THE ‘deeply flawed’ decision to downgrade North West London hospitals must be halted, according to a report by Michael Mansfield QC.
It warns that the closures threaten ‘the fundamental principles of a universal NHS’. The Independent Healthcare Commission for North West London, led by Mansfield, found that the ‘Shaping a Healthier Future’ (SaHF) plan will cost at least £1bn, with ‘spiralling management and consultancy costs’.
It calls for a reversal of the July 1st closure of the ‘exemplary’ maternity unit at Ealing Hospital.
It condemned consultation over the cuts and closures as ‘inadequate’ and warned that departments have been shut without providing adequate alternative healthcare.
Ealing Hospital’s paediatrics unit is the next department set to close, next June, followed by A&E. Waiting times at local A&E departments increased sharply after those at Hammersmith and Central Middlesex Hospitals were closed in October last year and the report warns that the reorganisation has no ‘up-to-date business plan’.
It said: ‘Overwhelmed’ GP services are ‘clearly failing to meet demand across the region’. Cutbacks had been aimed at the most deprived communities, and many vulnerable patients are now forced to travel to hospitals with poor public transport links. The SaHF programme has failed to consider the fast-growing population of North West London and the rise in the number of over-60s. It has sought to save money in anticipation of NHS cuts that had not transpired.
The report recommends
• The decision to close Ealing maternity unit should be reversed immediately
• Reopen the A&E department at Central Middlesex Hospital
• The National Audit Office should undertake a review of the programme’s value for money
• A new public consultation is needed as the proposals have changed significantly
• Substantial investment should be made in GP and out-of-hospital services
• Ealing and Charing Cross hospitals must retain full ‘blue light’ A&E services for the foreseeable future.
The plan aimed to redirect patients to Urgent Care Centres, but the commission said there was ‘widespread confusion’ among GPs, consultants and patients about what the centres could do and who should go there.
The landmark report says plans threaten fundamental principles of the NHS and provide ‘no realistic prospect of achieving good quality accessible healthcare for all’. SaHF has already seen the hugely controversial closures of two A&E departments, at Hammersmith and Central Middlesex hospitals and the closure of Ealing maternity unit.
Further downgrading of Ealing hospital is planned, along with the closure and sale of the majority of the Charing Cross hospital site. The Independent Commission also uncovered shocking details of spiralling management and consultancy costs. At the same time, a crisis is developing in emergency services, with GP services clearly failing to meet demand across the region, contributing to a crisis in A&E performance.
Michael Mansfield QC said: ‘The findings of the Independent Healthcare Commission for North West London are stark – the reforms, both proposed and implemented thus far, are deeply flawed. There is no realistic prospect of achieving good quality accessible healthcare for all, and any further implementation is likely to exacerbate a deteriorating situation.
‘Our recommendations are equally stark. It is the view of the Commission that the Shaping a Healthier Future programme should be halted immediately, and that the affected councils should consider a legal challenge if it is taken forward in the current circumstances. At the very core of any decent civil society is the imperative to ensure that the individuals and communities who make up that society have sustainable access to good quality healthcare.
‘The response from North West London NHS, flowing top down from central government, has singularly failed to deliver on this imperative, with all indications pointing to a further deterioration in the future. It is crystal clear that the impact of fragmentation through privatisation is slowly eroding what was a National Health Service, a development that ran like a thread through much of the evidence given at our public hearings.
‘In so many ways, the catalogue of failings, missed opportunities and profligacy we have seen in North West London act as a microcosm of a wider malaise across the English NHS. As such, though this report focuses on the NHS in North West London, it should act as a warning call to the top of government.’
Leader of Hammersmith & Fulham Council Cllr Stephen Cowan said: ‘People across west London have been horrified to see their treasured NHS deteriorating so quickly – and so unnecessarily. They have protested, sent in petitions and begged local health chiefs to stop this madness, and are furious that local NHS bosses have ignored them for so long.
‘My council colleagues shared this anger, commissioning the Independent Healthcare Commission, and in doing so keeping our pledge to fight for local health services. Today’s report from Michael Mansfield QC is a watershed moment. Rigorous, thorough, detailed and rightly independent, the review provides indisputable evidence that these changes to local health services are badly planned, hugely costly and causing life-threatening failures in local healthcare. The only sane decision is to put a halt to them right now.’
The reports key recommendations are:
* The Shaping a Healthier Future programme must be halted immediately
* North West London local authorities should consider their options for launching a legal challenge if a decision is taken to press ahead with the programme in the current circumstances.
The report’s key findings are:
* Cutbacks are being targeted on the most deprived communities
* The public consultation was inadequate and flawed
* The escalating cost of the programme (£1bn) does not represent value for money and is a waste of precious public resources
* There is no business plan to show the reconfiguration is affordable or deliverable
* NHS facilities have been closed without adequate alternative provision being put in place
* The plans seriously underestimate the increasing size of the population in North West London and fail to address the increasing need for services.
Dr Gurjinder Singh Sandhu, when asked what the result of further A&E closures would be, said: ‘Absolutely catastrophic. It will have a huge impact on the morbidity and mortality of this population. We are talking about people who are waiting longer for the ambulance to arrive and then they are waiting longer in the ambulance to get to their destination.
‘Then they are waiting longer for the ambulance to offload them. Then they are waiting longer in the A&E to be seen. Then there would possibly not be the appropriate intensive care unit bed for them at that location. If you look at something like sepsis or you look at something like renal failure or you look at the unconscious patient or respiratory distress, all of that amounts to minutes and hours which would be life-saving where cells are dying; patients are dying.’
