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Be warned, loss of hospital services will hit everyone
• THE proposed service changes by NHS London for North Central Sector of the capital (Camden, Islington, Haringey, Barnet and Enfield) are being implemented without active involvement of the public or the professionals involved in delivering the services.
As a group of front-line doctors working in hospitals and the community, we are gravely concerned about the implications of these changes. These include transferring the majority of care, currently delivered in hospital, to the community and the consequent downgrading of many acute hospitals.
These plans are supposed to be submitted to NHS London by the end of this year. This will involve loss of key services, including emergency surgery, paediatrics and maternity services, with the resultant loss of full A and E services in many hospitals.
In our area, hospitals with A&E services under threat include the Whittington, Homerton, and University College Hospital. In north west London plans have already been proposed which will affect Ealing, Hillingdon, West Middlesex and Chelsea and Westminster hospitals. This has already happened in south east London, at Queen Mary’s, in Sidcup, which has recently lost 24-hour emergency care.
Similar plans are being drawn up to be implemented across London after the next general election.
As clinicians we spend our lives striving to improve patient care so we embrace change when it benefits patients. We are worried about the pace of change as community services are in no position to take on this massive role and loss of emergency services will effect all readers.
There has been no meaningful involvement of the public or professionals by NHS London in developing these plans and we believe we all should have a voice in these important proposals.
MEMBERS OF ISLINGTON DIVISION OF THE BMA
Merger talk
• CONCERNING merger talks between the Whittington and the Royal Free (Patient numbers could be halved, November 12), two phrases came to mind – losing the plot and lunatics taking over the asylum.
When the NHS was founded, the number of managers inherited from the previous private system was minimal, for administration had rightly been seen as an unproductive cost, and rigorously controlled. Access to Treasury funding changed all that, and administration (or bureaucracy) began growing regardless of any actual need.
It was already over-large 30 years ago; yet with the reorganisation into various trusts, and introduction of the absurd internal market, the growth went on apace. Nor has it slackened since. With Tony Blair’s foundation trusts and the “new NHS marketplace” even more pen-pushers have been taken on. It’s the needs and priorities of the bureaucrats that dominate the NHS now, to the often despair of medical staff.
Without the least trace of a mandate, the government is slowly destroying the NHS.
If we carry on down this route, we’ll arrive in a few years at a bizarre place indeed.
The present grotesque bureaucracy will remain in place, perhaps even grow, a mass of make-work and make-believe “running” a tiny rump of hospitals – the remnants of the NHS. Hospitals, that is, whose disillusioned staff now need a degree just to bandage a cut finger, while most of the population, out of their catchment areas, will find untreated ill-health becoming the norm.
A return to the worst horrors of the Victorian age, in short. I hope I’m wrong…
Jack Smith
Fellows Road, NW3
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