THE daily picket to stop of Chase Farm Hospital will be marking its 150th day by mid-August.
Organised by the North East London Council of Action, it has grown in strength as staff members, patients and local residents have expressed their determination to defeat the plans to close the hospital’s Accident and Emergency Department, and its Paediatrics and Maternity Units.
On a daily basis, the picket has received enthusiastic support for its policy of occupation of the closure threatened departments to keep them open.
Meanwhile, the machinations of the Barnet and Chase Farm Hospitals Trust management, as it seeks to close the essential hospital services in the teeth of overwhelming opposition, were considered in last month’s Health Service Journal (HSJ) Local Briefing.
The HSJ wrote: ‘Barnet and Chase Farm Hospitals Trust this month announced it was seeking a partner for merger, after an analysis found it could not become a foundation trust on its own.
‘The north London trust now plans to cease operating as an independent organisation by September 2013.
‘The trust was writing to all NHS providers within a 25-kilometre radius, asking if they were interested in a merger or acquisition.
‘Absorbing Barnet and Chase Farm would be a major undertaking for even the largest providers.
‘The trust has a turnover of £351m, operates from two sites and has commissioners who ended 2011-12 with significant deficits.
‘It is also moving ahead with the Barnet, Enfield and Haringey clinical strategy, a contentious service reconfiguration that will see maternity and A&E services downgraded at Chase Farm.
‘These services will be largely transferred to the neighbouring North Middlesex University Hospital in Edmonton.’
It states: ‘Andrew Lansley set a deadline for all NHS trusts to achieve foundation trust status by April 2014.
‘Although the Department of Health has since been forced to admit some trusts will not hit this target, the DH (Department of Health) is still charged with getting organisations through Monitor’s authorisation process as soon as possible.
‘NHS London has a poor record in getting its trusts to foundation status, with more than a dozen still to go.
‘But, with only eight months until the strategic health authority’s abolition, a flurry of activity has seen mergers proposed or agreed at five trusts. Barnet and Chase Farm’s announcement brings that number to six.
‘The decision by the trust’s board followed a long-term financial modelling exercise commissioned for the organisation by the NHS North Central London primary care trust cluster and NHS London in May.
‘This concluded that in order to reach a state of sustainability the trust would have to make unrealistic and unprecedented savings over a sustained period.
‘After the approval of the Barnet, Enfield and Haringey clinical strategy, which will see Barnet and Chase Farm lose roughly £50m of its income, health secretary Andrew Lansley ordered a review of the feasibility of merging the trust with the North Middlesex.
‘The review concluded in December 2011 that there would be scant benefit in such a move.
‘It also saw the cluster commission long-term financial modelling exercises for the three remaining non-foundation trusts in the region: Barnet and Chase Farm, North Middlesex and the Whittington.
‘These concluded that while North Middlesex could be viable on its own, Barnet and Chase Farm could not.
‘The trust will spend the next two months considering its options before submitting its strategic outline case to NHS London in October.
‘If a full business case is approved by NHS London and then the health secretary next summer the new merged organisation will begin operating in September 2013.
‘Barnet and Chase Farm is asking for expressions of interest from all NHS providers within 25-kilometres of their sites, so potential bidders could include any of London’s acute, mental health or community service providers, or one of Hertfordshire’s trusts.
‘Closest to home, the two largest trusts in the North Central London region are the Royal Free London Foundation Trust and University College London Hospitals Foundation Trust, with turnovers of £500m and £700m respectively.
‘Far smaller but also nearby are Whittington Health Trust and North Middlesex University Hospital Trust, which have annual incomes of £277m and £174m respectively.
‘North Middlesex’s board is widely known to be against any further entanglement with Barnet and Chase Farm. Senior figures in the sector said a Whittington merger would not be viable.
‘An options appraisal in April ranked 11 different scenarios. HSJ understands this identified the Royal Free merger as the best fit.’
The HSJ added: ‘Although both trusts are tight-lipped about it there is a consensus elsewhere in the cluster and further afield that the Royal Free would be the most natural fit to take over Barnet and Chase Farm.’
Chase Farm Hospital does not need to be ‘taken over’ or ‘merged’. It must be maintained as a district general hospital, and the North East London Council of Action policy of occupation must be supported far and wide.
Other attacks on the NHS are underway far and wide.
At present, NHS foundation trusts can only appoint to their boards those who pass a ‘fit and proper persons test’ – a requirement enshrined in law.
But in a consultation paper, Monitor, which will oversee all providers of NHS-funded services in England, says it is considering ‘waiving the requirements of . . . the test’ for other providers after lobbying by ‘stakeholders’.
Officials said that while the requirement could not be ‘relaxed’ for foundation trusts without primary legislation Monitor believes that other healthcare providers – such as mental health trusts or private companies – should not have to meet the same criteria.
The regulator will have a ‘light touch’ and has retreated from plans that could have seen shareholders of private companies delivering healthcare subjected to a fit and proper test.
‘We do not want a hugely bureaucratic exercise. We will be satisfied with self-certification’.
However, critics say there will not be a ‘level playing field’ in the NHS, where providers will compete for patients from 2014.
The consultation paper also reveals that the regulator has backed away from other more radical proposals.
Earlier this year, Monitor had proposed that credit ratings agencies such as Standard & Poor’s and Moody’s could be asked to assess whether hospitals are financially robust enough to treat patients.
However, the regulator has said it will not now implement such a scheme.
After an industry backlash, Monitor has also dropped proposed rules that would have imposed strict financial conditions on health service providers.
After the Southern Cross care home debacle threatened to leave 31,000 residents homeless when the company collapsed last year, the regulator planned to impose borrowing limits on providers and restrict the selling and mortgaging of their own assets.
The new proposals reveal a more pro-market vision of NHS reform, with the emphasis on patient choice and competition between providers.
David Bennett, chair of Monitor said: ‘Today we have launched an important consultation explaining our proposals for how NHS providers will be regulated and services protected for patients in the future.’
Meanwhile, Sainsbury’s has opened two more GP surgeries in its supermarkets this year and has urged more practices to come forward to run primary care services in its stores.
The two surgeries come after four opened in Sainsbury’s stores across the country last year, but have come up against opposition from local GPs who say the new surgeries are a ‘disaster’ for the future of the profession.
The two surgeries are in stores in Newton Abbot in Devon, which opened in January, and Sunderland, which opened in May.
Last year the supermarket gave GPs the opportunity to set up branch surgeries free of charge in its stores.
By the end of 2011, there were surgeries open in four of its stores in Bath, Newcastle-under-Lyme, Greater Manchester and Lancashire.
The surgery, which will be operated by GPs at the Buckland Surgery, Newton Abbot, has a fully equipped consultation room and will offer GP consultations every Monday Wednesday, Thursday and Friday.
Dr Jill Millar, a GP at Buckland Surgery, said she hoped the store would make it easier for patients to do their shopping after they attended an appointment and that appointments on Mondays would be ‘useful’ for people who work during the day.
But Dr Michael Sparrow, a GP in Lifton, Devon, said the development was a bad move for the profession: ‘The minute we start leaving our independence to companies like Sainsbury’s is a disaster.
‘I wouldn’t do it because you’re working for someone who’s in it for a profit.
‘A group of medical people are being run by a group of non-medical people who do it to make money.
‘In all examples when the private sector move in, they cut services to make a profit. I’m very sceptical.’
David Gilder, professional services manager at Sainsbury’s, said: ‘Customers have really responded well to the two latest GP surgeries to open at our stores.
‘They really value the convenient locations, good transport links and longer opening hours that the surgeries offer.
‘I would invite any GPs out there who think a Sainsbury’s store would be a good location for a surgery to get in touch.’
Accident and Emergency Department closures were announced in four west London hospitals in June and local Labour MP Andy Slaughter wrote: ‘Four hospitals will lose their A&E departments, including Hammersmith and Charing Cross, in my constituency. Charing Cross will close completely save for an “urgent care centre”.’
He added: ‘North-west London is a prototype for what will happen elsewhere. That is, taking healthcare for millions of people back a generation.’
This prospect must not be allowed to happen. What must happen is that, following the Chase Farm example, Councils of Action must be formed in every area to mobilise the whole community to organise to defeat this government’s NHS cuts and closure programme with a policy of occupations.
The trade unions must also be mobilised to organise a general strike to bring down this class war coalition government and replace it with a workers’ government which will nationalise the banks and all the major industries under workers control, releasing the resources to maintain and develop the NHS and all our hospitals.
