Health Reporter Dave Himelfield looks at some of the vital questions behind the huge plans for health care in Huddersfield.

A new hospital could be built on the Acre Mills site in Lindley, to replace the existing Infirmary - but it will not offer the same range of services.

There will be operating theatres and a number of wards, and emergency care, but not a full A & E unit.

The proposals will be debated next week so what is the thinking behind the plan?

1) There were two accident and emergency departments at Huddersfield Royal Infirmary and Calderdale Royal Hospital, Halifax. Why is there only going to be one?

In short, it’s down to money and the increasing demand on accident and emergency (A&E) services. Health chiefs say there are not enough doctors or nurses to consistently maintain a safe service at both sites. Employing more clinical staff would be too expensive.

The current set-up is neither efficient nor financially sustainable. Calderdale and Huddersfield Foundation Trust (CHFT), which runs both hospitals fell into debt for the first time last year – and the trust is expected to end 2015/16 owing £25m.

Health chiefs believe that having Calderdale Royal Hospital (CRH) focus on emergency care while Huddersfield Royal Infirmary (HRI) focuses on inpatient care will be cheaper and will provide a better service for patients.

HRI/Acre Mills from above
HRI/Acre Mills from above

2) Why are emergency services likely to close at HRI but remain open at CRH?

Many have blamed the PFI (Public Finance Initiative) which was used to build CRH.

The contract, in which private companies front the money for the buildings, is expected to cost the trust £773m in interest – rather a lot for a campus that was worth £64m.

CHFT is locked into a 60-year PFI agreement with Catalyst Healthcare (Calderdale).

The trust may break free of the contract within 30 years – but it will cost £200m.

There are other reasons too. HRI’s buildings, some of which date back to the 1950s, are becoming increasingly out-of-date and expensive to maintain. CHFT must find £3.7m to avert ‘catastrophic failure’ causing by its ageing building. A further £6.3m is needed to fix other tired sections of the premises which pose a ‘significant risk’ of disruption to services.

Maternity services for women expecting complicated births were moved to CRH in the last decade. Having high-risk birthing services and emergency services on the same campus makes more sense.

READ MORE: Huddersfield Royal Infirmary: A timeline of the events that lead up to today's shock news

READ MORE: Huddersfield Royal Infirmary: MP fuming as hospital could lose A&E department

3) Who decides which A&E department will close?

Chiefs at the two authorities, which manage NHS services in Huddersfield and Halifax, respectively Greater Huddersfield Clinical Commission Group (CCG) and Calderdale CCG, will decide. They will receive guidelines and ultimately, the go-ahead from their bosses at NHS England. Other health providers, including the hospital trust as well as Kirklees and Calderdale councils, have been consulted.

4) If there’s a better A&E department in Halifax, what’s the problem?

Distance, mainly. For example, it’s 18 minutes by car from Meltham to HRI. That’s if the traffic is clear. But it’s 27 minutes to Calderdale Royal Infirmary. In heavy traffic that could be considerable longer, particularly on the Calderdale Way which notoriously snarls up about one mile south of CRH.

Huddersfield Royal Infirmary, Acre Street, Lindley, Huddersfield
Huddersfield Royal Infirmary, Acre Street, Lindley, Huddersfield

5) If the plan goes ahead will all ‘accident and emergency’ services close at HRI?

No. HRI will still have a minor injuries unit as well as resuscitation and first aid facilities.

6) What services WILL be at Huddersfield Royal Infirmary?

HRI will host inpatient services for example, endoscopy, and planned surgery.

poll loading

If Huddersfield's A&E closes, would that be the right decision?

500+ VOTES SO FAR

7) Is this a final decision?

No. The plan will go to public consultation on Wednesday although some health campaigners may feel it will be little more than a formality.

Councillors if they are unhappy with proposal, can refer it to the Independent Reconfiguration Panel (IRP) who will then make a recommendation to the Health Secretary.

Plans to downgrade Dewsbury District Hospital and concentrate emergency services at Wakefield Pinderfields Hospital were referred to the IRP by Kirklees and Wakefield councillors in 2014. Their appeal was, however, unsuccessful.