Saturday, 23 June 2012

No A&E in W12: who to blame?

Hammersmith Hospital in Shepherd's Bush
The blame game is on. Who is responsible for the proposed closure of the A&E Departments and downgrading of Hammersmith Hospital in Shepherd's Bush and Charing Cross Hospital in Fulham? Plans are afoot to turn our local hospital and Charing Cross into "specialist centres" with no A&E and significantly reduced capacity. If you needed A&E in our part of the world you would need to be taken to St Mary's in Paddington or Central Middlesex in Park Royal, near the Asda. In both cases it would take much much longer to get there.

As part of my own job I have been trained to a high level of emergency first aid because we tend to go to places where we might need it. And there is a phrase that is drummed into us by the trainers which is the "platinum ten minutes". Meaning, simply, that in many serious emergencies what happens in the first ten minutes can literally be the difference between life and death, or either full or partial recovery. So time matters. 

But do people in the north of the borough matter to our council? A Fulham bias is very clear from the reaction to the announcement from the NHS in North West London. Hammersmith & Fulham has started an online petition - but only to protest the closure of the A&E dept at Fulham hospital at Charing Cross, not the closure of the A&E dept and downsizing of our own hospital. And the Fulham Chronicle is living up to its' name by only being apparently interested in the fate of the Fulham service too.

Our council's priority
That wouldn't be the first time that the north of the borough has been left to one side by either the council or the local media, but what does matter this time around is knowing who is really responsible so that local people who live in these areas know who to protest to.

The local MP Andy Slaughter is very clear on the answer to that question - these are Government inspired closures and he is organising a protest march in Westminster this coming Monday to coincide with a meeting there of local health planning bosses.

Neighbouring MP Greg Hands is also issuing statements against the proposed plans - again only concerned with Charing Cross Hospital - but insisted to me on friday that this did not mean he had to resign his position as a member of the Government. These were not Government initiatives, he insisted, but local NHS bossses who needed to be opposed. That is also the line of our council.

Of the two Andy is right and Greg is plain wrong. The plans are being put forward because the local NHS has to find around £1 billion of savings over the next three years. That was made very clear by the NHS themselves when they launched the plans at the end of last year, under a banner called "Shaping a Healthier Future". The NHS in our part of the world is broke, basically. And under ruthless discipline that started under the last few years of the Labour Government and which has been continued under the coalition, the NHS has been told it isn't going to be bailed out. So cuts there are.

Speaking in February this year Dr Anne Rainsberry, Chief Executive of NHS North West London and Senior Responsible Officer for the programme, said:
“There will be some difficult decisions to make but unfortunately no change is not an option. This is all about providing the best possible care for our patients and saving lives.”
In fairness to the coalition if they did just bail out the NHS and save these hospitals there would be no incentive for the financially irresponsible bosses of the NHS not to simply rack up massive debts again. And Andy needs to accept that this happened under the last Labour Government, despite massive amounts of money being poured in. But we are where we are -and what matters now is that at least part of the cost of imposing financial discipline looks like it is going to be paid in local people's lives.

Unless they can be persuaded otherwise.


  1. What is wrong with taking longer to reach other, larger hospitals for A&E departments?

    Unlike smaller ones, they can have 24-hour, 7-day access to the most advanced diagnostic equipment, and always on-duty consultants and medical staff who have a higher work-load, so can develop greater expertise.

    Less patients therefore die.

    Once a victim is in an ambulance, they can be stabilised, and the extra journey time is unimportant. Paramedics have replaced "scoop and shoot" collection of patients by old-style ambulance drivers.

    Yes, it may be more difficult for visitors to reach hospitals, but that is unimportant in comparison with the benefits.

  2. ...and where will the Ambulance be travelling from to get to the casualty? Why, the hospital that is now much much further away of course! Thank goodness our roads are always clear.

  3. West Middlesex - where the hell is that? Is it even in London?

  4. I live in the London Borough of Hammersmith & Fulham. It is fast becoming the super Borough of Kensington & Chelsea, Westminster, and Hammersmith & Fulham.

    Unfortunately I live in the north of the Borough and Shepherds Bush has always been the poor relation. But don't worry they'll find a way to keep us alive to pay our council tax.

    I just hope our overpaid council leaders realise that they just might need an A&E department on a day that Hammersmith flyover is closed, Fulham and QPR are playing at home and both Shepherds Bush Green and Hammersmith Broadway are gridlocked.

  5. "What is wrong with taking longer to reach other, larger hospitals for A&E departments?"

    A lot, if you have had a cardiac arrest or a stroke, or many other conditions such as acute asthma attack or diabetic incident, as speed is essential and has a significant effect on mortality rates. Traffic in the area is such that theoretically short distances can take a great deal of time and having done an almost interminable journey in an ambulance from the Bush to Chelsea and Westminster, I am seriously concerned about these proposals. It is ridiculous to be planning to remove both Hammersmith Hosp and Charing X A&E.
    It would also help though if people did not abuse A&E services with unecessary visits that do not require emergency care.

  6. the facts and figures back shutting down the multiple centres and condensing them into more specialised hospitals.

    London Already has more hospitals than it needs, but this sort of subject is a red rag to people who have no idea what they're talking about.

  7. Condensing them into more specialised hospitals?????Follow this logic to the Nth degree and we'll just have one super hospital for all of London.And while you're at it why not have one super Borough Council to run all of London.

  8. "What is wrong with taking longer to reach other, larger hospitals for A&E departments?"

    "A lot, if you have had a cardiac arrest or a stroke, or many other conditions such as acute asthma attack or diabetic incident, as speed is essential."

    No, speed to hospital is not vital in any of those cases. All of them can be dealt with by paramedics, and stabilised patients can then delivered to the nearest big hospital. Ambulances are mobile hospitals nowadays.

    The worst case is to admitted to a small, local hospital, which has limited resources, at the beginning of a weekend. Abandon hope.

    We need only a handful of stroke hospitals in London in fact, and a handful of heart hospitals for the worst cardiac arrests. Taking dying footballers to local hospitals is not a good idea.

  9. "The worst case is to admitted to a small, local hospital, which has limited resources, at the beginning of a weekend. Abandon hope."
    SO what are the proposed urgent care centres for then?