hubbard - radiologists are the doctors who interpret images from X-rays and scanners - said even the Tory leader needed some clarification "because it seems so perverse".

The consultants seemed pleased with their intensive 15-minute session with Mr Cameron, who explained that the reason for Hinchingbrooke's debt seemed completely different from those at Ipswich and Bury St Edmunds hospitals, from which he had just come.

The doctors had explained that the largest chunk of the debt - predicted at £29.9million by the end of next March - had resulted from the Department of Health clawing back £19.1million that foundation hospitals would have been paid for consultations and procedures - even though £6.5million of that resulted from an administrative error at the hospital.

"If you had overpaid in any other circumstances, you would have expected to have the money returned," Dr Hubbard told The Hunts Post.

She said the health reforms that threaten to reduce Hinchingbrooke's workload were "rather metropolitan in their outlook. What is suitable for London and other conurbations is not suited to East Anglia," she said.

"It is thought that GPs in this area over-refer patients to hospital, but it doesn't feel like it to us. There's also a real dispute about the population that's served by Hinchingbrooke [the strategic health authority says the catchment is around 165,000 - doctors think it is many more]. We are suffering from some peculiar figures."

Dr Hubbard added: "We told David Cameron that the best thing that could happen to Hinchingbrooke would be for it to expand, with additional services and a larger catchment area for services such as elective surgery. If we filled the treatment centre with elective cases, it would wash its face financially. It was built for the future, not for now. Seventy per cent [the centre's capacity actually being used for elective cases] was probably not bad for the first year."

Filling the treatment centre would have the added advantage of separating elective and acute work in the hospital, reducing the risk of introducing infections such as MRSA and clostridium difficile. "It's not good practice to put medical patients on surgical wards," she added.

Mr Cameron had "appreciated the problem that you could not close one part of the hospital without seeing the whole thing unzip. Banbury hospital in his constituency has much the same problem in relation to The Radcliffe (Oxford University's teaching hospital) as we have with Addenbrooke's (Cambridge University's). So he was already on top of many of our problems."

The doctors had been fearful that changes would be made at Hinchingbrooke without sufficient public attention.

"But if, as a result of David Cameron's visit, it becomes the subject of a Prime Minister's Question, that would be very helpful indeed," Dr Hubbard

concluded.

# DIFFERENT departments at the hospital lock together like a jigsaw

Accident and emergency does not operate in a vacuum. It cannot function safely without - and this is far from an exhaustive list - orthopaedics (bones and soft tissues), radiology (X-rays and scans), general surgery, general medicine, oto-rhino-laryngology (ear, nose and throat), obstetrics, genitor-urinary and, most crucially, the intensive care unit.

Take any one of these departments away and the lot falls apart like a house of cards. That is why it is so urgent that Hinchingbrooke finds ways of streamlining those specialties in a way that loses nothing but cost.