The Destruction of the NHS in North West London

20.2.13

Yesterday’s news was expected, but it still hit hard. Last June, the Joint Committee of North West London Primary Care Trusts proposed the closure of four of the nine A&E Departments at hospitals in north west London, and on Tuesday, despite vigorous campaigns throughout the area against the proposals, the committee confirmed that, as the Evening Standard put it, “Hammersmith and Central Middlesex hospitals will lose their A&Es permanently while Charing Cross and Ealing will be left with a downgraded urgent care centres which will not accept emergency patients.”

This really is an alarming development, as it will leave three of the eight boroughs in north west London — containing about three-quarters of a million people — without a major hospital, out of the 1.9 million people in the whole of north west London. In addition, removing hospitals’ ability to deal with emergencies essentially sounds the death knell for those hospitals, as a huge range of hospital services rely upon emergency admissions and the ability to deal with emergencies. In Lewisham, for example, where similar cuts have been approved, at least 90 percent of the mothers in the entire borough (4,400 a year) will no longer be able to give birth in Lewisham itself, despite it having the same population as Brighton, Hull or Newcastle.

Following the announcement about the north west London hospitals, Andy Slaughter, the MP for Hammersmith and the secretary of Save Our Hospitals Hammersmith and Fulham, said, “This is the biggest hospital closure programme in the history of the NHS. It will put lives at risk across West London and will give a second class health service to 2 million people.” He also stated, “There will be no A&E in the London boroughs of Hammersmith, Ealing or Brent, which together have a population the size of Leeds.”

In addition, of course, as Andy Slaughter indicated, services will be dangerously overstretched at the remaining hospitals. As the Standard noted, “The pressure on already over-stretched hospitals in the area is set to increase. Chelsea and Westminster is the only A&E in the area which is not already exceeding waiting time targets.”

Anne Drinkell, a matron and NHS campaigner, told the Standard, “It’s worrying that people with serious conditions no won’t necessarily be treated in a timely fashion. The pressure on other already much-pressed hospitals, such as St Mary’s in Paddington and Chelsea and Westminster, will increase greatly.”

Providing further details of the cuts, the Standard also explained, “Ealing will lose its obstetrics and maternity units and Charing Cross its hyper-acute stroke unit, while both hospitals will lose emergency surgery and intensive care units. Central Middlesex will lose intensive care while its A&E, which has already closed, will not be reinstated [Note: This was some sort of premonition on the part of the Standard, as Central Middlesex's A&E Department is still open, but will, the board says, be closing in June]. Hammersmith will become a specialist hospital, without an A&E, while intensive care will become a specialist unit. All four hospitals will retain an urgent care centre — also known as polyclinics or walk-in care centres — to treat patients with less serious, non-life threatening injuries. They will be manned by GPs and nurses.”

Londonist provided more information. Mocking Hammersmith and Fulham Council for lying last week, when it claimed that Charing Cross had been “saved,” the website noted, “The buildings will be knocked down and the vast majority of the land sold off to developers; a replacement UCC [urgent care centre] run by GPs will take its place and 60 of the current 500 inpatient beds retained. It will become a specialist hospital without the facilities to perform emergency surgery or handle patients needing intensive care. What’s more, funding for some revised services at Ealing and Charing Cross has yet to be identified.”

While campaigners pledged to continue fighting to save their hospitals, and the announcement added to the urgency of creating a campaign across the whole of London, as identified by the “Defend London’s NHS” campaign that was launched last week, one of the key themes to emerge from these proposals — as at every other area affected (Lewisham, where I have been involved in a massive local campaign, the Whittington Hospital in Archway, and the hospitals of south west London) — is, firstly, that money is at the heart of the proposals, and secondly that the senior NHS managers responsible for the proposals are, whether deliberately or not, hiding this behind lies and spin about the need for savage cuts to improve services.

As the Standard explained, “In one of London’s biggest NHS land sales, trust bosses plan to dispose of most of the 30-acre Charing Cross hospital site.” They want to slash all 500 beds, leaving as just an acre — less than a football pitch — of land for buildings to treat patients. It will mean as little as four per cent of the current site will be used as a hospital, according to page 595 of the proposal.”

The Standard added, According to documents, the trust’s current estimate for the land sale would be up to £136 million but it is anticipated the true profit will be considerably more. Some of the money be reinvested to build new facilities on the smaller part of the site with the addition of 60 beds.”

The Standard noted “similar sell-off plans by the Whittington Hospital, where the trust wants to dispose of half of its buildings, including nurses accommodation, and cap the number of births to save £4.8million,” but failed to mention Lewisham, where the proposals to disembowel the hospital in a similar manner to the proposals for north west London include selling off 60 percent of the hospital’s buildings.

On the lies and spin, Londonist noted that “the remaining A&Es will be expanded,” — although, as with Lewisham, it is by no means certain that any extra money promised to achieve this will actually materialise — and also questioned “whether they’ll be able to cope with the extra demand.” The website also touched on the NHS officials’ false claims about urgent care centres, explaining that the rationale for their creation — as opposed to retaining A&E Departments — is that they “can treat about 70% of illnesses that patients go to A&E with,” although, crucially, “that assumes people will assess themselves and make a decision about how ill they [or]their family member really is.”

This is hugely important, as is the allied claim by the NHS officials proposing the cuts — that community-based care will reduce the demand on hospitals, even though it has been clearly established that the proposals are nothing more than an aspiration, without any grounding in reality.

As the BBC noted when the proposals for north west London were first announced last June, “Four out of nine accident and emergency wards will close under NHS reorganisation plans. The NHS says better care can be given by fewer, more specialised centres.” This is another of the empty mantras of the NHS management, which ignores the damage that will be caused by increased waiting times, increased travel times, and the added stress on staff at the hospitals that are supposed to take hundreds of thousands of extra patients a year, and is contradicted by the very next line in the BBC article: “Health bosses say there would be a £332m gap to plug by 2014/15 if no changes are made.”

In other words, it’s all about the money, whatever senior NHS officials tell themselves. If you care about the NHS, please be aware that the health service’s own senior officials — backed by the government — are currently engaged in plans in London which will lead to the loss of between 20 and 60 percent of A&Es, maternity departments, intensive care and other acute services, and the irreversible selling off of much of the hospitals’ land.

This should alarm everyone, and not just those in the currently affected areas. If you care, please get involved. Help is currently needed to fully establish the “Defend London’s NHS” campaign, so if you’re interested, and have particular expertise in establishing and running websites, dealing with social media via Facebook and Twitter, coming up with ways to attract media attention, or mobilising and organising supporters, then please get in touch with me.

Note: If you want to be involved in the campaign to save the hospitals in north west London, please see the Save Our Hospitals Hammersmith and Fulham website here, and get in touch here. Also see the Save Our Hospitals Ealing campaign, and get in touch here. Also see the response to the announcement on February 19 by Ealing Council, which, unlike Hammersmith and Fulham Council, has always opposed the plans. The council is backing local campaigners’ plans to refer the proposals to Jeremy Hunt, although, as the example of Lewisham has demonstrated, it is unwise to expect too much of the health secretary.

Andy Worthington is the author of The Guantánamo Files: The Stories of the 774 Detainees in America’s Illegal Prison (published by Pluto Press, distributed by Macmillan in the US, and available from Amazon — click on the following for the US and the UK) and of two other books: Stonehenge: Celebration and Subversion and The Battle of the Beanfield. To receive new articles in your inbox, please subscribe to my RSS feed — and I can also be found on Facebook, Twitter, Digg, Flickr (my photos) and YouTube. Also see my definitive Guantánamo prisoner list, updated in April 2012, “The Complete Guantánamo Files,” a 70-part, million-word series drawing on files released by WikiLeaks in April 2011, and details about the documentary film, “Outside the Law: Stories from Guantánamo” (co-directed by Polly Nash and Andy Worthington, and available on DVD here — or here for the US). Also see my definitive Guantánamo habeas list and the chronological list of all my articles, and please also consider joining the new “Close Guantánamo campaign,” and, if you appreciate my work, feel free to make a donation.

18 Responses

  1. Andy Worthington says...

    Anna Giddings wrote:

    Apparently GPs are being paid not to refer patients to hospital. All to be privatised. Dreadful

  2. Andy Worthington says...

    Yes, I keep hearing this more and more often, Anna, and yet it’s not reported sufficiently at all.
    The claim by senior NHS officials that community-based care can seriously reduce the need for hospital admissions is acceptable as an aspiration, but it doesn’t exist as a policy at all, and to see it apparently being used as though it was an active policy is shameful and dishonest. Allied to it is the equally risible claim that informing people better will mean less of them turning up at A&E. It’s not going to work in practice, at least not without a lot of time and effort and investment, and it’s deceitful to behave as though it will somehow magically come true.
    As I keep saying, we need to keep putting pressure on senior NHS officials, to show then up as traitors to the founding notions of the NHS, and to try and persuade those within the NHS who understand the scale of the assault on the health service to take a stand.

  3. Carol Brown says...

    Have you seen this? It seems as though it is even worse. Lucy Reynolds re privatisation. http://tinyurl.com/bcj7d3q

  4. Andy Worthington says...

    Thanks, Carol. Yes, very important.
    Posted below:

    Quick guide to section 75
    By Lucy Reynolds, a research fellow at the London School of Hygiene and Tropical Medicine
    Open Democracy, February 19, 2013

    The regulations apply the competition law regime to the arrangement of all NHS services, with very rare exceptions where to do so would be impossible.

    Competition law is a set of laws to manage markets. Because competition law was designed by commerce for commerce, the parts of it which cover public services are very pro-private enterprise. The forcing of competition law on all NHS spending through the implementation and enforcement of these regulations will have the effect of helping the private sector to cherry-pick the services where it can make most money, thus destabilising the finances of those of our traditional NHS hospitals which are not already on their knees financially because of PFI because the public sector providers will be left with all the difficult cases, which are by far the most costly.

    The government will then have an excuse to do all over the country what it is doing in South-East London: shutting well-functioning services which are working at full capacity, replacing A&Es with first-aid posts (“Urgent Care Centres” which have already been responsible for avoidable deaths), selling off the land on which hospitals stand, and outsourcing services to the private sector through tendering them out on long contracts.

    All this is completely unnecessary. While Sweden and the Netherlands are reporting soaring system costs and loss of access to services for the poor due to the implementation of competition law rules following their recent health service privatisations, Canada has successfully protected its affordable comprehensive universal system of care. It did this by declaring that it will be run as a public service, and not in such a manner as to be able to make profits from it. Scotland and Wales reversed the NHS market reforms in 2004, and subsequently saw healthcare outcomes improve and costs reduce as they saved the extra costs of running the market and were freed from the distortions to care choices that it introduces. We too should now eject the market from the NHS and claim the public health service exemption in the interests of keeping a national health service that serves us not its new owners.

  5. Thomas says...

    And of course the MPs who did this have private care. Whilst I and indeed most people don’t. If MPs were made to use the NHS when they got sick, they woulden’t damage it.

  6. damo says...

    well after they close people should start you know kneecapping all tories man woman and child and while they rush covered in blood to there nearest a,e only to find it closed ooh wot a shame,lol,lol wake up people take to the streets fight back destroy all tories ,kill all bankers.and smash all corperates ..thats wot there doing to us…fight back

  7. Andy Worthington says...

    The really rather sick part of the story, Thomas, is that David Cameron’s disabled son Ivan, who died in 2009, was cared for by NHS staff, and William Hague said this on behalf of the family after his death, as the Guardian described it: “The Camerons were ‘hugely grateful’ to the NHS care workers who ‘not only did their utmost for their son this morning but have helped every day since he was born.'”
    Cameron really has no principles. After this, and after promising no top-down reorganisation of the NHS, he then allowed his chum Lansley to do just that – and he must never, ever be forgiven for it.

  8. Andy Worthington says...

    Thanks, Damo. Sorry our paths didn’t cross on Saturday. Were you in Hammersmith for the rally? I had the opportunity to meet with Andy Slaughter and local campaigner Anne Drinkell for a brainstorming session afterwards – along with Dr. Louise Irvine from my neck of the woods, the chair of the Save Lewisham Hospital campaign. It was good to be in Hammersmith again (I lived there briefly in the late 80s), but like so many places that aren’t rich, the crippling realities of austerity were all too apparent on the high street. Britain has turned into America during my lifetime, Damo, and not the best parts of it – the low end consumerism, the commodification of everything, and the very deliberate attempt to strip meaningful political engagement or awareness from every single aspect of people’s lives. Very sad. Hammersmith looked rather defeated – ground down, of course, by the scumbag Tory council that cares only for Hammersmith and Fulham’s wealthy inhabitants. The council needs to be removed from office at the first available opportunity …

  9. Andy Worthington says...

    Thanks to everyone who has liked and shared this. This whole “reconfiguration” story across London’s NHS services remains of huge importance. Here’s the latest news from Sutton and Epsom, of a delay to the anticipated announcement of downgrades at St. Helier and Epsom Hospital – amid rumours that the Surrey Downs Clinical Commissioning Group is opposed to the plans. Also significant, no doubt, is the presence in Epsom of the disgusting Tory MP and minister Chris Grayling, probably intent on saving hospitals in his own constituency to save his wretched career: http://www.suttonguardian.co.uk/news/10242428.What_s_going_to_happen_to_St_Helier_Hospital_/

  10. damo says...

    your absolutly right get them out asap hammersmith and fulham council used to be one of the most progresive labour and socialist councils in the country well it was when i was a child in the 1970s they pioneered so many firsts ie the setting up of all adventure playgrounds the first in the country in the 60s my uncle and autie were involved a place were children could go,play ,be safe and for some of the poorest children ..be fed…now all gone litteraly every single one ..GONE….even the adventure for disabled children in bishops park gone turnrd into a private nursery there were no yuppie filth here in the 70s they started infesting the place in 80,81 now there super yahyah,s and yank investment bankers ..the place has had the life gentrified out of it hammersmith and fulham was once a shared place..not any more

  11. damo says...

    hammersmith and fulham is a prime example of greed and gentrification gone out of control north end road some of the poorest people ive seen in a long time litteraly no money ,gangs, crime,antisocial behaveiour,desperation ..and you look at ca morons fulham street after street of dead trophy houses ful of dead trophy wives and dead trophy children ..no one on the streets litteraly andy i kid you not ,,no one like the charlton heston film the omega man ..silent lifeless those same streets 40 years ago were full of life kids out playing people on the street the same houses but back then all run down ..flats studios,bedsits junk cars on the street..LIFE….fulham was a completely different place when ive told people how fulham was they cant belieave it the yuppies have killed the place just like there killing hackney there like a plauge a social menece ..LOCUSTS consuming all before them,lol now is the time for a revolution…NOW

  12. Andy Worthington says...

    And here’s the Ham & High declaring its support for the campaign to save the Whittington Hospital in Archway from savage cuts: http://www.hamhigh.co.uk/news/ham_high_s_hands_off_our_whittington_hopsital_campaign_launches_to_resounding_support_1_1942425

  13. Andy Worthington says...

    Powerful analysis, Damo, and I absolutely agree. The homegrown and international wealthy and super-wealthy have only become so through hyper-exploitation – of the rest of the world, where the sweatshops are, and now, at home, with the deprived ghettos increasingly resembling American poverty more and more. I haven’t posted my North End Road photos yet, from my visit in October, but I was shocked, Damo – the poverty was immense and obvious, until I crossed the invisible line, and wealthy Fulham began.
    The wealthy are only safe because the poor aren’t rising up.

  14. damo says...

    but when are they gonna rise up i mean for fucks sake how much longer we can see wots going on and how its all gonna go down yet people sit there ..you know in there own shit..doing and saying nothing ..god i feel like all im doing is whingeing and its a real bore..but my god were in this fucked up era where its gonna go either way to some kinda utopian future if we rebel and start again or its gonna go to destruction we as a spieces and the planet i think are at that tipping point and we were all warned about this 40 odd years ago in the late 60s and early 70s well were at that point and people are sitting on there hands transfixed by thease fucking gadgets,,brain dead ..fit for nothing

  15. Andy Worthington says...

    Well put, Damo. There isn’t an app for that, is there? People tweeting and updating their statuses and watching Beyonce and playing ultra-violent games while the world falls apart. What a shambles. You’re right to mention the late 60s and the early 70s. That’s when the writing was on the wall, but what did we get instead? Thatcher and Reagan and unfettered greed …

  16. damo says...

    greed and technoligy run amok ..sometimes i feel somethings comeing

  17. Andy Worthington says...

    Yes, me too, Damo. It can’t just be us a few thousand others burning with furious indignation. Come on, people! Wake up and get on the streets!

  18. Brains | Gabriel Vents says...

    […] Already over stretched public services will be reduced to breaking point by these changes: http://www.andyworthington.co.uk/2013/02/20/the-destruction-of-the-nhs-in-north-west-london/ . These will also be accompanied by hundreds of thousands of newly homeless people. No one from the […]

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