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PUBLISHED: 12:03 19 March 2008 | UPDATED: 09:59 12 August 2010

IN the final stage of your exclusive opportunity to grill health chiefs at A Picture of Health (APOH), we put to them your questions about WHY these changes

IN the final stage of your exclusive opportunity to grill health chiefs at A Picture of Health (APOH), we put to them your questions about WHY these changes have to take place and whether there are any other options?

The health service could be improved, not by cutting necessary services but by ridding the NHS of unnecessary bosses, administrators and no doubt quangos that are overpaid, doing little for the patients. Cutting services in no way improves matters. In view of the foregoing, what are you suggesting for a shake up, in a positive light, to improve the situation?

Mr L J Osborne

Beckenham

A spokesman for A Picture of Health said: "APOH is not about cutting services but is about providing them in different locations. Some will be provided nearer to patients' homes whilst others will be concentrated in specialist centres with a greater degree of clinical expertise.

"We have put together three options, all of which our clinical teams -- doctors, surgeons, nurses, midwives and other healthcare professionals - across the four boroughs have advised us will produce better outcomes for patients. So our "shake up" will see more patients being treated closer to their homes; tests results and diagnoses will be speedier, planned surgery will be less prone to cancellations and in emergency or complex cases, patients will be seen by specialists in centres of excellence."

If the PFI debt at Princess Royal was written off, would these changes still take place?

Alison Mason

Orpington

A spokesman for A Picture of Health said: "Yes. We are proposing the changes for strong clinical reasons. Our clinicians believe that for some services better outcomes could be achieved by concentrating services on fewer sites, enabling these sites to become centres of expertise. Meanwhile other services could be delivered closer to patients' homes.

"The proposals will also put an end to the trend of the four hospitals ending the year in financial deficit. Even if debts were written off change needs to take place to bring the hospitals back into financial balance at the end of each year."

Why are the four hospitals being grouped together? Why are other hospitals being punished for Bromley's bad management?

Lizzie Rose

Chislehurst

A spokesman for A Picture of Health said: "The boroughs that the hospitals sit within share boundaries, transport links and neighbourhoods.

"The degree of clinical change required means that hospitals cannot act in isolation and need to work together to provide solutions to improve patient care. These changes in turn will improve the financial performance of the four trusts."

With its poor track record how can you be sure that Bromley will manage the extra pressure?

George Smith

Joyden's Wood

A spokesman for A Picture of Health said: "For each of our options we have modelled future patient flows to the four hospitals to enable us to estimate the capacity required at each.

"In future, we estimate that more patients will be treated at Bromley Hospitals NHS Trust for emergency or complex surgery, in-patient maternity services and in-patient paediatric services.

"However, planned surgery services, sometimes called elective surgery, will be transferred out, thus creating some additional capacity. Also, in future, we estimate that patients will spend less time in hospital, or not be admitted to hospital at all, as many could be cared for in the community or in their own homes.

"This too will free up capacity.

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