Brent Council shrinks from outright opposition to Central Middlesex A&E closure

The Brent Health Partnerships Overview and Scrutiny Committee last night approved a response to 'Shaping a Healthier Future' which fell far short of outright opposition to the proposals which will mean the closure of Central Middlesex Accident and Emergency.

Although the response contains many reservations about Urgent Care Centres,  community care and transport issues the overall conclusions are anodyne:

Overall conclusions

5.1 The Brent Health Partnerships Overview and Scrutiny Committee believes a strong clinical case for change has been made by NHS North West London and that health services need to be reconfigured to secure better outcomes for patients. This will mean that difficult decisions will need to be taken, but to “do nothing” is not an option and it is in everyone’s interests to ensure that services in London have a sustainable future.

5.2 That said, we urge the Joint Committee of PCTs to consider the following points when making its decisions regarding Shaping a Healthier Future:

(i). Efforts need to be focused on successful implementation of the borough’s Out of Hospital Care Strategy and ensuring this is properly resourced before the reconfiguration of acute services.  Changes to the acute sector are dependent on this – cost shunting, or under resourcing out of hospital care would not be acceptable to the council and will lead to a worse service for patients escalating costs in the acute sector.

(ii). That services to be provided from Central Middlesex Hospital are confirmed as soon as possible. Work should begin with local communities to spell out what the future is for the site so they can be reassured their health and wellbeing won’t be adversely affected by the changes.

(iii). That Shaping a Healthier Future emphasises to TfL the conclusions relating to

transport set out in paragraph 4.11 above.

Earlier in the meeting committee members had subjected Care UK to a grilling regarding the loss of x-rays  and child protection procedures at the Central Middlesex UCC and the time they had taken to answer complaints.  Care UK told them that the problems had been caused by high staff turnover, a large number of interim staff and a failure to recognise the importance of the issues. Cllr Helga Gladbaum stressed the importance of safeguarding children in the brough with its history of cases such as Victoria Climbie, Care UK said that staffing was being stabilised, protocols were in place and there was robust auditing and monitoring. Cllr Sandra Kabir said it was astounding that Brent had not ended up with a terrible disaster on its hands. Dr Sarah Basham, representing the Brent Clinical Commissioning Group said that they had found Care UK willing to listen and learn from each other and they had been open and willing to meet. GPs ere aware of the situation and a feedback mechanism was in place.

There was a lively debate, mainly conducted at a comradely level between councillors apart from a tetchy spat between Cllr Gladbaum and deputy leader Cllr Ruth Moher, on public health. Local councils have now taken over public health functions from the NHS and a proposal had been made to appoint a Director of Health to be shared with the London Borough of Hounslow. The proposal goes before the Executive on Monday.

Phil Newby,  Director of Strategy, Partnerships and Improvement, moved a report advocating such an appointment in a long speech rich in rhetoric but short on substance. He wanted an evangelical leader to drive policy and change. Questioning revealed that the Director would have no budget and would not be part of the Corporate Management Team. Simon Bowen from Brent NHS addressing the committee said that such a 'part-time'  post-holder would be weak and marginalised and it would be hard to recruit to the post. The post was statutory and subject to guidelines. He said that Brent had been transformed in the last 5 years while Hounslow was 5 years behind it. Brent's gains would be put at risk by such an appointment.

Newby defended his report saying that the current Hounslow post-holder had just been given a new job in Croydon and that innovative strategies would be welcomed.

The Committee agreed to recommend to the executive that while they supported mainstreaming public health in the body of the Council that they had serious concerns over sharing a Director with another borough.