| Yesterday’s news was expected, but it still hit hard. Following proposals put forward last June, the Joint Committee of North West London Primary Care Trusts proposed the closure of four of the nine A&E Departments at hospitals in north west London, and on Tuesday, despite vigorous campaigns throughout the area against the proposals, the committee confirmed that, as the Evening Standard put it, “Hammersmith and Central Middlesex hospitals will lose their A&Es permanently while Charing Cross and Ealing will be left with a downgraded urgent care centres which will not accept emergency patients.” This really is an alarming development, as it will leave three of the eight boroughs in north west London — containing about three-quarters of a million people — without a major hospital, out of the 1.9 million people in the whole of north west London. In addition, removing hospitals’ ability to deal with emergencies essentially sounds the death knell for those hospitals, as a huge range of hospital services rely upon emergency admissions and the ability to deal with emergencies. In Lewisham, for example, where similar cuts have been approved, at least 90 percent of the mothers in the entire borough (4,400 a year) will no longer be able to give birth in Lewisham itself, despite it having the same population as Brighton, Hull or Newcastle. Following the announcement about the north west London hospitals, Andy Slaughter, the MP for Hammersmith and the secretary of Save Our Hospitals Hammersmith and Fulham, said, “This is the biggest hospital closure programme in the history of the NHS. It will put lives at risk across West London and will give a second class health service to 2 million people.” He also stated, “There will be no A&E in the London boroughs of Hammersmith, Ealing or Brent, which together have a population the size of Leeds.” In addition, of course, as Andy Slaughter indicated, services will be dangerously overstretched at the remaining hospitals. As the Standard noted, “The pressure on already over-stretched hospitals in the area is set to increase. Chelsea and Westminster is the only A&E in the area which is not already exceeding waiting time targets.” Anne Drinkell, a matron and NHS campaigner, told the Standard, “It’s worrying that people with serious conditions no won’t necessarily be treated in a timely fashion. The pressure on other already much-pressed hospitals, such as St Mary’s in Paddington and Chelsea and Westminster, will increase greatly.” Providing further details of the cuts, the Standard also explained, “Ealing will lose its obstetrics and maternity units and Charing Cross its hyper-acute stroke unit, while both hospitals will lose emergency surgery and intensive care units. Central Middlesex will lose intensive care while its A&E, which has already closed, will not be reinstated. Hammersmith will become a specialist hospital, without an A&E, while intensive care will become a specialist unit. All four hospitals will retain an urgent care centre — also known as polyclinics or walk-in care centres — to treat patients with less serious, non-life threatening injuries. They will be manned by GPs and nurses.” Londonist provided more information. Mocking Hammersmith and Fulham Council for lying last week, when it claimed that Charing Cross had been “saved,” the website noted, “The buildings will be knocked down and the vast majority of the land sold off to developers; a replacement UCC [urgent care centre] run by GPs will take its place and 60 of the current 500 inpatient beds retained. It will become a specialist hospital without the facilities to perform emergency surgery or handle patients needing intensive care. What’s more, funding for some revised services at Ealing and Charing Cross has yet to be identified.” While campaigners pledged to continue fighting to save their hospitals, and the announcement added to the urgency of creating a campaign across the whole of London, as identified by the “Defend London’s NHS” campaign that was launched last week, one of the key themes to emerge from these proposals — as at every other area affected (Lewisham, where I have been involved in a massive local campaign, the Whittington Hospital in Archway, and the hospitals of south west London) — is, firstly, that money is at the heart of the proposals, and secondly that the senior NHS managers responsible for the proposals are, whether deliberately or not, hiding this behind lies and spin about the need for savage cuts to improve services. As the Standard explained, “In one of London’s biggest NHS land sales, trust bosses plan to dispose of most of the 30-acre Charing Cross hospital site.” They want to slash all 500 beds, leaving as just an acre — less than a football pitch — of land for buildings to treat patients. It will mean as little as four per cent of the current site will be used as a hospital, according to page 595 of the proposal.” The Standard added, According to documents, the trust’s current estimate for the land sale would be up to £136 million but it is anticipated the true profit will be considerably more. Some of the money be reinvested to build new facilities on the smaller part of the site with the addition of 60 beds.” The Standard noted “similar sell-off plans by the Whittington Hospital, where the trust wants to dispose of half of its buildings, including nurses accommodation, and cap the number of births to save £4.8million,” but failed to mention Lewisham, where the proposals to disembowel the hospital in a similar manner to the proposals for north west London include selling off 60 percent of the hospital’s buildings. On the lies and spin, Londonist noted that “the remaining A&Es will be expanded,” — although, as with Lewisham, it is by no means certain that any extra money promised to achieve this will actually materialise — and also questioned “whether they’ll be able to cope with the extra demand.” The website also touched on the NHS officials’ false claims about urgent care centres, explaining that the rationale for their creation — as opposed to retaining A&E Departments — is that they “can treat about 70% of illnesses that patients go to A&E with,” although, crucially, “that assumes people will assess themselves and make a decision about how ill they [or]their family member really is.” This is hugely important, as is the allied claim by the NHS officials proposing the cuts — that community-based care will reduce the demand on hospitals, even though it has been clearly established that the proposals are nothing more than an aspiration, without any grounding in reality. As the BBC noted when the proposals for north west London were first announced last June, “Four out of nine accident and emergency wards will close under NHS reorganisation plans. The NHS says better care can be given by fewer, more specialised centres.” This is another of the empty mantras of the NHS management, which ignores the damage that will be caused by increased waiting times, increased travel times, and the added stress on staff at the hospitals that are supposed to take hundreds of thousands of extra patients a year, and is contradicted by the very next line in the BBC article: “Health bosses say there would be a £332m gap to plug by 2014/15 if no changes are made.” In other words, it’s all about the money, whatever senior NHS officials tell themselves. If you care about the NHS, please be aware that the health service’s own senior officials — backed by the government — are currently engaged in plans in London which will lead to the loss of between 20 and 60 percent of A&Es, maternity departments, intensive care and other acute services, and the irreversible selling off of much of the hospitals’ land. This should alarm everyone, and not just those in the currently affected areas. If you care, please get involved. Help is currently needed to fully establish the “Defend London’s NHS” campaign, so if you’re interested, and have particular expertise in establishing and running websites, dealing with social media via Facebook and Twitter, coming up with ways to attract media attention, or mobilising and organising supporters, then please get in touch with me. Note: If you want to be involved in the campaign to save the hospitals in north west London, please see the Save Our Hospitals Hammersmith and Fulham website here [http://www.saveourhospitals.net/], and get in touch here [mailto:campaign@saveourhospitals.net]. Also see the Save Our Hospitals Ealing campaign, and get in touch here [mailto:ealingsoh@gmail.com]. Also see the response to the announcement on February 19 by Ealing Council, which, unlike Hammersmith and Fulham Council, has always opposed the plans. The council is backing local campaigners’ plans to refer the proposals to Jeremy Hunt, although, as the example of Lewisham has demonstrated, it is unwise to expect too much of the health secretary. 4 Responses 1.Andy Worthington says... Anna Giddings wrote: Apparently GPs are being paid not to refer patients to hospital. All to be privatised. Dreadful ...on February 21st, 2013 at 12:12 am 2.Andy Worthington says... Yes, I keep hearing this more and more often, Anna, and yet it’s not reported sufficiently at all. The claim by senior NHS officials that community-based care can seriously reduce the need for hospital admissions is acceptable as an aspiration, but it doesn’t exist as a policy at all, and to see it apparently being used as though it was an active policy is shameful and dishonest. Allied to it is the equally risible claim that informing people better will mean less of them turning up at A&E. It’s not going to work in practice, at least not without a lot of time and effort and investment, and it’s deceitful to behave as though it will somehow magically come true. As I keep saying, we need to keep putting pressure on senior NHS officials, to show then up as traitors to the founding notions of the NHS, and to try and persuade those within the NHS who understand the scale of the assault on the health service to take a stand. ...on February 21st, 2013 at 12:12 am 3.Carol Brown says... Have you seen this? It seems as though it is even worse. Lucy Reynolds re privatisation. http://tinyurl.com/bcj7d3q ...on February 21st, 2013 at 2:09 am 4.Andy Worthington says... Thanks, Carol. Yes, very important. Posted below: Quick guide to section 75 By Lucy Reynolds, a research fellow at the London School of Hygiene and Tropical Medicine Open Democracy, February 19, 2013 The regulations apply the competition law regime to the arrangement of all NHS services, with very rare exceptions where to do so would be impossible. Competition law is a set of laws to manage markets. Because competition law was designed by commerce for commerce, the parts of it which cover public services are very pro-private enterprise. The forcing of competition law on all NHS spending through the implementation and enforcement of these regulations will have the effect of helping the private sector to cherry-pick the services where it can make most money, thus destabilising the finances of those of our traditional NHS hospitals which are not already on their knees financially because of PFI because the public sector providers will be left with all the difficult cases, which are by far the most costly. The government will then have an excuse to do all over the country what it is doing in South-East London: shutting well-functioning services which are working at full capacity, replacing A&Es with first-aid posts (“Urgent Care Centres” which have already been responsible for avoidable deaths), selling off the land on which hospitals stand, and outsourcing services to the private sector through tendering them out on long contracts. All this is completely unnecessary. While Sweden and the Netherlands are reporting soaring system costs and loss of access to services for the poor due to the implementation of competition law rules following their recent health service privatisations, Canada has successfully protected its affordable comprehensive universal system of care. It did this by declaring that it will be run as a public service, and not in such a manner as to be able to make profits from it. Scotland and Wales reversed the NHS market reforms in 2004, and subsequently saw healthcare outcomes improve and costs reduce as they saved the extra costs of running the market and were freed from the distortions to care choices that it introduces. We too should now eject the market from the NHS and claim the public health service exemption in the interests of keeping a national health service that serves us not its new owners. ...on February 21st, 2013 at 2:32 am |