Hospital’s prime site just what developers ordered

• WHITTINGTON A&E must be saved despite some criticism it has received on an internet blog. If complaints are about staff, facilities or equipment, that can be adjusted. But if this hospital is downgraded and eventually closed and demolished like the Royal Northern in Holloway in 1992 then that is the end. 

There will never be another hospital in that space. It will be sold off at the usual knockdown price to property developers. Take a look at the shoddy housing they built on the site of the old Royal Northern, wander into the tiny Royal Northern Gardens where the war memorial is and take a look at another memorial to the Royal Northern, the saddest of all – a piece of wall that once formed part of the excellent St David’s ward. It is much like wandering among the headstones in a cemetery. Dr Albert Rinsler, author of An Illustrated History of the Royal Northern Hospital, 1856-1992, adored this hospital with its magnificent architecture. A sad obituary. 

The Whittington occupies some of the most expensive land in Highgate. It is next to open spaces like Waterlow Park and the museum-like Highgate Cemetery. Ten minutes walk beyond that is Parliament Fields, within Hampstead Heath. More humane governments in the past felt that the ill deserved better surroundings. The Whittington is one of the last hospitals in a fine environment.

 Look at newish University College Hospital in central London, surrounded by traffic-choked streets. Look at the equally newish Royal Free, crushed into a small space that once contained  a small hospital with beautiful lawns, now left with a couple of green spaces that would scarcely serve the average house.

 Going back even further to the early 1950s, Swiss Cottage once had a hospice surrounded by equally beautiful lawns. Then it was gone, to build the grey, crushed-in Swiss Cottage Library and swimming pool. More recently, that ship-like block of private flats has been added to the crush. A postage stamp of green is all there is left. The hospice? Up some side street. 

Has any of this improved the quality of life. You must know the answer to that.

WILSON JOHN HAIRE
Lulot Gardens, N19

• AFTER the two packed protest meetings at Archway chaired by MP Jeremy Corbyn hundreds of Islington and Haringey people continue to sign petitions objecting strongly to the proposed closure of Whittington Hospital’s A&E. On Monday, campaigners protested to Islington Council’s health and wellbeing committee, many of whose members already share their views. But no conclusions were reached, and the situation will be reviewed in the future.

This proposed A&E closure is only a forerunner of several others in north London. Hospitals admit around 30 per cent of inpatients from A&E, so closure results in a hospital’s greatly reduced intake and allows its downgrading to “local hospital” status. This is part of former health minister Lord Darzi’s plan to “reconfigure” the NHS. In place of large hospitals he aimed to introduce polyclinics – basically enlarged health centres with a wide range of medical services, thereby avoiding many hospital admissions. It is less widely publicised that Darzi envisaged the new polyclinics inviting commercial companies to apply for staffing positions, thus further infiltrating the NHS with privatisation, a feature which he regarded as desirable although a vast majority of the public does not.

There is a reasonable case for reducing the role of hospitals in favour of semi-localised polyclinics nearer people’s homes. But we should consider why GPs must refer many patients to A&E. Surely they are often obliged to do so because modern medicine relies heavily on diagnosis, which frequently requires laboratory analyses or expensive diagnostic equipment such as X-ray or CT scanning apparatus. Such facilities are too costly to be provided by GPs or semi-local  centres. Will they be so fully equipped? We have not been told. If they will, it will multiply formidably expensive provisions; if they will not, polyclinics will be obliged, like GPs now, to pass patients on to a fully equipped hospital. If the Whittington’s A&E closes, patients and ambulances would have to travel to the Royal Free or University College London Hospital, whose A&E capacities are already very busy, while ecologically undesirable journeys to reach them would take longer.

Another administrative change envisaged is the creation of “urgent medical treatment” centres, probably alongside the old A&E premises but open for many fewer hours instead of providing a 24-hour service.   

Adaptation and modernisation of the NHS may be desirable, but on several conditions: that they do not forsake the basic principles of the NHS; that they are understood and approved through democratic consultation; and that they simplify rather than add costly complexity.

ANGELA SINCLAIR
N5