Friday, 8 February 2013

Charing Cross: Dust settling but questions remain


Last night I was contacted by an official from Hammersmith Council who was excited. Very excited. As well they might be since they were sitting on potentially momentous news which was, as we now know, the saving of Charing Cross Hospital.

Or has it been? Moments after the press release had found its way into meejah inboxes the Council's cry of victory was echoed by the Chronicle and a local blog from the W14 area. It was, they all cried in unison, nothing short of total victory, and people should dance in the streets.

OK I made the dancing bit up.

Yet a bit later that evening some rather awkward questions began to be asked by the residents campaign which has led local action to save both Charing Cross and Hammersmith hospitals. Those carrying the banners, had rallied and who had marched the streets of the borough, were less than convinced. And less than happy that they'd been kept out of the picture too.

Being kept out of the picture by the Council was perhaps inevitable once the Opposition had abandoned the cross party approach that characterised the early stages of the campaign. But the factual questions being asked were really quite important.

Why, they asked, having made contact with the NHS NW London Business Director themselves, did NHS NW London claim not to know anything about the deal being trumpeted by the Council? Was it really the done deal that the Council had described? And why, they wanted to know, did it appear that despite a £90 million investment into the hospital, was it set to lose 440 beds, going from 500 to 60? How could that be called "saving" the hospital?

Even reporting these questions drew particularly venomous responses from local Tories who happened to be as sad as I was and online at that time in the evening. The questions were part of a Labour Party plot to be disingenuous and all part of nasty Andy Slaughter's machinations, said Cllr Peter Graham. Political debate in this borough has always been robust, but there was real not just synthetic anger on both sides this time.

So what of the beds? And the status of the hospital?

The Evening Standard is reporting that the truth lies somewhere in between, essentially. And speaking to Council officials in the cold light of this morning, that more or less seems to be the case. Here's what a spokesperson told me earlier today:
"Last night at 7pm leading officials from NWL NHS informally met with eight boroughs which form  the 'Joint Overview and Health Scrutiny Committee' . H&F was represented.

NWL NHS told the eight boroughs that they are proposing to its own Board (which will meet on Feb 19th) that £90m will be invested into CX, there are also major concessions on emergency facilities.

The proposal wil be formally published on the 15th of February.

NHS NWL officials also told the eight boroughs that CX will continue to treat between 80-90% of H&F patients who currently use the hospital.

We think this is pretty momentous considering where we were a month ago - ie the hospital was set to be substantially downgraded to little more than a polyclinic.  NHS NWL told the eight boroughs that CX will have specialist status and will retain its teaching status".
I'm inclined to agree. But I pressed him on how sure they could be that a "proposal" would actually translate into actual policy? And what about the 440 beds being lost, was that true?

On the status of the "proposal", he said this:
"Yes, you are right that this is a proposal but it's a proposal made by NHS NWL to its own board - ie it carries a lot of weight".
Hmm. The formal board papers would be published next Friday and the actual decision later on. So why rush the announcement out, before it's actually confirmed and moves beyond proposal status to actual policy? The only answer I can think of is to put one over on the residents campaign, and specifically the Labour Party who have supported it. If they had waited then they could all have welcomed or debated it together - but the politics have been so soured recently I guess they saw this as a chance to claim the credit.

On the loss of beds he spake thus:
"On the issue on what is there and isn't there, we need to see all the details but we have reported on what we do know, ie major concession on existing A&E so it will continue to treat two out of three existing people (ie Lewisham model) - it will retain many specialities and it appears add a new speciality around social care. NHS said last night that nearly nine out of ten people in H&F who currently use the hospital will continue to use it".
And on the big picture he gave me a thoughtful response which does make a lot of sense to me, and so I share them with you to give you a sense of the Council's reasoning:
"Have we got everything? Probably not. Will it be identical to what is there now? No. It may be smaller with focused specialist services but everyone concedes that the NHS had to change. What we are saying is that the community has secured the future of the hospital and that is quite some achievement given where we were a month ago. The Council thinks that accepting no change would have resulted in the worst possible outcome, ie the orginal 'Plan A' to substantially reduce the footprint to something like 4,000 sq metres. The new recommendation is something like 4 times bigger so it would really be a local hospital for local people treating nine out of ten people who currently go there."
So the Standard seems to have called it just about right - somewhere in between what the Council announced and what residents campaigning feared.  I won't make myself popular with the campaign when I say on balance I can see where the Council are coming from in striking a deal, compared to the alternatives. I think they've probably done the right thing. And, whatever the political machinations around the announcement might have been, that's the thing that matters most to residents.

It doesn't, of course, answer the fact that Hammersmith Hospital in our part of the borough, is now toast. We live on average eight years less than our Fulham dwelling counterparts, and this news does little or nothing to address that. And would you want to be the heart attack patient relying on an ambulance driver being able to squeeze down the Fulham Palace Road? Perhaps that's a debate that all sides can come together to address now. 

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