I was shocked by the leaked letter (see my earlier post) that showed the Whittington would lose it’s A & E department under all four options being put forward for the reorganisation of health services in what is called London North Central (LNC) Sector of the Strategic Health Authority (Islington, Camden, Barnet, Enfield and Haringey).

I had not been reassured by the hasty press release by LNC saying that the first letter had been confusing and re-issuing a version which changed the Whittington’s fate to being designated a ‘local hospital’ in the options rather than mentioning A& E at all.

‘Local Hospital’ if you look up its meaning on the Department of Health website means that A& E would be reduced to effectively ‘urgent care’ for between 8 and 16 hours per day with no emergency surgery on site. Given the level of need locally – the idea of people having to travel to the Royal Free which has appalling public transport access – does not seem to be designed with local people in mind at all.

Moreover, Haringey which doesn’t actually have a hospital, relies on both the Whittington and The North Middlesex for A & E – and the North Middlesex’ A & E is also under threat in one of the current four options.
Anyway – today I had urgent meetings with both LNC (Stephen Conroy) and the Chief Exec of the Whittington (Rob Larkman) – separately. In terms of LNC – Mr Conroy was very keen to emphasise that nothing was final, that options were still being discussed and drawn up, that no decisions had been taken – and that the options (whatever they ended up as) would go to the Review Panel in December and pre-consultation in January. To avoid the elections – the public consultation on the options would be in September 2010. So if the letter hadn’t been leaked – local people would not have had any say before the election.

The proposals are all around what should be provided where and which of UCH, The Royal Free, Barnet, North Midds, The Whittington and Chase Farm would become ‘major acute’ hospitals and which local.
When I pushed for assurance that the 24 hour A & E service at the Whittington would not be terminated – Mr Conroy could not and would not give that assurance.

I also asked him what autonomy and status the Whittington Board had in all of this. From his answer it is quite clear that whilst the Whittington Board’s opinions are important, they are considered ‘organisationally loyal’ and when looking at the bigger picture of service needs in the ‘sector’ it would be the LCN who would take the decisions.

We also pushed (I was accompanied by Cllr Nigel Scott, LibDem local health spokesperson and Ed Butcher, my Head of Office) for openness and transparency about the processes. We are concerned that by the time there is a wide public consultation (as I said – after the election) – the basic decisions will have been made. That first letter stating that the Whittington would have no A & E even though withdrawn – has left its mark – and I can’t help thinking that where there’s smoke….

It has also been pointed out to me that the Whittington sits on top value land – and that letting the hospital wither on the vine of ever reducing services might at some point enable land sales to a cash-strapped Strategic Health Authority – I hope not!

At the subsequent meeting at the Whittington Hospital, Rob Larkman (CEO) said that they had been shocked too by the letter stating that A & E would not be provided in any of the options and that it was his challenge on that letter that had forced LCN to put out the second letter.

In fact I think the Whittington Board may, to an extent, be an ally of local people in the fight to retain A & E and maternity and obstetrics. The Chair of the Board was also in attendance at this meeting and he said that the Board also fought for what the local community wanted and needed.

So to me, the crucial issues are not the labels that LNC may wish to give their new configurations of major acute, acute, local and so on – the key is still keeping important services like 24 hour A & E and maternity and obstetrics local at the Whittington – whatever the configuration.

I made it quite clear that I would, apart from keeping in close contact with what is happening, make sure that local people are kept informed about what is going on and about what I regard as a real threat to both the 24 hour A & E and the continued provision of maternity and obstetrics at the Whittington – and that I would be campaigning along with my Liberal Democrat colleagues in Haringey and Islington for what local people want and need.