Deeply flawed hospital plans must be halted immediately

One of the country’s biggest hospital shake-ups is deeply flawed, likely to exacerbate a deteriorating situation, a threat to the fundamental principles of a universal NHS and should be halted immediately, according to a landmark report from the Independent Healthcare Commission chaired by Michael Mansfield QC.

NHS North West London’s Shaping a Healthier Future (SaHF) programme has already seen the hugely controversial closures of two A&E departments, at Hammersmith and Central Middlesex hospitals and the closure of Ealing maternity unit. Further downgrading of Ealing hospital is planned, along with the closure and sale of the majority of Charing Cross hospital site.

The Independent Commission also uncovered shocking details of spiralling management and consultancy costs. At the same time, a crisis is developing in emergency services, with GP services clearly failing to meet demand across the region, contributing to a crisis in A&E performance.

Independent Healthcare Commission Chair Michael Mansfield QC said:

“The findings of the Independent Healthcare Commission for North West London are stark - the reforms, both proposed and implemented thus far, are deeply flawed. There is no realistic prospect of achieving good quality accessible healthcare for all, and any further implementation is likely to exacerbate a deteriorating situation.

“Our recommendations are equally stark. It is the view of the Commission that the Shaping a Healthier Future programme should be halted immediately, and that the affected councils should consider a legal challenge if it is taken forward in the current circumstances.”

“At the very core of any decent civil society is the imperative to ensure that the individuals and communities who make up that society have sustainable access to good quality healthcare. The response from North West London NHS, flowing top down from central government, has singularly failed to deliver on this imperative, with all indications pointing to a further deterioration in the future.

“It is crystal clear that the impact of fragmentation through privatisation is slowly eroding what was a National Health Service, a development that ran like a thread through much of the evidence given at our public hearings. In so many ways, the catalogue of failings, missed opportunities and profligacy we have seen in North West London act as a microcosm of a wider malaise across the English NHS. As such, though this report focuses on the NHS in North West London, it should act as a warning call to the top of government.”

Leader of Ealing Council Cllr Julian Bell said:

“This report highlights serious concerns about the scale, speed and untested nature of changes to our hospitals in this part of London. The reconfiguration plans have lacked effective engagement and overlooked important facts. The cost of implementing it is now spiralling out-of-control with current estimates at £1billion – five times the cost approved by the NHS. 

“I welcome the commission’s recommendation that this programme is halted.  We need the NHS to share its business plan so it can be scrutinised in the best interests of patients in the region and for the National Audit Office to see if these proposals offer value for money to the taxpayer.”

The reports key recommendations are:
• The Shaping a Healthier Future programme must be halted immediately
• North West London local authorities should consider their options for launching a legal challenge if a decision is taken to press ahead with the programme in the current circumstances.

The report’s key findings are:
• Cutbacks are being targeted on the most deprived communities
• The public consultation was inadequate and flawed
• The escalating cost of the programme (£1bn) does not represent value for money and is a waste of precious public resources
• There is no business plan to show the reconfiguration is affordable or deliverable
• NHS facilities have been closed without adequate alternative provision being put in place
• The plans seriously underestimate the increasing size of the population in North West London and fail to address the increasing need for services

In today’s landmark commission report, Michael Mansfield QC also recommends that: 
• Ealing and Charing Cross hospitals must retain full ‘blue light’ A&E services for the foreseeable future
• The decision to close Ealing maternity unit should be reversed with immediate effect
• The A&E department at Central Middlesex Hospital should be re-opened
• The National Audit Office should undertake a review of the value for money of the programme
• A new public consultation is needed as the proposals have changed significantly
• Substantial investment should be made in GP and out-of-hospital services, which are clearly overwhelmed and inconsistent.