THE Independent Reconfiguration Panel (IRP) has endorsed proposals to close Chase Farm Hospital as an acute District General Hospital (DGH).
This is in order that its elective services can be privatised and its acute services farmed out to Barnet and North Middlesex Hospital (NMH).
Health Secretary Alan Johnson has accepted the advice of the Department of Health’s so-called Independent Reconfiguration Panel, and recommended the closure of Chase Farm Hospital (CFH).
The IRP thus endorsed the decision of Barnet Enfield and Haringey’s Primary Care Trusts ( BEH PCTs )
Proposals
The proposals are that the Chase Farm site be reduced to:
• An urgent care centre open for only 12 hours a day, including consultant-led geriatric and paediatric assessment units, and night cover provided by on-call GPs.
• An elective surgery centre
• (Maybe) a midwife-led birthing unit
• Some intermediate care beds
• Some outpatients
CFH would no longer be an acute DGH. It would lose all its acute services i.e accident and emergency (A&E), consultant-led maternity unit, paediatric unit, 24-hours emergency surgery and anaesthetics, intensive care and acute medicine and its 24-hour imaging department.
No longer would a patient with acute appendicitis say, or a fractured hip, or chest pain be admitted at this site. Patients would have to travel all the way to Barnet or NMH.
Reasons given
The reasons given for this downgrading by the PCTs and the IRP were that services on the CFH site were no longer ‘sustainable’ and could not be of a high enough standard because of lack of sufficient trained doctors and nurses in paediatrics, obstetrics and gynaecology, and the European Working Time Directive (EWTD), i.e. the need to reduce junior doctors’ hours.
But these are all problems that adequate funding could solve.
Real reasons
The real reasons for the decision to downgrade the hospital were not given.
These are that the Department of Health (DH) is privatising the NHS. Bit by bit all NHS structures are being closed down or taken over by the private sector.
In the case of Barnt Enfield and Haringey, this privatisation is taking three forms
1. Privatisation is already proceeding via the construction of new buildings through the Private Finance Initiative (PFI) at Barnet and North Middlesex Hospitals (NMH).
2. The proposed facilities to replace CFH could all be tendered out to the private sector; the elective surgery centre as an independent sector treatment centre (ISTC), the urgent care/walk-in centre, and there could be a private polyclinic there.
3. The PCTs have been instructed, under the Darzi Healthcare for London plans, to close down GP surgeries and push GPs into polyclinics. These are tailor-made for the corporate private sector.
PFIs
The second phase of Barnet Hospital was built as a PFI which cost £54m and has to be paid back over 25 years. Barnet and Chase Farm were fused into one trust in 1999.
Local residents soon realised that the merger was designed to run down Chase Farm to help pay Barnet’s PFI debts.
Now that NMH has signed a PFI deal worth £118m, the BEH PCTs have to find yet more funds over the next 30 years.
The PFI deal ties the PCTs to pay a unitary charge for the lease of the new buildings and the non clinical maintenance costs.
The funding is top-sliced off the PCTs’ budgets. The only things the PCTs can cut to pay for these are the budgets for clinical services or they can sell land.
The closure of CFH is likely to lead to many redundancies of clinical staff and result in a large “saving”. Not all staff may be able to get jobs at Barnet and NMH or in what remains.
Acute services would have been “rationalised”. There would be fewer acute services than there were before. If you were acutely unwell it could be more difficult to access a hospital bed.
ISTC
The proposed elective surgery centre, for cancer patients and other non emergency patients, is the sort of facility that the government likes to tender to the for-profit private sector in the form of an ISTC.
These have been set up all over the country, many where they are not needed, and have taken elective surgery patients away from local NHS DGHs.
They ‘cherry pick’ the non emergency cases, and take funding away from their acute neighbouring hospitals.
When Averil Dongworth (Chief Executive of CFH) says that ‘the elective surgery centre will work like the best private hospital’, one wonders if she knows something we do not.
The urgent care centre (even the IRP report said that it was not a local A&E), is another candidate to be run by a private healthcare company.
The PCTs already pay Chilvers McCrea to run a nurse-led walk-in centre at the front door of NMH.
Polyclinics
The Darzi Healthcare for London plan instructs all PCTs to phase out GP surgeries and replace them with polyclinics.
There are to be 150 polyclinics in London. Local GPs have indicated that Haringey favours moving most of its GPs into five polyclinics, leaving only 15 GP surgeries.
The British Medical Association (BMA) GP’s committee has launched a campaign to defend NHS GPs because they realise that the purpose of these changes is to hand the running of general practice over to big business.
The government has announced that it is allocating contracts worth £1.25bn to private equity consortiums such as Alliance Boots and Meryll Lynch private equity, to run polyclinics and GP surgeries, and aims for 15 per cent of primary care to be run by the private sector.
Financial problems.
CE CFH Dongworth told the Enfield Advertiser (18.9.08) that the PCTs do not have the £100m necessary for the reconfiguration.
They do not have the money to enlarge the A&E and paediatrics at Barnet, beef up services at NMH or revamp the surgi-centre at Chase Farm.
She admitted that a lot more would be required and that some money would have to come from NHS London land sales and borrowing.
In the present financial climate with major banks going bankrupt and stopping lending, plus the collapse of property prices, this scenario is pie-in-the-sky.
The response of the Brown government to the world economic crisis is to privatise all public services, (NHS, state education, the post office, civil services) to cut public sector pay and reduce public spending. The money will not be forthcoming.
If the closure of CFH is allowed to go through, the patients will be the losers as their precious local acute DGH will have gone and anything like an equivalent service will not be there to replace it.
This vandalism must be halted!
Response
The response of the Labour MP for Enfield, North Joan Ryan, implying that this decision is a victory, is highly misleading.
She told the local press: ‘But Chase Farm Hospital is staying open. In fact for the first time in decades, the future of Chase Farm Hospital as a whole is safe.
‘And that in itself is a significant victory for local people . . . It is true there are going to be some changes.
‘. . . While it is pointless to pretend we got everything we wanted with regard to A&E, it would be equally wrong to pretend there won’t be significant improvements to our local NHS overall.’(!)
She cannot come straight out and admit that the Labour government is closing down Chase Farm as an acute DGH, and running down and privatising the NHS.
The local residents have fought in every way that they can, through electing local councillors, attending meetings, huge petitions, and four demonstrations.
The struggle
The same struggle is going on all over the country as DH ‘reconfigurations’ ordain the closure of A&E paediatric and maternity units, thus ensuring the rundown of comprehensive acute DGHs.
We have to continue the fight to keep CFH as an acute DGH and to defend our NHS GP surgeries.
We do not want PFIs and privately-run ISTCs, walk in centres and polyclinics.
We need a change of government, a workers government and socialist measures.
The PFI debts should be cancelled. The present hospitals should be fully funded and properly staffed. NHS GP surgeries should receive the necessary refurbishments and support.
The North East London Council of Action will continue to picket the hospital and calls on all residents staff and trade unionists to affiliate.
We have to keep Chase Farm Hospital open by all means necessary, including occupation.
There is a public meeting on Thursday October 8th, at Chase Side Primary School, (see advert page three).
