THE latest secret plan outlining how the NHS intends to change healthcare in Oxfordshire is now out in the open. But the likelihood is that it will serve only to heighten the protests against what is seen by many as cuts in services.

The unelected NHS mandarins who marked the plans as secret made a grave mistake. They decided to link Buckinghamshire, Oxfordshire and Berkshire West (BOB) together to revolutionise the way healthcare is provided. Then they stopped the Oxfordshire Clinical Commissioning Group, which provides the money to put those plans into actions from telling the public about it.

As a result those who pay for the services feared the worst and the protests against specific changes already known.

Technically the plans for transforming healthcare have still not yet been published by the NHS. They were leaked by Reading Council because councillors felt strongly that the public should be in the know as soon as possible.

That was also the stance of Healthwatch Oxfordshire which registered a complaint under the Freedom of Information Act procedure calling for details to be published. Both this and the subsequent appeal were turned down.

When the BOB plan surfaced it became clear that the full scope of the revolution will no doubt spark off more protests across the whole county because it has confirmed the worst fears of the protesters.

It is already known that the Oxford University Hospital Trust, which runs the John Radcliffe, Nuffield Orthopaedic Hospital and the Churchill Hospitals in Oxford as well as the Horton General Hospital at Banbury, wants to close down 118 beds as part of the policy change to treat people nearer to their homes.

The same trust has 'temporarily' downgraded the maternity department at the Horton Hospital to a midwife-led unit, with all emergencies being attended to in Oxford, because they claim they cannot recruit enough consultants to staff it. During the roadshows in some of the county’s towns earlier this year there were strong hints that the future of the community hospitals would come under the spotlight, which has already happened with the community hospital at Chipping Norton.

Now, the leaked BOB plan makes it certain that not only the maternity unit at the Horton Hospital is in doubt, but that the whole of the Horton services will come under review, which will no doubt give further impetus to the protestors in that area.

The plan also revealed as a certainty that the roles of the county’s community hospitals, which are already well used, will 'change'. Unfortunately the BOB plan, does not spell out how this will happen and there is a fear that some community hospitals will be closed down.

However, the plan does spell out in broad terms that the intention is to provide more day-to-day services in the community, which will reduce the need for many people to travel to the main hospitals in Oxford except for 'specialised' services. The intention is that more care will be given closer to home, which will be fronted by GPs and backed up by nursing and care staff.

In my view, now that the plan has become public, the authorities should make the position clearer instead of talking in generalities. In other parts of the country, where plans have also been leaked, it is clear that the revolution is being orchestrated nationally from the top down to an NHS format, with very little input so far by patients. The other plans that are more specific show there is an intention to group all specialised services in the major hospitals and close down most of the beds in community hospitals.

The local authorities should come up front now with more detail to keep matters calm.

They are making a big deal over the fact that the plans will go out for public consultation. But they need to spell out exactly what they mean in a way the public can understand.

For instance, if there are to be wholesale changes at the Banbury Horton, what are they? Is it the intention to close beds at community hospitals? What are the alleged increased facilities in the community? Although the plan says the already overstretched GPs will play a leading role and will be backed by a new army of nursing staff, they should explain how and where the extra staff are coming from and what they are qualified to do.

The authorities deny that they are making cuts in the health service and say they are designed to treat people more effectively and at lower cost so that the services are sustainable in the future.

The protesters are claiming that the transformation is aimed purely and simply to cut costs, and that in the process more services will be downgraded.

All this adds up to the probability of the continuation of a major row, stirred up by protestors, when what is needed is a period of calm and explanation. The BOB plan acknowledges that the public is cynical about the motivation of the authorities and in stamping Top Secret over the overall plan by the NHS might explain why that is so.