Reassurances from the R.U.H. over services at the ‘Min’. While one ex-Governor asks if ‘patient power’ could help secure it’s future?

The Royal National Hospital for Rheumatic Diseases.
The Royal National Hospital for Rheumatic Diseases.

The future of one of Bath‘s best-loved Georgian buildings is proving a major issue in the city. The Royal National Hospital for Rheumatic Diseases, known as The Min, is set to merge with the Royal United Hospital to create a single foundation trust.

It has been unclear whether services provided by the Min will continue at its current location in Upper Borough Walls or be moved to the RUH site in Weston.

Now though the Chief Executive of the RUH Kirsty Matthews has publicly stated that patients should be reassured the Min is still in business. Although financial pressures had caused the closure of the neuro-rehabilitation service, there was no change  to other core services.

Meanwhile the Georgian originating hospital was launching new services which included a fatigue management service for people who have had cancer, and also a rehabilitation service for people suffering radiation damage as a result of treatment for breast cancer.

She said people would be kept informed as the RUH planned for the future .

The historic building – for which the foundation stone was laid in 1738 – has been under assessment.

John Wood's plan for the hospital.
John Wood’s plan for the hospital.

The first stage of the complex, designed by architect John Wood the Elder, with stone given freely by quarry-owner Ralph Allen and funded with money collected by Beau Nash, was built on the site of an old theatre.

With a personal view of developments and a move to utilise ‘patient power’, Professor George Odam, who was Patient Governor of the RNHRD for nine years until his resignation in August last year, raises his concerns for the building’s future and has his own ideas about how the Min could still play a useful role to enhance the city’s reputation as a health spa.

Professor George Odam
Professor George Odam

George was the first Professor of Music to be appointed at Bath Spa University and subsequently was Head of Research at the Guildhall School of Music and Drama in London – retiring in 2007. He has lived in and around Bath for 45 years and has a keen interest in its history and art.

‘Patients of The Royal National Hospital for Rheumatic Diseases, or the Min, as it is locally and affectionately called, are becoming increasingly concerned about the future of this wonderful hospital.
The Min was one of the very first Foundation Trusts (FT), set up with the guidance of the government quango Monitor, and has remained the smallest of all the FTs. The idea of FTs is to give the hospital complete financial control in order to encourage entrepreneurial thinking and action. But along with this came a hugely exaggerated administration, the cost of which, from the beginning, made the hospital financially unviable.
The Min was the very first national hospital, caring for patients with special conditions from all over the UK – ever since it was set up by Act of Parliament in 1739 in the reign of George II. Since then it has specialised in the treatment of rheumatological conditions with the aim of rehabilitating patients as soon as possible, and the historic casebook, in the hospital’s museum, gives precise detail of cases from the very beginning. 
In the 1940s, following severe bombing, The Min was rebuilt with energy and vision, spurred on by the determination of Bath’s own Dr George Kersley, who founded the first department of rheumatology and gave the name to this new discipline. The Min survived and has remained in the historic buildings that patients have grown to love so much for their friendliness, charm and lack of normal health institutional atmosphere. 
Research has been a king pin of this hospital’s work over the centuries and The Min has more recently become a national centre for research into and treatment of a rare rheumatic condition called Ankylosing Spondylitis (AS). Clinicians have worked creatively with physiotherapists and hydrotherapists to evolve a residential course for AS patients. This course has no equivalent anywhere else and thousands of patients from all over the UK and also from other parts of the globe have benefitted from it, often describing it as life-changing. 
Now all this and much more of what it does for patients with Chronic Fatigue syndrome, other rheumatological conditions and those with severe and untreatable pain, is at risk. Some 5 years ago Monitor proposed that The Min should merge with the RUH, allowing both hospitals to share administrative work that is otherwise replicated in both. This has been done in other parts of the country where two merged hospitals have formed a new Foundation Trust that allows each to retain its purpose and identity.However the plan evolved with the RUH made no such guarantees. Above all it relied on the RUH gaining Foundation Trust Status. 
When it was first mooted the RUH was hugely in debt. This has been addressed, but at what cost can be seen by the latest Care, Quality Commissions (CQC) inspection report last March that failed the RUH on many counts. The CQC inspectors had visited The Min in the same round of visits and passed its work with flying colours. The result has been that the RUH’s application to become a Foundation Trust, on which the merger between the two hospitals is based, has failed this month and its application has been deferred for a year.

In a recent survey by CQC The Min was found to be performing better than most other trusts in the country in seven of the eight categories in the survey, and got the highest score in the overall views and experience and waiting to get a bed on the ward categories. Food served to patients and visitors at the RNHRD has this week received a healthy eating award from Eat Out Well assessed and managed by B&N E S and Sirona Care and Health. The Ralph Allen restaurant at The Min is the first in the region to be awarded in this way. It is open to visitors as well as patients and staff. 

So where does this leave patients who need and have come to rely on this excellent quality of care? We have a small, specialist, research-based hospital, without a merger partner, having waited for more than two years for this to happen. In April the full force of the new Health Bill came into effect and fundamentally changed the ways that patients are funded for treatment. The Min has been supported by the Strategic Health Authority and several Primary Care Trusts, but these have now been disbanded. The funding of a national resource has therefore become even more problematic. 
It makes no sense in any way to destroy something that has, over many years, proved itself so effective in providing such high quality care based on latest research. It is also significant that Bath remains the only European Spa town without a specialist hydrotherapy hospital. The Min already has a conduit for the hot springs to feed its pool, now unused. 
Patients have produced a new support website where patients and friends are urged to sign up and to leave messages of support. Patient power is what the government encourages and we need to make our voices heard so that this excellent hospital continues, in its historic buildings in the centre of Bath, to provide the care upon which we rely.’