Monday 23 April 2012

Charing Cross Hospital To Close? “We Have To Save £1.8 Billion Or We’ll Go Bust”

Three leading representatives of NHS North West London attended last Tuesday night’s Housing, Health and Adult Social Services Select Committee. They were there to detail their plans to reorganise local hospitals and cut the number of hospital accident and emergency departments in the area from nine to just five. Charing Cross hospital is one of those earmarked for closure leaving patients with up to an hour’s travels for some emergencies.

NHS NW London’s director of strategy, Mr. Daniel Elkeles, sped through a bells and whistles presentation that set out to sell the idea that patients would be better off with the reduced number of services. The premise was that having specialist doctors and consultants in hub A&Es would raise the quality of care and save lives. Mr. Elkeles and his colleagues argued that there aren’t enough medics to go around and suggested that is the predominant reason some A&Es will have to close. You can read their report on page 14 of these papers.

Throughout the presentation I asked about different aspects of funding and if there were any financial drivers for these cuts. The NHS managers admitted they had done a considerable amount of work on the finances but refused to give any indication of any headline numbers saying they would come to that at the end. That didn’t happen. Instead, when the presentation ended they told the committee “We’re working to conclude financial modelling and will release that later.” I persisted, despite Cllr. Lucy Ivimy (Con), the Chair, intervening to try and stop this line of questioning using the excuse that she was happy to accept their position on the finances. After several minutes came the bombshell when one of the NHS NW London’s managers exclaimed, “OK, we have to save £1.8 billion or we’ll go bust – so put the figure down as £1.8 billion then!” That is a staggering amount of money for NHS NW London to have to cut. There is no doubt it will have a damaging affect on local NHS services.

It was astonishing that Mr. Elkeles and his team had clearly decided not to refer to this or any funding matters at any point in their presentation.  Also missing was any objective information on any of the negative consequences these changes would bring to patients’ health. I asked about any risk analysis or other assessments they had done, such as looking at the dangers of longer emergency journey times in an ambulance. But instead they repeated the positives mentioned in their presentation. It was a thoroughly one-sided and disappointing presentation that had more in common with a sales pitch than a serious briefing to a select committee. I said this to them and told them they needed to come back with balanced and thorough briefing next time if they wanted to have any credibility. I will let you know when they do.

Reductions in Charing Cross’ A&E services were first reported to the Select Committee on 15th February 2011 which you can read about on page 34. That was a disappointing meeting. Not one Conservative committee member asked a single question about those changes and the Chair of that Committee, Cllr. Andrew Johnson (Con) even urged us all to nod through the report. When I raised concerns that this looked like the beginning of all A&E services being salami-sliced out of Charing Cross Hospital Cllr. Johnson complained my Opposition Labour Councillors and I were asking too many questions. Within weeks the Leader of the Council had become involved and wrote to the Health Secretary and NHS managers to express his concerns. The Cabinet Member also signed those letters as bizarrely did Cllr. Johnson – presumably after the Council Leader had given him a clip around the ear for such a previously lacklustre approach.

It is now certain that there will be a wholesale reduction in A&E and other local hospital services. The attached graph shows some of NHS NW London’s initial considerations about which cluster of hospitals' services will survive. What’s clear is that local NHS services will be cut and it currently looks like Charing Cross Hospital is being lined up to be a considerable part of that.

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