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Published: 24th June, 2011
by ANDREW JOHNSON

THE future of the accident and emergency unit at Whittington Hospital was plunged into confusion this week when the head of the NHS in north London refused to rule out closures or a reduction in opening hours as health chiefs seek to axe £230million from their annual budget.

When approached by the Tribune, however, a spokesman for the new commissioning body – NHS North Central London (NCL) – said there were “no plans” to reduce accident and emergency opening hours or to close the Archway unit.

Emily Thornberry, Labour MP for Islington South, and Shadow Health Minister said the confusion revealed “the chaos” at the heart of the NHS. “Of course, they can say they have no plans, because no one has any plans. No one knows what they are doing,” she said.

The row emerged on Saturday at a rally to defend the NHS when 200 people packed the Assembly Rooms at Islington Town Hall.

Ms Thornberry held up a letter she had received from Paula Khan, chairwoman of NHS NCL – the body formed from the merger of Camden, Islington, Haringey, Barnet and Enfield primary care trusts, which is responsible for commissioning care in the five boroughs.

The body needs to cut £230m from its budget. Of that £230m, £26m has been earmarked to be lopped off “unscheduled care plans” by 2015.

Ms Thornberry had written to Ms Khan seeking confirmation that “unscheduled care” means A&E and ambulance services and, if so, whether NHS NCL was considering “restructuring and/or reducing A&E and ambulance services”.

She also asked: “Will A&E departments like the Whittington maintain the same opening hours, levels of staff and quality of care in 2014-15?”

In reply, Ms Khan wrote: “I can confirm that our definition of un­scheduled care includes all services where a patient needs to access a health professional urgently and therefore does include A&E and ambulance services.”

She added that the trust was introducing “urgent care centres” next to A&E units to treat people who turned up to casualty but did not need specialist emergency care. This was to reduce costs and increase the service.

She continued: “Our [financial] plan will clearly impact on the pattern and design of service provision across NCL and will have implications for the level of income available to providers, the extent of which is not yet fully known.”

The letter went on to say that the Whittington was looking at its own future provision and when this was complete “we will have a clearer understanding of [its] future financial and clinical viability”.

It added: “Lastly, I’m sure you will appreciate that because of the planning work still to be completed... we have not been able to answer your specific questions about the future of service provision. However, that should become clearer in the next three to four months.”

However, a spokeswoman for NHS NCL told the Tribune : “There will be no cuts to A&E. There are no plans to close A&E.”

Last year, the Tribune led a successful campaign to keep the A&E at Whittington Hospital after it was threatened with closure.

Ms Thornberry said the confusion was caused by the Tory-led government’s reforms of the NHS.

“Of course, they can say no plans, because they have no plan. That’s the whole point,” she said. “There is chaos in the health service and no one is able to plan anything.”

At Saturday’s meeting the MP said the NHS reforms were being driven by an agenda of privatisation.

“The problem as far as [Health Secretary] Andrew Lansley can see is we need to cut,” she said. “He believes the way to do this is to introduce the private sector, including competition. That is contrary to what the NHS is about and why it was created in the first place. We can’t have competition in the NHS. The NHS is a socialist idea and he just can’t get his head around it.

“We have a dog’s dinner of a bill and a £230m shortfall. Who by? Who’s accountable. They do not know because they are still making decisions. The cuts are coming and we need to make sure we are united.”

Islington GP Dr Paddy Glacken, who is secretary of the Local Medical Council, which represents doctors, said GPs were calling for the controversial NHS reform bill to be withdrawn. 

He added that the bill was an attempt by the government to remove accountability for the NHS from the health secretary.

“This will let them off the hook when things go wrong. That is unacceptable,” he said. “Duty to provide competition – this makes no sense to us. “It will destroy the trust that is at the heart of the relationship between GPs and patients. 

 “There is just one GP in Islington who is a fundholder, representing less than one per cent of patients. Ninety-nine per cent of GPs in Islington want nothing to do with fundholding.”

Ken: Without the NHS  I’d be fighting for my life

KEN Livingstone, former Mayor of London, told the meeting that had it not been for the NHS he would now be “fighting for his life” following a cancer diagnosis. 

“The NHS is the most cost-effective health care service in the western world. We know what the Tories want. They want to privatise it and all the US private companies are in the wings waiting to make vast profits,” he said.

“The government has no legitimate right to do these cuts. The people who oppose them have every legitimate right to do so. 

“I owe my life to the NHS. I was diagnosed with cancer. If this... hadn’t been there I wouldn’t be here now. I’d be fighting for my life.”