North West London and Ealing NHS Hospital Trusts Selling you More for Less

This picture shows notes from a break-out group discussion (with advocates of merger plans in the background), taken towards the end of a public consultation meeting on 12 December 2011 at the Sattavis Centre in Brent. The meeting was hosted by Brent LINk on behalf of the Ealing Hospital Trust and North West London Hospitals NHS Trust. A full report of the meeting is given by my colleague Martin Francis here and a previous posting describes the running down of the Central Middlesex Hospital's A&E department.

Due to a speaking engagement, I was not able to hear the presentation but residents will be able to attend another consultation meeting in Harrow on 12 January 2012 at Premier House Banqueting, Canning Road, Harrow, HA3 7TS (5.30-8pm).

Unforunately, judging from the discussion I did witness, there is some cause for alarm. Martin Francis asked, "Won't you have a problem if there was a major incident? How would you cope?" He was not satisfactorily answered. A woman, waving a merger plan, asked why the motivation to cut costs was not made transparent in their proposals. Reading the briefing document, "Stronger together", I can attest to the fact that this motivation is not made properly explicit. The obvious question then arises whether core and specialist services won't suffer, if the main driver is cost savings. Under "financial drivers" the merger proposal states:

"While the key driver for merging our organisations is to improve clinical quality, we also have to consider what financial benefits merger will bring. Our services need to be affordable, as we know there will be a reduction in hospital income when resources shift to the community. We need to match our services to this change in funding."

This is a very odd way of expressing cost-cutting as a driver and it's certainly difficult to decipher cause and effect from this statement. Instead it sounds like the decision to "shift resources" has already been made. If the merger advocates had said, "Sorry, we need to run these services for less therefore we can't maintain the level of health provision across the board. Sorry for any inconvenience or damage to health caused," we might all know where we stood.

But to pretend that 800,000 residents can receive more for less seems to rely on some perverse logic. Perhaps, instead, the status of this "consultation" is revealed on the penultimate page:

"Whilst we do not have to formally consult with the public about the merger, we would still like to hear your views.."

So much for the patient-centred care ethic, even if the Trusts were right about their interpretation of their duties to consult.