Thursday 23 August 2012

Astonishingly, no risk assessment carried out on NW London NHS proposals

The NW London NHS proposals for far reaching changes in health provision have not been subject to a risk assessment despite them involving the closure of four Accident and Emergency facilities, including that at Central Middlesex Hospital, and the down-grading of several hospitals in the area.  The proposals affect 700,000 people.

The revelation was made at the August 2nd meeting of the NW London NHS Joint Overview and Scrutiny Committee on which Cllr Sandra Kabir is Brent's representative. Risk registers are a standard method of assessing the risks on a High, Medium or Low traffic light system, establishing the nature of the risk and who is affected, and the strategies for reducing that risk.  Brent Council has such a scheme in its Corporate Risk Register LINK

Instead the authors of the Shaping a Healthier Future proposals proposed that the risk assessment would only be made AFTER the consultation and when the proposals have been approved. This means that councillors and the general public will have no way of assessing the severity of the risk posed to residents,  which clearly could  be a matter of life or death, during the consultation period. In effect they will be making a response without knowledge of the potential impact of the proposals on people's health and well-being.

The committee was clearly concerned and agreed to 'revisit' the issue at a later meeting.Cllr Lucy Ivimy (Conservative, Hammersmith and Fulham) wrote to a concerned member of the public who attended the meeting:
I agree with you about the lack of a risk register and as you say, for the NHS to produce one only after the decision has been taken is extraordinary. The committee will be looking further into various aspects of risk. I am personally concerned that the full impact of the proposed changes has not been made clear in this consultation process.
A further critical issue was the consultation document's claim that the proposed changes were based on 'tried or tested ways of delivering healthcare' that it claims already work in many parts of NW London and the rest of the county (p20). The two expert witnesses heard by the committee were less sure. Asked about whether the structure worked in other parts of Europe Professor Welbourn admitted, 'there is no evidence the  system will work'. Asked whether it would be possible to deliver the necessary community services involved in the changes, Dr Honeyman said, 'no one knows, no one has ever been here before'.

These revelations show that we are being sold a pig in a poke and it is imperative that the proposals are subject to robust scrutiny at the appropriate committees at the  NW London NHS and local council level. They confirm the need for a broad-based campaign against the changes..


Anonymous said...

What is the point of assessing risk after decisions have been made? Any idiot knows that assessing risk should inform and make for wise decision making.

Anonymous said...

In the operations of disaster captialism as they apply to public service delivery/demolition in the UK, I am reminded of the explanations fallout from the sinking of the Belgrano by the Royal Navy in what became the Falklands/Malvinas War.

In the aftermath of that war, I was told that in emergencies people often make decisions and only come up with rationale for those decisions later. But now reading Naomi Klein's 'The Shock Doctrine: The Rise of Disaster Capitalism', I am more inclined to believe that ideologically blinkered people detached from the lives of ordinary public service users really only regard those public services as cash-cows. See Camden New Journal article "I am not an NHS patient", says new Commissioning Board Chairman Malcolm Grant, for example.

Alan Wheatley
a member of Haringey Green Party