Turmoil at trust making hospital decisions

It was always made clear that Norfolk Primary Care Trust would lose two of its key players at some stage in the coming months. Hilary Daniels was only ever going to be the interim chief executive - she never wanted the job on a permanent basis - and director of commissioning Audrey Bradford was in the post in an acting capacity.

It was always made clear that Norfolk Primary Care Trust would lose two of its key players at some stage in the coming months.

Hilary Daniels was only ever going to be the interim chief executive - she never wanted the job on a permanent basis - and director of commissioning Audrey Bradford was in the post in an acting capacity.

Yet their sudden departures, which were unexpected at this critical time for the PCT, have added to the appearance of a health trust in turmoil.

Trust insiders also speak of an organisation suffering internal instability with redundancies in the pipeline in coming weeks following last October's merger of five Norfolk PCTs into the larger organisation.

New chief executive Julie Garbutt arrives today with the task of steadying the ship, examining work that has already been carried out so far on a range of issues and raising morale in what is becoming a beleaguered organisation.

Yet it remains one with a £900m budget and the health and wellbeing of the people of most of Norfolk as its responsibility.

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Mrs Garbutt currently has interim chief executive status and is understood to be in the frame when a decision on a permanent appointment is made at the beginning of March to a trust that may not be able to withstand any more changes at such a high level for some time.

She has been in the county this week, casting an eye over the trust, sitting through senior management and staff meetings, as she assesses the task in hand.

It is a job that nobody else wanted - Norfolk was one of the few new PCTs left without a permanent chief executive when it formed in October. That was perhaps not surprising given the size of the job and one where services would have to be cut before any forward progress was undertaken. The PCT has taken some unpopular decisions in recent weeks: cuts in services to help offset a massive £42m deficit, changes to treatment criteria and a review of the GP out-of-hours service, among many.

But it is perhaps the planned changes to intermediate care that have sparked the most public response. With the future of nine cottage hospitals and scores of community beds under threat, the PCT has faced severe opposition from campaigners who hope it will not be their unit that is closed or faces cutbacks.

Mrs Garbutt is planning to visit as many of those hospitals as possible in the next few weeks and will look closely at the work that has been carried out on the plan to date. There is a degree of optimism among campaigners that she may see scope to tone down the plan, though she is making no promises and at this stage is adamant it will not be reviewed.

But some campaigners are taking a degree of hope from the delay in the consultation process, seeing it as a positive step in the circumstances.

Freda Abell, from the Friends of Dereham Hospital, said: "Hopefully this will give us more time to put our case. If we can use this opportunity to put more pressure on them then we jolly well will."

About 500 letters have been sent out to local people asking them to support the campaign

A Kelling Hospital campaigner Charles Simeons said they were quietly hopeful that the unit at Holt ticked all the boxes of the kind of model hospital being promoted for the future.

He did not think the timing of the report would make much difference, but hoped the decisions were made on clinical grounds rather than financial.

Cromer hospital friends' group chairman Mary Northway said it made sense for the new chief to have time to "see for herself" the hospitals potentially under threat, such as Benjamin Court.

A spokesman for Cranmer House at Fakenham said: "We are obviously disappointed at the delay on news of any decision. On the other hand, this delay could signal a little bit of hope that the PCT is not going to carry out such an extensive proposed closure of beds as originally suggested."

And last night, it was that little bit of hope that campaigners hoping to save community hospitals across Norfolk were clinging to.