Wednesday, 29 July 2015

Update on Charing Cross Hospital

I have had a series of meetings on the future of our local NHS, and Charing Cross Hospital in particular, in the last two weeks. These have ranged from seeing the management of Imperial Healthcare Trust, who run Charing Cross, Hammersmith and St Mary’s, to the long-awaited meeting with the Department of Health on the whole ‘Shaping a Healthier Future Programme’ – the blueprint for A&E and other acute service closures across west London.

Jeremy Hunt still refused to meet us as he has for two years – despite there now being 12 MPs anxious to lobby him on the effect of the closure programme. But we did see the hospitals minister, Jane Ellison, and all the leading NHS bureaucrats in charge of the project. This is what I learned.

• They are still intending to go ahead with the demolition of Charing Cross and its replacement with a small primary care/ elective surgery ‘local hospital’.

• The timetable is slipping. The business case – ie funding for the scheme -may not be agreed until 2018. Hence their decision to move all stroke services from St Mary’s to Charing Cross for at least five years – so no demolition until at least 2020.

• The business case, in fact the whole project, looks increasingly rocky. It will require at least £1 billion in capital and £250m in implementation costs. £500m is for St Mary’s rebuilding alone, and another £150m for Charing Cross.

Frankly, I can’t see this ever happening. It is another white elephant scheme like Paddington Basin. The difference here is that for all the public money and input of time and effort (much of the cash going to management consultants) the end result would be a smaller, less comprehensive NHS. The whole thing is quite mad.

If I am right, Charing Cross will still be there for them to attempt to close again in 20 years’ time (remember the last attempt was in 1992). The logic of keeping it (and Ealing Hospital) is remorseless. Population is spiralling in west London with 50,000 new homes planned just in H&F. Our health needs grow more complex, especially as the population ages. The primary and community care services that are supposed to reduce demand for acute hospital services are vestigial and will never replace the need for A&E services (not my view but that of the College of Emergency Medicine).

But this doesn’t mean I’m optimistic for the future of the NHS – just like the reorganisation that the Coalition Government inflicted on it, this rebuilding programme, even if it never happens, is a huge distraction and opportunity cost and staff are voting with their feet to go elsewhere.

Meanwhile, there was still no sign of the report into the effects of the Hammersmith and Central Middlesex A&E closures on waiting times at Charing Cross and elsewhere, six months after it was supposed to be published.

A Parliamentary Question from me [http://www.theyworkforyou.com/wrans/…] elicited the response that it had been quietly slipped onto the NHS England website [http://www.healthiernorthwestlondon.nhs.uk/…/gb-14-july-ite…] a few weeks ago – hidden in plain sight.
No one was told about it, indeed Imperial denied they knew anything about it.

You can understand why – it showed even a small change in demand threw the remaining A&Es into chaos before Christmas [http://www.standard.co.uk/…/revealed-northwick-park-hospita…].

These were two small part-time or under-resourced A&Es. What would happen if they did close the major services at Charing Cross?

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