PATIENTS and residents have genuine fears for the future of services at Horton General Hospital after it becomes managed from Oxford.
This is despite assurances from local NHS bosses that patient care will not suffer.
Campaigners say their arguments have already prevented a drastic scaling-down of the children's and maternity services.
This was during the Davidson Inquiry in 1996, called for by the Government as the Horton's debt grew.
Oxfordshire Health Authority, which pays hospitals to treat Oxfordshire patients, argued:
Management costs were too high for what is a relatively small hospital;
Too few patients used some services;
There was too much duplication of services at the Horton and Oxford;
Children's in-patient and maternity services should be moved to Oxford;
Most specialist services should be provided by Oxford only; and
All serious injury cases to go to Oxford casualty unit - Horton's A&E should treat less serious cases.
Campaigners said this would force patients to make a long trip to Oxford for treatment, and the distance would make it difficult for families to visit.
They won part of the argument and the children's and maternity services will continue at the Horton.
The Davidson report recommended all basic services should remain, but that the hospital was not financially viable as a separate NHS trust.
About £600,000 a year will be saved with the loss of the Horton's senior management team.
Just one representative from the Horton will go on to the board of directors at the Oxford Radcliffe. Sue Edgar, spokesman for pressure group Banbury Health Emergency, said: "If they take the consultants out of the A&E department so it is just for minor injuires, then that is the end of the Horton.
"This is because the night-time paediatrician will no longer be needed, so children's services will go and then bang - the Horton is just another community hospital.
"If the John Radcliffe decides to remove this, or any other service, there is no local accountability. We would be negotiating with a huge corporate entity for whom 90 per cent of its catchment is not in this area.
"If it was just a question of clinical integration, then that would be jolly good. But it is management integration and managers will look at the Horton as a side-line of the John Radcliffe and argue it is not cost effective."
Michael Taylor, chief executive of Oxfordshire Health Authority, said: "There will be no major changes in services in the first year," he said.
Future changes would be made by the Oxford Radcliffe managers after they have fine-tuned the balance of services between Oxford and Banbury.
Mr Taylor added: "We wish to maintain a clinically appropriate range of services at the Horton."
These changes have to be in line with the Davidson report, whose author re-visits the county at the end of March to check his recommendations are being followed.
Campaigners say they will watch closely to make sure the report is not breached after Mr Davidson has gone.
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