This prediction by Tony O’Sullivan, Consultant Paediatrician at Lewisham Hospital, was made to over 100 people at the Ealing Save Our NHS rally in the centre of Ealing on Saturday 12 March 2016. He made it in response to Ealing Clinical Commissioning Group’s (ECCG) ‘Shaping a Healthier Future’ (SaHF) plans to severely downgrade Ealing Hospital’s Paediatric services. On 16 March 2016 ECCG confirmed to the press that the children’s in-patient ward and the children’s A&E service at Ealing Hospital would close on 30 June 2016.
Tony’s nightmare scenario is of a very sick child arriving at the doors of Ealing Hospital being carried by a parent in 12 weeks time. With no A&E facilities available for children, the Urgent Care Centre (UCC) – devoid of Paediatric Consultants and Paediatric Nurses – will likely have difficulty in accurately diagnosing and adequately treating a very sick child.
Currently 93% of all sick children arriving at Ealing Hospital are brought by their parents and carers and not by ambulance. Around 6,000 children annually attend Ealing Hospital A&E. Just under 2,000 children annually are admitted as patients to the hospital.
So what will happen to the thousands of sick children who the Ealing Hospital UCC determine need A&E services? The plan is that the NHS Patient Transport Service (PTS) – not the London Ambulance Service – will transfer them variously to hospital A&E units at remote locations including those in Harrow, Hillingdon and Isleworth. The NHS PTS has a poor reputation. A comprehensive report on PTS in London by Transport for All in October 2014 discovered many patients facing long waits for transport to hospital appointments. It’s unclear (and almost certainly unlikely) whether a Paediatric nurse or doctor would accompany each sick child on his or her trip out of Ealing. Distraught parents and carers will have to make their own way to these remote hospitals to be re-united with their sick child.
It is an absolute certainty that the time to expert diagnosis and commencement of treatment will be increased by these closures. This will inevitably introduce the risk of increased physical and mental pain, condition deterioration and death.
ECCG presented a paper on its Paediatric reconfiguration aspirations at Ealing Council’s Health and Social Care Scrutiny Panel on 8 March 2016. The paper is almost completely bereft of Paediatric patient numbers, explanations and analyses. Scandalously the paper makes no mention at all about how the specific emergency needs of children arriving at Ealing Hospital suffering from severe mental health episodes and conditions will be diagnosed and treated.
The MindEd Trust has recently publicized the fact that just 0.7% of the NHS budget is spent on the mental health needs of children and adolescents. The ECCG apparent ‘blindness’ with regards mentally ill children presenting themselves at Ealing Hospital is symptomatic of the empty senior NHS rhetoric of ‘parity of esteem between physical and mental health’. Still the ECCG approach is horribly consistent with the 2012 SaHF proposals which contain no mention of mental health services whatsoever.