THE GREAT DEBATE: Swindon councillor Owen Lister, who is also a former GP, shares his thoughts on the university proposals. Much has been written about Coate in the past week or so, and the proposed development there of a university in addition to housing, but to date one aspect of this development has been completely overlooked, namely the need for expansion of the Great Western Hospital site.

I am aware that the hospital authorities have suggested that the present hospital is of a satisfactory size and have indicated that the five hectares of land (a little more than 12 acres), which they have requested is all the additional land that they will require.

At the present time one is unable to obtain information regarding the number of patients awaiting admission to GWH, and at a recent meeting with councillors the chief executive of the GWH said that they now preferred to talk about waiting lists in terms of weeks of waiting. Whether the number of weeks was the average for all specialities, or the longest or shortest wait for any particular speciality was never explained.

Her coyness on this subject leads one to suppose that little or no inroads have been made on the 3,000 patient admission waiting list that existed when the hospital opened some two and a half years ago.

That this is so should come as no surprise. For when the GWH opened it had a little over 600 beds compared with 527 beds at the Princess Margaret Hospital (PMH) and 226 beds at St Margaret's Hospital, Stratton, which closed before GWH opened. Thus there was a loss of 753 beds in exchange for 527 beds a loss of over 200 beds. This situation improved somewhat this year with the opening of the new Diagnostic and Treatment Unit, so that we now have some 758 beds. In other words we are now roughly back to the bed complement that existed when PMH closed. In the light of this history it is likely that the current admission waiting list is substantially in excess of 3,000 (the December 2002 waiting list figure).

In such circumstances is it reasonable to suppose that the waiting list for admissions can now be substantially reduced, given that the admitting ability of the GWH is now much the same as was the case with PMH. Regrettably the obvious answer is that such a reduction seems impossible.

When one considers that the Northern Sector (Abbey Meads) housing is not yet complete, that the Southern Development Area together with the Burmah Castrol site have yet to be started, it is clear that over the next 6-10 years there will be a substantial increase in the population of Swindon some 15,000 would be a conservative estimate. When you add to this the population expansion that will result from the implementation of the Regional Spatial Strategy, it is perfectly possible that the population of Swindon will be of the order of 250,000 within 20 years.

This is however, not the full extent of the population expansion for which the GWH will be expected to cater. At a recent meeting with councillors the hospital's chief executive stated that the hospital's current catchment area population was of the order of 330,000. If this is indeed the case, and there is no reason to doubt the accuracy of the statement, then by 2025, when most of the new development will have taken place, the hospital's catchment area population is likely to have risen to 500,000.

As it is already evident that the GWH cannot cope with a population of 330,000, the situation when the population reaches 500,000 will be disastrous unless a very substantial number of new hospital beds are created. The alternatives are therefore either to build another hospital (with all laboratory and diagnostic facilities) or to enlarge the present hospital to something like twice its present

capacity. This will require a site at least twice as large as the present hospital site (ie about 25 hectares) which is five times as much as the hospital authorities are currently seeking on the Coate development site.

In considering this matter of bed provision, it should be borne in mind that there are no medical conditions requiring hospital admission that improve with waiting. Early diagnosis and treatment are the keys to the optimum outcome in the treatment of illness. The unwelcome truth is that without an adequate number of beds waiting lists will inevitably increase, and this will cost even more patients their lives. It may be only one or two per year, but that is, I suggest, one or two too many. The message to whoever is responsible for the development of the Coate site must be leave enough room for substantial hospital expansion including the necessary car parking.

If that means that there is insufficient room for the university, then another site for that facility should be found. The university's keeness for the Coate site stems from the fact that they are being offered the site at no cost. If there is no university at Coate it will not be a disaster, but if the hospital cannot expand then disaster it will most certainly be.

We don't agree

Lyn Hill-Tout, chief executive of Swindon and Marlborough NHS Trust, said: "I do not understand Coun Lister's assertion that information on waiting list numbers could not be obtained as information has been provided recently.

"Anyway up to date waiting list information is reported to our monthly board meetings which are public.

"There is no point in going over, yet again, the issue of beds as this debate has been drawn out ad infinitum. The amount of land we believe we need for further expansion should be more than adequate to meet our future development needs."