It’s time to open up

Published: 23 April, 2010

• MARTIN KLUTE Klute noted that NHS Islington’s chief executive seemed to regard herself as sole decision-maker regarding the proposal to close Whittington Hospital’s A&E (A&E: it’s about more than one bureaucrat’s decision, April 9). We agree that decision-making by an NHS bureaucrat is neither democratic nor necessarily correct.
Until recently, NHS Islington has been niggardly in providing information about itself and its responsibilities. We were about to request such basic information when last month it sent out dozens of copies of Your Guide to Local Health Services in Islington. Although it gives useful summary information about healthcare organisations in Islington it gives barely any about itself.
Much about the organisation of local branches of the NHS is far from clear to the public, for example, the extent to which services have been or are being outsourced and privatised.
One may also wonder whether, after commissioning other organisations to provide various health services, NHS Islington still needs to have departments nominally in charge of them. Are the numbers of headquarters staff reduced when it no longer runs services itself?
How much is being paid to fix contracts with independent bodies, involving salaries of lawyers and accountants, so incurring additional (many would feel unnecessary) NHS expense? And does the NHS select and pay for their accommodation and equipment ?
It was surely remarkable that, when it was proposed to close Whittington Hospital’s A&E, we learnt about this from the Tribune rather than from NHS Islington. NHS Islington claims that a consultation about this took place five years ago. So few people have any memory of it that it must have been very poorly attended or singularly unimpressive. Although the closure must have been under consideration since 2007, as one consequence of Lord Darzi’s plans, the public was not kept informed about this possible development.
I do not recall any formal consultation about the modernisation of Finsbury Health Centre until after the announcement that it should be sold off because it could not be afforded.
It certainly merited consultation, now only being achieved following widespread strong and continuous protest.
Since we all pay for our health services through national insurance contributions, we should have a significant say about how our money is spent. We have not delegated this responsibility to an unelected local boss whose judgement is fallible. For NHS Islington to become more transparently accountable and trustworthy, it needs to provide us with more information about itself, and to consult before considering major decisions which affect us all. 
ANGELA SINCLAIR-LOUTIT
Islington Pensioners’ Forum

• LIKE many others I kept an eye out on the leaders’ debate last week.
My main focus was health and the NHS. Nick Clegg repeated his very clear condemnation of closures and repeated the promise to keep A&E and maternity departments open. 
Gordon Brown looked on vacantly and proceeded to ignore the issue. One-nil to Mr Clegg in my book. 
So far, the Greens are the only other party to unequivocally call for the retention of the A&E and maternity departments at the Whittington. Unlike the Lib Dems, the Greens are clear that the issue is also one of stopping the creeping privatisation in the NHS.
After the recent Tribune article about “Operation Save Emily”, I couldn’t help but be struck by Mr Brown’s appearance in Islington on Sunday. Having fallen to an ignominious third place in the polls, was he hoping some of Emily’s sparkle would rub off on him? 
For her part, I presume she pressed him heavily about the Whittington. So far, it looks like he has given Emily, and us, the cold shoulder.  
With only a couple of weeks before we go to the polls, let’s hope that Mr Brown can reverse the apparent decision to make cuts at the Whittington. 
RICHARD ROSSER
Highbury New Park, N5