Consternation at threats to health provision in Brent voiced at Council meeting

Dawn Butler MP for Brent Central took the unusual step of addressing last night's Council meeting on the threat to cut the overnight hours of the Urgent Care Centre at Central Middlesex Hospital. A 24 hour UGC had been promised to compensate for the closure of Central Mid's Accident and Emergency service. She spoke about the distances that would have to be travelled by people needing urgent treatment at night time and the dangers involved.

Cllr Ketan Sheth, chair of Community and Wellbeing Scrutiny, spoke about his Committee's attempt to hold Brent and Barnet Clinical Commissioning Groups to account over their proposals to close the Cricklewood Walk-In Centre and other councillors referred to the Pembridge Hospice closing its doors to new admissions and the financial difficulties of the St Luke's Hospice.

Cllr Nerva said that he was a keen supporter of the NHS but could not stand by while the service was whittled away in front of our eyes. It was unacceptable that people had to wait for more than a year for an operation or that access to a consultant was being reduced. He said other areas were not being affected to the same extent and called for an explanation of how the NW London NHS Trust had got into this predicament.

The motion proposed by Cllr Mary Daly (Sudbury) was passed unanimously:

Our Community. Our Health Care 

This Council notes: 

·      The Government has presided over the longest funding squeeze in the NHS’ history; deepened by cuts to Public Health Services and Adult Social Care. 


·      There are currently over 100,000 staff vacancies in NHS England, including 41,000 nurses and nearly 10,000 doctors. This figure could easily rise to 350,000 by 2030 according to research conducted by The King’s Fund, the Health Foundation and the Nuffield Trust. 


·      There are similarly 17,000 fewer hospital beds now than in 2010. 


·      The impact of Conservative cuts to public services and rising poverty are evident in the new Long Term Plan, with NHS England calculating that socioeconomic inequality causes £4.8 billion a year in greater numbers of hospitalisations. 


·      Nine years of austerity, cuts and privatisation have resulted in nearly 2.8 million people waiting over 4 hours in A&E last year, over 540,000 patients waiting over 18 weeks for treatment and NHS waiting lists growing to over 4.3 million. 


·      The underlying deficit of nearly half of the NHS trusts which provide secondary care to patients referred by a GP is close to £5 billion. 


This Council further notes, the consequences of these swingeing cuts: 


·      North West London Clinical Commissioning Groups (CCGs) face a significant deficit in the forthcoming year, with a projected deficit of £112m. The clinical commissioning group for Brent represents £9m of this debt. 


·      While North West London’s population has grown by 5%, funding is stagnant, and worsened by unplanned emergency care rising by 25%. 


·      In 2018, London North West Healthcare Trust received a second Requires Improvement report from the CQC. 


·      Proposals to merge eight CCGs in North West London into one CCG by April 2021 will lead to yet more re-organisation, change and ultimately disruption to residents. 


·      Public Health funding for Brent services such as smoking cessation and alcohol recovery 
treatment have again been cut by the Government, by £0.5m for the next year.

·      Age UK states there is a “perfect storm” in the Adult Social Care sector with parts facing “total collapse”; with £8 billion needed to stabilise the system and tackle increasing complex care. The latest promised Government green paper on the sector has been delayed at least six times over the last 18 months. 


·      According to the Royal College of Psychiatrists, Mental Health Trusts have less money in real terms to spend on mental health now than in 2012 and the number of mental health nurses has fallen by 4,000. 


·      IFS analysis indicates that if we leave the EU, the public purse is likely to lose enough money each year to fund the whole of NHS England for 3 months. 


This Council believes: 


·      The NHS belongs to the people; it is Labour’s proudest achievement, designed for universal healthcare for all on the basis of need, free at the point of use - the NHS should always have the resource to provide a comprehensive system, where everyone counts. 


·      The NHS should work across organisational and geographical boundaries, to facilitate services for every resident. 


·      The Government has passed the buck with cuts to public services delegated to our local NHS, resulting in a hollowing out of services in Brent and the surrounding area. 


·      Residents and members of the Community and Wellbeing Scrutiny committee are concerned about the stymieing of access to GP services across the borough and upon its boundaries: with Cricklewood GP Centre under consultation to cease its walk-in provision; and Central Middlesex Urgent Care Centre consulting to curtail its hours of operation; and Pembridge Hospice in Ladbroke Grove closing its doors to new admissions. 


·      The reduction of services from Central Middlesex UCC will impact on our poorest residents, without access to their own vehicles, with alternative services involving lengthy journeys by public transport at night, upwards of an hour. 


·      These changes will be felt far and wide across the health economy, as more residents seek support through accident and emergency or via their general practitioner. 


·      The sustained reduction in the ability of the NHS to provide essential services affects everyone, young to old and certainly those most vulnerable.

The Council resolves: 


To work with Brent’s Members of Parliament, to voice our opposition to any future arrangements in which alterations to local NHS services threaten the safety of patients or residents alike, and re- affirm the need for health services to put people at the heart of any future plans. 


Scrutiny Committe unconvinced by assurances on Northwick Park A&E

Yesterday the BBC reported that ambulance crews would have to call ahead to the control room before taking patients to A&E at Northwick Park Hospital because of the pressures on the hospital. Local GPs are being asked to refer patients to other hospitals. It also reported that in September 179 patients had to wait for more than 30 minutes for an ambulance and 30 patients have to wait for more than an hour.

Yesterday at Scrutiny Committee councillors put the NW London NHS Trust under pressure regarding these issues.  In often emollient replies to tough questioning councillors were assured that there was no danger to patients.

Problems were ascribed to an increase in acuity of patients arriving at the hospital with a sustained rise in medical emergency admissions. In other words more Brent people are becoming sicker.

Although the planned increased bed capacity at Northwick Park would not take place until Autumn 2015 the Trust were taking steps to increase 'in year' capacity at Northwick Park by 32 beds and 20 at Ealing Hospital. Ealing had not shown a marked rise in admissions but there had been an increased length of stay for patients.

Measures to cope with the problem included quicker discharge and less DTOC (delayed termination of care).

In a rather chilling statement an NHS officer said that there was no evidence  that the problems were having an  impact on mortality rates. 'Yet...' was what I said to myself.

Summing up the Committee's view, last night's Chair, Cllr Reg Colwill,  said they were concerned about the timescale of the implementation of improvements to Northwick Park and the danger this posed to Brent residents.

The discussion of the repercussions of the closure of Ealing Hospital Maternity ward also centred on capacity.

Councillors were told that the facility was no longer viable and an earlier closure than the two years initially planned was necessary to maintain safe services. Northwick Park and Imperial had the capacity to expand maternity provision without infrastructure work and a maternity booking service would be introduced.  41% of Brent mothers already attend Imperial which includes Queen Charlotte's in Hammersmith. Ealing staff would be transferred to other facilities over a transitional period.

Officers said that current activity in the hospitals was less than the previous maximum and the expected rise in numbers would be within that maximum. there was an expectation that 95% of women would get their first choice of maternity care. The only cap was at Queen Charlotte's Hospital.

Cllr Mary Daly challenged this in the light of the area's rising birthrate. In summing up Cllr Colwill said that the Committee was not convinced that the rise in birthrate had been sufficiently taken into account and remained  concerned about whether alternative provision would be in place in time.

The main discussion on the future use of the Central Middlesex Hospital site following the closure of the A&E, was the transfer of rehabilitation beds from the Willesden Centre to Central Middlesex.  This raises the question of the future use of the vacated space at Willesden.

The plans for moving Park Royal mental health facilities to Central Middlesex are not going ahead. This was because the costs arising from the 'enhancements for mental health service would not be economically appropriate'.

£7m spent on Shaping a Healthier Future consultation

The Daily Mail LINK has revealed that the NW London NHS Trust consultation cost £7,000,000. It seems that at national and local government level PR companies are one of the main beneficiaries  from austerity as those in power seek to dress up cuts decisions already made with spurious and meaningless 'consultation' exercises. In the case of Central Middlesex Hospital keeping the A&E open  was never an option the public were allowed to choose. Moreover with no risk assessment  in the public domain respondents had no way of assessing the true human cost of the changes. A shameful waste of public money. With so few turning up to consultation meetings it would be interesting to know the cost per attendee.

Meanwhile in Brent the PR bill for the Willesden Green Redevelopment project continues to mount as plans are tweaked but no ground given on the fundamentals.

When I worked for Erwin Wasey, Ruthrauff and Ryan Limited, an advertising agency, in the 1960s, I asked about a job in their Public Relations Department. In the interview I was naive enough (I was only 16) to say that I thought I was suited to work in PR because I got on with people. The director who interviewed me exploded and said, "Well you shouldn't work in PR then. You have to hate people and hold them in  contempt if you want to do well in this business."

David Cameron worked in PR for Carlton Television in order to have some experience outside politics. He got the job because his then girlfriend's mother, Lady Astor, had a word on his behalf with her friend, Michael Green, who was executive chairman of Carlton. He started on a salary of £90,000.

Brent LINk vote against Central Middlesex A&E Closure

After a debate between Dr Mark Spencer of NW London NHS and Graham Durham of the Brent Patients Campaign, Brent LINk members and any public attending, voted to oppose the closure of Central Middlesex A&E. There were two abstentions and no votes against.

In the course of the debate Dr Spencer repeatedly failed to answer Graham Durham's request for him to explain why he had stated in a BBC interview before the consultation began that four Accident and Emergency units would have to close in NW London.  Dr Spencer also admitted that despite the rise in the number of children in Brent schools and the importance of child health, that schools, headteachers and governing bodies had not been consulted.

There will be another chance for the public to make their views known when the 'Shaping a Healthier Future' roadshow comes to Harlesden Methodist Church on Saturday September 29th. The Q&A session will be from 11am until 12 noon.

Will Sarah Teather MP  come and hear what her constituents have to say about the proposals so that she can champion their views in the House of Commons?

Northwick Park accounts for 92% of all redirected A&E admissions

Doubts about Northwick Park Hospital  A&E Department's ability to cope now, let alone when other NW London A& E departments are closed have been reinforced by data published after a Freedom of Information request.

Between February and August 16th 2012, there were 49 requested redirections of patients to other hospitals. Of these 45 were from Northwick Park, usually to Central Middlesex which is of course ear-marked for closure. In addition Northwick Park transferred to Ealing, St Mary's, Hammersmith, West Middlesex and Hillingdon. 92% of all redirections were from Northwick Park. Hillingdon and West Middlesex had two planned redirections each. Central Middlesex none.

Without a risk assessment this NHS consultation is nonsense

The Coalition Government's failure to make public a risk assessment carried out on the NHS reforms created a huge controversy.

NW London NHS has gone one step further by refusing to carry out a risk assessment on the changes to the local health service and hospital provision it proposes in 'Shaping a Healthier Future'. Instead they will do so AFTER the consultation, which means of course that individuals, patient groups, GPs and local councils will not be fully informed of the risks when they submit their views.

What kind of democracy is it when you are unable to put forward an informed view because the decision maker won't carry out a vital assessment of the impact of proposed changes?. Changes which could be a matter of life or death

In case you missed it Rob Sale had a letter published in local papers last week about the issue:

We are writing to alert your readers to the way those pushing through the ‘Shaping a Healthier Future’ changes to our NHS, including closure of the four A&E departments, are refusing to produce a ‘risk register’ for the stated options until after the ‘consultation’ finishes on the 8^th October and the decision has been taken.

This became clear at a meeting of the Joint Overview and Scrutiny Committee of the eight local councils affected by the proposals held on 2^nd August in Harrow. The Vice Chair of this committee is Brent Councillor Sandra Kabir.

Preparation of a risk register, listing key risks with possible mitigation factors in clear tabular form is a standard tool used in assessing the pros and cons of courses of action. Brent Council has such a scheme in its Corporate Risk Register.

By refusing to carry out this process until AFTER the decision has been taken, the authors of these proposals show their unwillingness to consider the severity of the risk posed to residents by their plans, which clearly could be a matter of life or death. We, the people affected, and our elected representatives are to be deprived of this vital information during the consultation period. This must call into question the will for genuine consultation and, indeed, whether the whole process runs the risk of legal challenge, something we would encourage our Council representatives to investigate.

The Chair of the Committee, Cllr Lucy Ivimy (Conservative, Hammersmith and Fulham) made her position clear in an email to a member of the public who attended the meeting:

‘…for the NHS to produce (a risk register) 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’.

We therefore urge the Committee to insist upon risk registers for all of the options including 'doing nothing’ to be provided in advance of any meeting to reconsider risk and these documents should be publicly available. Time is running out.

Robert Sale

On Behalf of Brent Fightback

Anger mounts in Harlesden over Central Middlesex A&E closure

 I was down in Harlesden this afternoon for our regular spot publicising the closure of Central Middlesex Hospital A&E and the planned protest march on September 15th. We often had queues waiting to sign the petition to local MPs asking them to take a stand against the closure and opposing the privatisation of the NHS.

Local people, many wearing  special T-shirts and Jamaican colours ahead of the 50th anniversary of Jamaica independence, expressed anger at the closure, blamed the Coalition and its attitude to the poor and several took away petition forms to collect additional signatures in the community.

Many expressed support for the hospital where they had been treated and where their children had been born and stressed that the needy local community, particularly the young and the elderly, needed a readily accessible local A&E. They were scathing about the proposal that they should go to Northwick Park in future.There was fury at the likely downgrading of the hospital after millions of 'our money' had been spent up grading in the recent past.

There were frequent comments about privatisation and comments such as 'this government wants to make this country like America where you don't get treated unless you have the money'.

One local shopkeeper who has signed the petition last week came over and told me that he had been down to Central Middlesex to try and find out what was happening. He said that he had been told it was a 'done deal' and that the Trust intended to sell off surplus land created by the closure to build  housing or a hotel. I was rather doubtful about the latter but the sell of makes sense in terms of the Trust's debts. Once again it seems that it will be the poor who pay, this time with their health or in the worst scenario, their lives.