BY ANNA ATHOW BMA COUNCIL MEMBER
THE destruction of NHS hospital care continues in London with the NORTH WEST LONDON CLUSTER.
This includes Primary Care Trusts (PCTs) in Brent, Harrow, Hillingdon, Ealing, Hounslow, Hammersmith and Fulham, Westminster and Kensington and Chelsea.
These have been divided into three subclusters
(i) Outer – Ealing, Hillingdon and Hounslow
(ii) Brent and Harrow
(iii) Inner – Hammersmith and Fulham, Kensington and Chelsea, Westminster.
Ealing Hospital NHS Trust (EHT) in Southall, is a large District General Hospital (DGH) without a PFI building. It is not in deficit and has not been approved as an FT.
The US management consultants McKinsey are drawing up a strategic outline case to merge Ealing with North West London Hospitals trust (NWLHT) – a merger of Northwick Park hospital, St Mark’s in Harrow and Central Middlesex in Park Royal. Part of Ealing hospital’s A&E is being handed to a private company.
NWLHT has long term debt problems and cannot achieve Foundation Trust (FT) status. In 2009/10, the trust made £32m cuts, shed almost 400 posts and sold off land. It is on the SHA’s list as a financially challenged trust.
If merged with Ealing, the population served would be 750,000 with 1,100 beds.
NWLHT is planning to axe 87 posts, 49 of them clinical.
Northwick Park hospital came to notice in 2006, when a CQC report investigated 10 maternal deaths between 2002 to 2005. It is one of the busiest trusts in the country for emergency surgical admissions.
Central Middlesex Hospital was merged with Northwick park in 1999. Its high risk maternity services were moved over to that hospital in 2002. Last year its paediatric department was downgraded and emergency surgery patients were no longer admitted at night, but referred on to Northwick Park.
Much of the original hospital land was sold off to finance an £85m PFI scheme in 2008.
The walk-in centre is run by Care UK, which aims to ‘forwardly integrate’ with the rest of the A&E.
Staff believe that the whole site is planned for outsourcing to private companies.
West Middlesex Hospital, in Isleworth, has been instructed to cut £22m by 2015, £11.5m in the first year. It plans to axe 334 posts and 30 beds. Forty five beds were removed in the last 18 months.
The trust was rebuilt as a £120m PFI in 2003, but will cost considerably more over 35 years. It is on the SHA’s list as a financially challenged trust.
Imperial College Healthcare Trust, which runs St Mary’s, Hammersmith and Queen Charlotte’s and Chelsea, and the Western Eye Hospital and Charing Cross hospital is facing a funding cut of £40m. It will therefore not be able to achieve FT status. Management consultants Ernst and Young are assisting it to make the cuts.
Imperial plans to cut 150 staff and 10 per cent of beds. Next year the trust estimates it will need £89m in funds to bail it out.
The Royal Brompton and Harefield NHS Foundation Trust ( RBHT) are fighting a plan to remove its paediatric cardiac services. Staff at the hospital suggest that removing children’s heart surgery, would destabilise the cardiac unit as a whole which performs 400 operations a year, and would spell the closure of the hospital itself.
The Royal National Orthopaedic Hospital at Stanmore, which narrowly escaped closure at the last election, lists four ways in which it could achieve FT status, one of which is being franchised out to a private operator. The trust is planning a PFI rebuild.
SOUTH WEST LONDON CLUSTER embraces the PCTs of Richmond and Twickenham, Wandsworth, Sutton and Merton, Croydon and Kingston.
Hospitals include Kingston, Croydon (formerly Mayday) St George’s Tooting, Epsom and St Helier.
St George’s, one of the largest providers in SW London and a teaching hospital, has been instructed to make cuts of £55m this year and estimates that 500 posts will be cut, seven per cent of the total, including 214 nurses and 22 consultants, resulting in 100 bed and three ward closures. It has put back its application for FT status till 2013.
St George’s is paying £119m for neurological and cardiac units, worth £46m acquired by PFI in 2000.
Kingston announced 486 posts would go over five years, including doctors and nurses. £41.6m has to be saved. The hospital is applying to be a FT. An ‘alliance’ with St George’s Tooting is envisaged whereby more day case patients would go to Kingston. The hospital expects a 49 per cent cut in A&E attendances and 38 per cent reduction in outpatient appointments.
Kingston has a five story surgical centre, built as PFI in 2004 for £27.6m but costing £337m by 2034.
The Mayday University hospital trust, spent £27,000 changing its name to Croydon University hospital trust.
Croydon health services NHS trust (the PCT) which runs the hospital, is aiming to cut £34.7m over the next three years and axe 200 jobs. The hospital is due to close four wards by 2014. Already 12 beds for elective surgery have gone.
In April, the care quality commission CQC instructed the hospital to increase the number of midwives in its maternity unit, as this unit was not meeting six essential standards of care. There had been recent maternal deaths, and the trusts ability to provide optimum emergency care in a high risk situation was questionable.
Epsom and St Helier NHS Trust (PCT) is seeking the most dramatic ‘efficiency savings’ in the country. It was given a large-bail out in the last month by the SHAs challenged trust board and is selling off a mental health facility at Orchard Hill for £12.7m.
It runs Epsom, Sutton, and Sutton and St Helier hospitals. The trust plans to axe 12.7 per cent of its £313m turnover in 2011/12 i.e. almost £40m. Paul Burstow, health Minister is the conservative candidate for Sutton and Cheam which covers this area.
The trust is seeking a merger or an acquisition with another trust.
• Continued tomorrow
