High profile NHS panel struggles to present case for A&E closure

Just back from the public meeting in Hornsey with Rachel Tyndall, Chair of the North Central London (NCL) review panel, the body that has put forward the proposals to close the Whittington A&E, and Richard Sumray, Chair of Haringey Primary Care Trust.

The huge meeting hall at the Greig Academy was packed and many people had to stand. Every single seat was taken.

Mere platitudes

Both Rachel and Richard clearly struggled to rise above mere platitudes and present the case for the proposed A&E and maternity closures at the Whittington convincingly.

Yes – there was a lot of talk of “change”, “efficiency” and providing “world-class services” but unfortunately very little substance. They failed to provide any real data on why it makes financial sense to close the A&E or how patients would benefit from this change.

The only specific data we were given was regarding patients suffering a stroke and how being cared for in highly specialist units, not an average A&E, would improve their chances of survival. But, as a clinician in the audience pointed out, this data only referred to a certain, narrow condition which was easily diagnosed and which would only affect a very small number of A&E service users.

Patronizing clinician

Rachel and Richard had brought along their own clinician to answer specific questions. I didn’t catch her name but that is probably for the better. She managed to alienate even the more moderate members of the audience by claiming that even if the Whittington A&E closes patients will be able to get to hospital in time as long as they participate in the transport and in identifying their condition.

My question about infant mortality rates

I managed to ask my question to the panel which was about how the closure of the A&E and maternity services at the Whittington would affect the health inequalities we suffer in Haringey, in particular the infant mortality rate of 8.1 deaths in every thousand births. The rate in Haringey is roughly three times higher than in Richmond.

Rachel answered that infant mortality was not so much influenced by giving birth. On this issue they would need to work very hard on ante-natal care. After the close of the meeting I followed up on this point and asked how ante-natal care, which for me is currently provided by a team of midwives based at the Whittington, would be provided if the maternity unit would be closed. The answer was that the midwives would still be based at their hospital, for example UCLH, and provide ante-natal care in the community.

I struggle to see how ante-natal care and consequently the infant mortality rate will be improved if midwives have to travel longer distances to work in the community. There is a well-known shortage of midwives in the UK. In fact there is a protest in Whitehall on Sunday calling for more midwives.

Will consultation mean anything?

Crucially, Richard failed to re-assure the audience that a planned consultation on the closure plans would actually be able to influence, and possibly prevent, the decision to close the A&E. Despite being pressed on a number of occasions the most honest answer he could muster was that “no one could ever say what will happen after a consultation.”

I came to the meeting hoping to get some clear answers. Instead I am left in dismay that the plans seem to have no basis on evidence or thorough analysis of data whatsoever. So what’s behind it all?

Great people – moving stories

The good part of going to the meeting was that I got chatting to a number of really nice people all of whom had a very personal and moving story to tell about the Whittington.

To the nice lady who sat  in front of me and is due to give birth at the Whittington in August: I didn’t catch your name but thanks a lot  for asking for the link to my blog and thanks for reading 🙂

Lynne Featherstone has just posted a really good summary of the meeting on her blog.