A&E closure a step towards bigger role for private firms

Published: 5 March 2010

• LAST Saturday’s demo in support of Whittington Hospital’s A&E may have startled NHS Islington and NHS North Central London by its numbers, estimated at 3,000 to 5,000. Surely this was numerous enough to drive them to think twice, and plan only tentatively before a belated consultation in September. I fear, however, that between now and the autumn the authorities may be obstinately proceeding with considering their four already-formulated future policy options; only one of these envisages continued approval of a fully-functioning Whittington A&E.
As letters to the Tribune show, many readers’ protests are mainly motivated by personal positive experiences of the Whittington’s A&E services. Some were life-saving because of the hospital’s proximity to their homes. It’s not clear how many protesters realised that this closure is only the first of many proposed for north London. All are aimed at downgrading hospital services in favour of a range of polyclinics yet to be created.
The Whittington A&E closure seems ridiculous because it follows by only a few years the hospital’s extension and modernisation, at the expense of a huge private finance initiative loan, to bring it up to a high standard as one of London’s major (and student-popular) teaching hospitals. Does the NHS’s right hand know what its left is doing?  
I hope a growing number of local people realise this proposed closure is not merely excused as a regretted reaction to the need for economies. It is a deliberate step towards the implementation of ex-Health Minister Lord Darzi’s plan to “reconfigure” the NHS. The huge changes Lord Darzi recommended deserve widespread publicity and explanation, plus detailed consultation, before being allowed to proceed in the direction this expert knee surgeon regards as desirable. They are set against the comprehension and acceptance by a huge majority of the public of the NHS as organised at present – in spite of its admitted deficiencies.
Many may agree with Lord Darzi about the desirability of bringing a wider range of health services nearer to people’s homes, thereby reducing demand for hospital beds. But it is far from clear that the 100 or so polyclinics which (I have read) are being proposed for London could provide a viable range of services usefully supplementing those of GPs, or those cases which our GPs refer to A&Es, either for emergency care or use of their costly diagnostic equipment such as X-ray, imaging and lab analyses.
Imagine you are at home suffering perhaps suddenly from acute pain. Should you, as you would now, contact your GP, or is the pain so acute you reckon you should go straight to your nearest A&E? Why might you consider any intermediate solution such as going to your nearest polyclinic? You might well feel worringly confused about which option to choose.
What we do know about polyclinics is that they will invite the participation of private organisations and staff, thereby outsourcing NHS provisions. Richard Rosser (Letters, February 19) points out that Britain is required to do this by having signed up to the Washington Consensus (have any readers ever heard of this?), GATT and the World Trade Organisation, “whose objectives of hiving off our public services to private providers via outside tendering” are principles now enshrined in our law.
If Mr Rosser is correct, this policy could undermine basic principles of the NHS. A significant part of health services might in future be driven by private enterprise, whose providers’ main aims are profitablity rather than response to public need. It is perhaps a desirable objective of modernised health provision to localise a wider range of health services. But it’s quite another to allow the intrusion of yet more privatisation into the fabric of the NHS, changes which compromise its crucial role and character.
If you are not rich enough to pay for expensive private health care, your life may depend on the NHS. So consider joining Keep our NHS Public.
ANGELA SINCLAIR-LOUTIT
Islington Pensioners’ Forum

• I WAS at the march to save Whittington Hospital. It was great to see so many residents turning out to make their feelings clear.
Apart from being surprised at there being practically no speakers except Labour MPs, I was struck by how all of them avoided the key issue: why the Whittington is under threat.
All they seemed to do was blame “NHS managers”. But who manages the NHS? Surely their own Labour government ministers?
This public hand-wringing while pretending the threat to the Whittington is nothing to do with the government is outrageous. If they really want to stop the threats to the Whittington A&E they surely have the power to do it before the elections? The question is: will they have the courage to take on their own Labour government and fight for local people and services? Or will they just insult our intelligence by pretending it’s nothing to do with them?
ANNA HABERMAN
Newington Green Road, N1

• YOUR campaign to save the Whittington’s casualty unit has been nothing short of inspiring.
For thousands to take to the streets in defence of this vital service demonstrates the strength of the cause.
However, I feel some politicians are merely jumping on the bandwagon, motivated solely by cynical electioneering.
Not a week goes by without some variety of Liberal Democrat popping up in your pages to offer hand-wringing, heart-melting platitudes in a vain effort to convince voters that “they are on our side”. Such an effort insults the intelligence of the people who live in Islington.
These people are treating us like fools.
The Lib Dems control NHS Islington. They knew about these plans for a full six weeks but only bothered to appear to take action, or even brief their council colleagues, when they read about the public outrage in local papers.  
I have painful memories of my time as leader of the Youth Council, when the Lib Dems closed youth facilities in Camden Town while simultaneously showering residents with leaflets claiming they were campaigning against the cuts.
It can only be wrong for any party to seek to bamboozle voters in this way.
The Lib Dems have been in the driving seat in Islington for eight years. We, the electorate, have empowered them to stand up for our interests, and for crucial services to the community.
In the words of Councillor Catherine West, leader of Islington Labour group, instead of washing their hands of our troubles they should stand up and take some responsibility.
A little humility can go a long way.
AXEL JOHN LANDIN
Former Youth Council chief
Bramshill Gardens, NW5