It reminded me of those Victorian pictures of the ragged, scrawny child, barefoot in the snow, with nose pressed against a restaurant window staring at the big-bellied rich tucking into their suppers in a warm glow of complacency.
We were in the opulent surroundings of a ballroom in the Hilton Metropole, Edgware Road trying to tell the smooth, expensively suited gentlemen from NW London NHS on the platform just what untold damage their 'Shaping A Healthier Future' (SAHF) proposals would do the people of Harlesden and Stonebridge, two of London's poorest wards. The whole consultation exercise to reach a foregone conclusion has cost £7,000,000
We were presented with a IPSO/MORI consultation report that ignored the thousands who had signed petitions against the proposals but instead went on to suggest that that the far fewer people who had submitted a response to Options A, B or C (all rejected by the petitioners) somehow represented some kind of democratic endorsement. 66,000 signatories on 18 petitions were apparently counted as 18 responses.
Andy Slaughter MP summed it up:
This is a complete farrago, a complete sham, a completely and utterly dishonest exercise!
This was the beginning of many exchanges about the consultation which I felt rather let IPSO/MORI take the fire that should have been aimed at NW London NHS for the inadequacy and downright dangerousness and dishonesty of their proposals.
Ann Drinkell, put her finger on the dangers towards the end of the Q and A session. She claimed that SAHF had been dishonest about the ability of community care being suddenly able to pick up on the slack when fewer people were admitted to hospital or stayed for a shorter period.
Everyone know we aspire to good community care, good palliative care, but everyone also knows how difficult it is. It is disingenuous to suddenly think it will be unproblematic. The impact of restructuring and budget cuts on community care and social care will be enormous. You are treating us like children.
Dr Mark Spencer then proceeded to do just that, treating us to a couple of anodyne PowerPoint slides on the 'Programme of Work' and 'Clinical Review of Responses' that would now begin. We were not allowed to ask questi9ons about this.
After a buffet supper (those ragamuffins in my head again) we went into 'Stakeholder Workshops'. These were introduced by Lucy Ivimy, Chair of the Joint Health Overview and Scrutiny Committee, a Conservative councillor in Hammersmith and Fulham.
She said that the initial impetus for the proposals had been the rationalisation of Accident and Emergency wards in the area and the fall out was a consequence of this, The virtual closure of two hospitals had been hidden deep in the plans, Given the wide geographical area and the propensity of people wanting to protect their own local facilities it had not been possible for the Committee to reach agreement.
She said that there were two main concerns:
1. SAHF was premised on success of the out of hospital strategy. This had been promoted for years but in real life admissions had continued to rise. We need more evidence on the strategy and a firm path to follow.
2. Transport was a big issue. Although there was a claim from the ambulance survey that there was little impact on the 'blue light' journeys the majority of journeys to hospital are by other means including public transport. There had been no analysis of these journeys.
A skirmish followed about whether this represented the committee and it emerged that an initial very critical report had been replaced by a much sifter version which was the 'official report'.
The workshops that followed were actually very interesting and dealt with issues that should have been discussed prior to the formulation of the plans. The public were feeding back on their real lived experiences - not going through a desk-top exercise. The world turned upside down.
In the workshop I attended I protested once again that schools as stakeholder had not been consulted at all and that children had been left out at a time when the child population is rising and they will be making demands on the health service. Gurjinder Sandhu, a specialist in infectious diseases, working at Ealing
Hospital backed this up describing the importance being able to access hospitals and their presence aiding recovery, how A&E picked up child protection issues and that the difficulty schools would have in trying to deal with fragmenting services. A&E had a role in detecting TB which was very high in Southall and Ealing - not to mention HIV.
In the workshop on Urgent Care Centre a disagreement became apparent between practitioners about how reliable UCCs were with a suggestion that staffing levels and expertise were poor and that this represented a risk to patients. This was even more so when there was no A&E on the same site as will be the case with Central Middlesex Hospital.
The strong underlying thread was that health services and access to health services would worsen for the most vulnerable. The ragamuffin has been left out in the cold.
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