One of the country’s biggest hospital shake-ups is 'deeply flawed' 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.
“It is crystal clear that the impact of fragmentation through privatisation is slowly eroding what was a National Health Service.
"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 Hammersmith & Fulham Council Cllr Stephen Cowan said:
“People across west London have been horrified to see their treasured NHS deteriorating so quickly – and so unnecessarily.
"They have protested, sent in petitions and begged local health chiefs to stop this madness, and are furious that local NHS bosses have ignored them for so long.
"My council colleagues shared this anger, commissioning the Independent Healthcare Commission, and in doing so keeping our pledge to fight for local health services.
“Today’s report from Michael Mansfield QC is a watershed moment. Rigorous, thorough, detailed and rightly independent, the review provides indisputable evidence that these changes to local health services are badly planned, hugely costly and causing life-threatening failures in local healthcare.
"The only sane decision is to put a halt to them right now.”
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.
The report recommends that:
- The programme needs to be halted.
- Local authorities should consider a legal challenge.
- 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.