Independent Review Panel (IRP) A&E Closure at Ealing Hospital is Delayed ‘,..until further work has been completed…’
On 30 October 2013 the IRP report on changes to NHS Services in North West London delayed the destruction of Ealing Hospital A&E using these weasel words:
‘The A&E departments at Ealing and Charing Cross hospitals must be sustained until further work to inform a final decision on the future of these two local hospitals has been completed and the alternative services that will provide a safe, high quality urgent emergency care system for local residents are in place’.
So it’s not ‘if’, but ‘when’.
Jeremy Hunt MP, Secretary of State for Health, did not have the bottle to spell this out in Parliament as Ealing MPs Bray, Sharma and Pound successively battered him and demanded clarity.
Appeal Court Overrules the Department of Heath – Lewisham Hospital Wins Yet Again
On 29 October 2013, an Appeal Court Judge rejected the DoH’s appeal against a Judicial Review decision that halted the downgrade of Lewisham Hospital. This was a slap in the face for Health Secretary Jeremy Hunt MP and an expensive waste of tax payers’ money.
Ealing Council Loses Ealing Hospital Judicial Review in the High Court
On 9 October 2013 Mr Justice Mitting in the High Court would not give his permission for Ealing Council to pursue a Judicial Review against Ealing Hospital downsizing (part of NHS Shaping A Healthier Future – SAHF).
Ealing Council admits that the judge pointed out that alternative proposals to SAHF had been invited, but none had been given by Ealing Council. The judge cited the approval of SAHF by Ealing clinicians, and that the public consultation was not flawed. These two latter statements are just plain wrong and this leads us to believe that this legal judgement was politically driven.
Maybe this outcome was inevitable or maybe Ealing Council argued the wrong case. We will probably never know, as Ealing Council has consistently refrained from open, collaborative working with activist groups or Ealing Hospital staff to fight the destruction of our local hospital.
The decision seems to be one of approving the SAHF process, rather than approving the NHS NW London closures’ decision. This should worry us all very much as many activists have over and over again highlighted multiple flaws in the public consultation process, not to mention the complete absence of any community engagement during the formative phase of plan making.
We now have the ‘verdict’ of the Independent Reconfiguration Panel (IRP). The IRP Chair, Lord Ribeiro, has never voted against his Tory Party’s wishes. When I was giving evidence to the IRP, the questions from and discussions with panel members almost resembled community engagement. How ironic to have community engagement after the SAHF process has finished, rather than before the plan was formulated! I’m reminded of the Queen’s comment during the trial in ‘Alice’s Adventures in Wonderland’ – ‘sentence first – verdict afterwards’.
Now we know that the IRP and Hunt now back the SAHF, we can look forward to the complete demolition of Ealing Hospital. Somewhere amongst the blocks of private flats some kind of new medical facility will be assembled occupying just 4% of the site that for 34 years housed Ealing Hospital.
Four Ealing residents and patients attended the Ealing Hospital Trust (EHT) Board Meeting on 26 September 2013 as observers. There is no permanent Ealing Hospital boss. However the Acting Chief Executive Officer, David McVittie, attempted to answer some of our questions in public and then offered us a separate meeting with him. Unfortunately, because of his holiday arrangements, this meeting will not take place until 7 November 2013.
The questions and issues we will be quizzing him on include those concerning privatisation, staffing, the attempted merger of the Ealing Hospital NHS Trust with the North West London Hospitals Trust (which includes Northwick Park Hospital), out of hospital services, risk analysis, Foundation Trust aspirations and finance. Mr McVittie is apparently in a difficult conflict of interest position with regard to the merger machinations, as he is the CEO of Northwick Park Hospital, as well as the Acting CEO of Ealing Hospital.
Ealing Hospital NHS Trust is forecasting a £8.9 million deficit for this financial year. Monitor, the NHS regulator, will only grant Foundation Trust status to those Trusts which the Care Quality Commission say are providing good quality care. Foundation Trust status allows NHS staff and facilities to be used by private patients to generate income for the Trust.
All these confusing references to ‘Trust’ are ironic as it’s trust in the future of the NHS which millions of us in England no longer have.
I, like thousands of other Ealing residents and patients, want the retention of District Hospital status for our local hospital – Ealing Hospital.
Dr Mark Spencer Promises What He Can’t Deliver, Reshapes Local NHS Healthcare On the Fly and Voices Unsupported Opinions
On 24 September 2012 Dr Spencer, at a public meeting in West Ealing chaired by Eric Leach, promised to identify two West Ealing GPs who supported the SAHF proposals. Some eight months later after lots of chasing no such individuals have been named.
Dr Spencer emailed Colin Standfield on 25 October 2013 in connection to loss of Obstetric services at Ealing Hospital ‘…Chelsea and Westminster (Hospital) are online to open their expanded maternity services in December.’ This will be of little comfort to pregnant women in Southall when Obstetrics at Ealing Hospital is destroyed. Colin also points out that the CQC rates Chelsea and Westminster Hospital as overall a riskier hospital to attend than Ealing Hospital.
On BBC London News on 30 October 2013, Spencer said ‘there will be smaller A&Es at Ealing and Charing Cross, (but) they’re unlikely to take blue flashing lights’. A ‘smaller A&E has no defined existence anywhere in the NHS. Did Spencer just make this up on the spur of the moment?
Spencer also comes up with opinions unsupported by any evidence. He states ‘We know that maternal deaths are most common in the early hours and at weekends.’ Standfield is Chair of Ealing SOS campaign and an established and respected medical research analyst. He spent five days searching for data to back up Spencer’s claims. He looked at data collected in the UK, Guyana, India, Canada, New Zealand as well as in worldwide UN studies. He found no supportive data. The key research report/body in the UK CEMACH/CMACE also failed to support the Spencer assertion.
Dr Spencer MBBS, FRCGP, DRCOG, is the Medical Director, Quality and Service Design, NHS England (London). Worrying isn’t it?
Hospitals and Clinical Units with Insufficient Staff Should be Closed Down Says Robert Francis QC
Robert Francis, the author of the hugely damning NHS Mid Staffordshire Hospital scandal report, believes there is an intimate link between staff numbers and care standards. So much so that units with too few nurses and doctors should be closed down. On that basis Ealing Hosptial A&E in August 2013 with only 76 out of 106 staff should almost certainly have been closed down.
Further, Mr Francis believes that the arguments for legally mandated ‘safe staffing’ ratios, supported by Labour and the Royal College of Nursing – but rejected by Jeremy Hunt MP – are persuasive.
He has also re-iterated his concern that Mr Hunt seems unwilling to introduce some of Francis’ far reaching proposal, such as introducing a duty of candour on individual NHS staff.
After looking at the NHS for three and a half years he has found that willing staff often lack the support to do their job and feel under valued in what they can do. (‘The Guardian’ 9 October 2013). The Department of Health’s final response to the Francis Report is due later this month.
Jeremy Hunt Wants GPs To Break The Law and Work More Than 48 Hours per Week
The working convention in England for many decades has been to work five days a week and not to work at weekends. The current European Working Time Directive (EWTD) allows GPs to work over nine hours per day Monday to Friday. Those really are quite long days and where some GPs are seeing 60 patients per day even most fit GPs will be tired come Saturday each week. One of the legal solutions to these long hours is the hiring of more GPs. Mr Hunt’s solution is apparently looking at ways the EWTD can be circumvented or in fact changed.
NHS Regulator Mouths Off About The Wonders of Cheap Mexican and Indian Healthcare Services Such As Cataract Surgery and Orthopaedic Services
‘The Guardian’ of 10 October 2013 quotes David Bennett, Monitor’s Chief Executive, as saying that NHS services could be provided at much lower cost by the NHS employing Mexican and Indian private healthcare companies.
These comments seem inappropriate from the person running a body which is the health services ‘referee’ existing to make sure all participants play by the rules and act fairly.
Most of his other comments were about costs and not about how enforcing the ‘rules’ would bring about better clinical outcomes for more and more people. Reducing the number of hospital beds, closing hospitals, introducing private healthcare companies, shifting patients into their community (and into their bedrooms) seem to be Monitor’s raison d’etre.
Is Serco Fit For Purpose? Are Some NHS Contracts Fit for Purpose?
Why, oh why, should Serco be allowed to subcontract an NHS service contract to another organisation? Serco won a contract in Devon to provide out-of-hours GP services, but now (for whatever reason) it wants to subcontract this service to another organisation. For starters, private contractors should not be allowed to subcontract at all. Accountability goes out of the window and service fragmentation is almost inevitable.
And why Serco anyway? Serco was found by ‘The Guardian’ to have falsified its GP out-of-hours performance data when reporting to an NHS Trust in Cornwall. Serco won this contract on cost. However it was caught out as unsafe and, on one occasion, had only one GP on duty over night to cover the whole of Cornwall.
GP Surgeries ‘Open All Hours’ is Pie In The Sky
One does wonder sometimes whether David Cameron was actually listening in his basic arithmetic classes at Eton College. The Royal College of GPs (RCGP) tells us we need 10,000 more GPs to cope with rising demands. RCGP also informs us that GPs as well as working in their surgeries are also looking after patients in Urgent Care Centres and walk-in clinics and through 111, NHS Direct and out-of-hours providers. So how exactly can any surgery provide an 8am to 8pm service seven days a week as Cameron trumpeted at the Tory Party Conference in Manchester? An even more extraordinary trick would be for the 18 one person GP Surgeries in Ealing to provide this 12 hour every day Primary Care service!
Of the 9,305 GP Surgeries in England only 100 are open on Saturdays and Sundays. 1,439 are open on Saturdays.
The £50 million Cameron pledged to pay for nine 12 hour/7 days a week GP Surgery pilots has been stolen from another part of the healthcare budget and is not ‘new’ money.
We rate very poorly worldwide on our patient-doctor ratio in England. It’s 440:1, and that places us 37th in the world. In Cuba it’s 170:1, in the US it’s 390:1 and in Ireland it’s 360:1. Our medical schools are full to bursting with 10 students applying for every place.
The Government/NHS seems to revel in beating up GPs. How this helps to persuade medical students to go into general practice in England, rather than into hospitals here and abroad, is hard to fathom.
What Do We Want from Our NHS?
When we feel unwell we need rapid access to free expert triage, advice, diagnosis, prognosis, treatment and after-care. Face to face is better than telephone, email, texting or Internet. Using legacy NHS structures this means access to a GP close by and access to a local District General Hospital. It also means access to responsive telephone, email and texting services staffed by clinicians.
It’s not rocket science is it?
NHS England London Region Plans for £4 Billion Additional Cuts
This new regional body, which has replaced NHS London, is already talking about present NHS services in London being ‘unsustainable’. It is proposing future additional cuts of £4 Billion throughout London by 2020. More on this at www.peoplesinquiry.org
The Two Faces of Hunt
‘Stop rejecting complaints by patients…’ says Hunt:
+ Over 60,000 patients complain in writing about plans to close Ealing Hospital A&E, Maternity and Paediatric units. So what does TwoFace do? He’s closing down these hospital units
+ Over 20,000 complain in the streets of Lewisham about plans to close Lewisham Hospital’s A&E, Intensive Care and Maternity units. What does TwoFace do? He’s changing the law so he can close down these units at Lewisham Hospital.
+ ‘Ealing Hospital A&E will not close’ says TwoFace in the House of Commons on 30 October 2013. IRP report of 30 October 2013 accepted by Hunt states, in effect, that after ‘further work’ including setting up ‘alternative services’ – A&E will close.
£22.7 Billion Set Aside by NHS to Cover Medical Negligence Lawsuits
The NHS 2013/14 budget provision for medical negligence is a staggering 22% of the whole NHS budget for England. With this money over one million nurses could be hired. Some individual payouts are over £1 million.
Competition Champion To Take Over NHS England
Simon Stevens, currently President of the largest US healthcare company UnitedHealth in Minneapolis, will replace David Nicholson as NHS England supremo in April 2014. He’s 47 years old, born in Birmingham and a former Labour Councillor
Stevens, a former advisor to Tony Blair from 1997 to 2001, is a fan of Free School zealot Michael Gove MP. Ominously he drove the introduction of independent private sector healthcare suppliers into the NHS under New Labour.
UnitedHealth must be heart broken to lose him. Maybe he will find some way to connect with his former senior executive chums in his new role…..
CQC Rates NHS Northwick Park, Central Middlesex and West Middlesex Hospitals as At Risk of Poor Quality Care
The Care Quality Commission (CQC) exists ‘..to make sure hospitals, care homes, dental and GP services and all other care services in England provide effective, compassionate and high quality care’.
CQC in October 2013 rated NHS Trusts from 1 to 6. 1 = high risk of poor quality care and 6 = very low risk of poor quality care. Northwick Park, Central Middlesex and West Middlesex Hospitals are rated at 2 i.e at risk of poor quality care. Hillingdon Hospital is rated at 6 i.e with a very low risk of poor quality care. Ealing Hospital is rated as neither high nor low risk at 3.