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Mansfield calls for scrapping/suspension of Shaping A Healthier Future

The Mansfield Commission's Interim Report into the Shaping A Healthier Future consultation states of the programme that would rsult in the closure of four of the nine acute hospital sites in the North West London area and the loss of Central Middlesex A&E:  

The SaHF programme in our view was a preconceived solution that was imposed on the North West London health system without there being any clear problem that it was designed to solve. 

In particular there was no proper assessment of the needs of the whole area to which the health and social care system would respond.

 The following recommendations are made:

1.     We recommend that the SaHF programme is abolished / suspended, thereby saving a considerable sum at one fell swoop. 


2.     We recommend that an independent review of the North West London health system is undertaken under the auspices of a joint health and local authority initiative that builds its case on a thorough assessment of the needs for health and social care of local populations, at local levels. 


3.     There must be no presumption that so-called ‘reconfiguration’ of acute services is the solution to what may not be a problem at all. 


4.     In addition there must be no presumption that the solution will involve a top-down approach across the whole area as SaHF assumed; there should be an openness to consideration of local solutions possibly at the borough level where these can be shown to work. 


5.     The NHS and local authorities must agree to work together to achieve a joint aim to provide good accessible health and social care to all local populations within a sustainable financial model. 


6.     We recommend that the attempt to close Ealing and Charing Cross hospitals is immediately stopped; that a guarantee is given to sustain acute health services on these sites – with no more double talk from NHS leaders – until the above review is complete and any associated business cases are taken through to Full Business Case level, which is likely to be at least five years. 


7.     We recommend that in the light of current failures in the system in North West London there is an independent review of the emergency system under the auspices of the above joint health and local authority initiative; and that this as a matter of urgency examines the closure of Hammersmith and Central Middlesex A&E departments with a view to opening these, if that is what the review suggests is needed, and what local people want. Local people must be given honest and genuine choices; the opportunity cost of retaining these sites as A&Es must be made apparent. 


8.     We recommend that there is a review of primary care services in the region, and that following this review, immediate steps are taken to rectify any issues. However any investment must be based on a clear business case that relates costs and benefits to changes across the whole system. 


9.     Likewise we recommend that there is a review of OOH services in the region, to establish a clear case if it exists for OOH acting as a way of reducing demand for acute services, and also as a way of reducing total system costs. Following this review, any investment in OOH services must be based on a clear business case that relates costs and benefits to changes across the whole system. 


10.  In the case of changes that take place in primary care and OOH services as a result of the reviews outlined above, there must be a clear business case presented that makes a clear case for system- wide improvement arising out of these changes, and this should be consulted on with the relevant local populations; there should be no assumption that this is the population of the whole of North West London. 

The full report can be read here: 

The commission's final public session will be held at the Brent Civic Centre on Saturday 9 May 9am-5pm. Brent Trades Council and Brent Fightback are among those who have submitted evidence. It would be good to have as many health campaigners as possible at this session. More evidence will be heard

Brent Council Budget protest Monday 6.30pm Civic Centre

Brent fighting back against the cuts

Claim Back Our Cash - Reclaim Our Services

Challenge the cuts at Cabinet on Monday February 23rd

Monday's Cabinet will be approving the budget to go to the Full Council on March 2nd amidst press coverage of the row over the leadership refusing to take account of the vote of the Labour Group in favour of a Council Tax rise.

Meanwhile residents, and particularly the young and parents, have got togather to challenge some of those cuts.

The Cabinet will be receiving an unusually high number of petitions, accompanied by speeches from the petition organisers, which indicates the strength of feeling in the borough.

I am sure they will welcome support from the public at the meeting which starts at 7pm in the Civic Centre.

These are the petitions:

Cabinet – 23 February 2015

Petitions have been received in the following terms in response to the budget proposals:

1) Keep Stonebridge Adventure Playground Open “We the undersigned insist that the redevelopment of

Stonebridge School and the new housing, includes keeping the Stonebridge Adventure Playground open.”

From:         Brent Play Association

2) Keep Welsh Harp Environmental Study Centre open This petition comprises numerous letters from individual children at Chalkhill Primary School.

From:         Chalkhill Primary School

3) Save our youth service (paper and e petition)

“Youth services are vital for young people as well as the community and we

believe there will be an adverse effect if the service no longer exists. This will

put added pressure on statutory services such as the Youth Offending

Service, the police and social care. We call on Brent Council to consult with young people effectively before making any cuts to any youth provision in the borough.

We call on Brent Council to scrutinise existing provision to ensure that these

resources are appropriate and effective. The young people of Brent are willing and able to assist Brent Council with this important task. We call upon Brent Council to consider the voice ofyoung people in the light of these savings!”

E-petition: started by Roisin Healy (Brent Youth Parliament)

4) Save School Crossings Patrols

“Brent Council is under a legal duty to promote road safety and to promote sustainable transport, such as walking and cycling.  Road traffic accidents are the biggest killer of children in the UK (they peak when children start primary school and secondary school). 2011-2020 is the United Nations Decade of Action for Road Safety. School Patrol Officers are an integral partof the community, ensuring the safety of our children and they encourage children to have independence. Many schools in Brent are on busy roads (e.g. Salusbury Primary School and Islamia on Salusbury Road in NW6) which are only going to get busier with new housing developments with a new influx of cars and residents. Our roads should become safer places for our children, not more dangerous. And children should be encouraged to walk and cycle to school rather than be driven.”

E petition started by: Michelle Goldsmith on behalf of local residents .

5) Leopold Primary School - save our School Patrol

Officer

“Brent Council is considering removing our Lollipop crossing patrol at Hawkshead Road. The School is surrounded by several busy roads. We believe this is unacceptable and will directly put our children in danger of a road traffic accident.”

From:         the Parent, Teachers and Friends Association of Leopold Primary

                   School

6) Keep Bridge Park Community Leisure Centre Open

“The centre provides a venue for many members of our  local community and plays a vital part in our leisure time. Many of us use the facility on a weekly basis to play football, use the gym, relax in the steam and sauna and meet friends. The centre hosts children education, courses and activities th at are beneficial to their development. The centre serves as a venue where rooms can be hired to many different groups who hold meetings, training and celebrations. Closing Bridge Park would affect all of us in different ways. We need this Centre to remain open so that our young people have a place to meet and do sports in a safe environment.

Stonebridge is a deprived area and we feel that crime and unsocial behaviour will increase if the centre is closed. Unlike a few years ago the centre now is used by men and women of all ages and faith. People come to Bridge Park to get fit and improve their health. Although we understand that the council funds are limited, the cost of dealing with health and antisocial behaviour will far outweigh the cost of operating our leisure centre. We have signed below to show our opposition to the closure.”

From:         Mr Adam, Tordjok, local resident.

Extra time to write to the Independent Healthcare Commission about health cuts

The Independent Healthcare Commission set up by four boroughs and chaired by Michael Mansfield QC to look into the effects so far of the implementation of the Shaping a Healthier Future proposals has extend the deadline for submitting evidence to February 24th. This is the evidence Brent fightback has submitted:

In addition to the points made in the BTUC submission which Brent Fightback endorses, we would like to add that effective out of hospital care, care in the community, cannot be provided if social care provided by the Council is slashed.

Brent Council's funding has been drastically cut and among their proposals to achieve a balanced budget are many cuts which will severely damage the quality of care available - in particular the reduction in time from 30 to 15 minutes for carers' visits which has been widely criticised by elderly peoples' charities as ineffective and dehumanising. Also the closure of the (ironically titled New Millenium Day Centre which caters for 80 plus people with complex mental and physical needs - the group SAHF proposals are supposed to focus on.

Also the withdrawal of any provision for rough sleepers who have a high level of unmet health needs and already a disproportionately high level of A&E attendances because they lack alternative means of care.

At the other end of their residents' lives, Brent Council proposes to close ten of its seventeen children's centres. As well as providing facilities for play and education, children's centres often host health services for under-fives including baby and child clinics and advice on health and diet for parents and their small children. Brent has a very poor record on child immunisation, dental health, child mental health and obesity. If these facilities are lost, the NHS primary care services will be put under even more strain.

This is the Submission made by Brent Trade Union Council
 

Over many years the Brent Trade Union Council has campaigned with other concerned organisations and the local trade union movement about the cuts to the local health service.Our colleagues in the health service unions warned us that the removal of services from Central Middlesex Hospital (CMH) would lead to the eventual closure of A & E.

Central Middlesex Hospital was rebuilt and extensively modernised at a cost of more than £62 million, reopening fully in 2008. This modernisation was funded in large part by PFI and was specifically designed for emergency medicine.

In spite of this, over the intervening years, many services have been moved from CMH to Northwick Park Hospital in a far more prosperous area. Services were transferred without consultation, because there was no obligation to consult since the two hospitals were part of the same trust. Staff were often given only a few days' notice that they were required to transfer and eventually Central Middlesex was left without the back up services needed for its A & E to remain viable. So we have a situation where management moved the services, then used it as a justification for saying that A & E was no longer safe or effective as maintaining an A & E service is dependent on the full range of hospital services being available to patients. Yet, right up to the day of its closure the A & E department at CMH was still being sent patients from the overstretched departments at both Northwick Park and St Mary's.

Having moved so many services to Northwick Park and closed the A & E at Central Middlesex, the CCG is now responsible for a splendid modern building which they will have to pay for until the end of the PFI contract and the dilemma of how to make use of it.

Throughout these years, Primary care services have been severely overstretched and continue to be so despite the Shaping a Healthier Future organisation and the local CCG having a “vision” of improving those services by investing to prevent illness, lessen the need for hospital admissions and shorten the length of time patients need to spend in

hospital. Of course the BTUC supports improvements in primary care, but promises were made that these improvements would be in place before radical changes were made to hospital services. However, they remain, to quote the CCG's own documents, “visions” and “aspirations”.

There is a crisis in recruitment of GPs, community nurses, health visitors and other staff needed to transform these visions and aspirations into reality, just as there is a crisis of recruitment for hospital staff and an expensive and destabilising reliance on agency staff. BTUC believes that the government's refusal to pay NHS staff even the 1% advised by their own pay review body and the housing crisis which is extreme in Brent, contribute to the recruitment crisis in the NHS, while cuts to the Council's budget threaten the provision of adequate social care, essential if patients' needs are to be met in the community.

The two Brent wards closest to the hospital, Stonebridge and Harlesden, are some of the most deprived in the Borough. The Locality Profile for Harlesden makes for grim reading. Harlesden is ranked in 30s for deprivation for England.

Despite having a young population 32% below the age of 20 years, in Harlesden ward, life expectancy is 13.4 years for men and 9.6 years for women less than the highest expectancy rate in Dudden Hill ward. It can be described by a tube train journey. If you take the train from Harlesden station and travel a few station north you will gain a decade in life expectancy.

Chronic Illness is significantly higher when compared to London and England figures, the biggest killers are Cancer, Circulatory and Respiratory diseases.

Mental illness affects one in six residents, TB is the second highest in the Borough and HIV is “considered to be very high” (Locality Profile).

Too many Children are found to be obese in their reception year when starting school and teenage pregnancies are also high.

We have only outlined a few items from the Brent Locality Profile for Harlesden Ward but we want to emphasise how completely unacceptable it is to close the A&E and other services in the middle of a population that so desperately needs a proper A&E and the important the general health services that go with it.

To compound this misery the facilities at Northwick Park which is the A&E that is suppose to replace the CMH facility, cannot cope with the extra load from the CMH and was rated as the worst A&E in the country.

The near impossibility of using public transport to go to Northwick Park. The difficulty of taking a sick child in the middle of the night to the A&E does not bear thinking about. Again the Harlesden and Stonebridge wards have the lowest levels of car ownership and minicab costs are prohibitive for those on low incomes.

Brent Trades Council also want to support and be associated with the submission from The Hammersmith and Charing Cross Save Our Hospital Campaigns.

On behalf of the Brent Trades Union Council please place our submission before Mr Mansfield.

 Brent Fighback adds:

In addition to the points made in the BTUC submission which Brent Fightback endorses, we would like to add that effective out of hospital care, care in the community, cannot be provided if social care provided by the Council is slashed.

Brent Council's funding has been drastically cut and among their proposals to achieve a balanced budget are many cuts which will severely damage the quality of care available - in particular the reduction in time from 30 to 15 minutes for carers' visits which has been widely criticised by elderly peoples' charities as ineffective and dehumanising. Also the closure of the (ironically titled New Millenium Day Centre which caters for 80 plus people with complex mental and physical needs - the group SAHF proposals are supposed to focus on.

Also the withdrawal of any provision for rough sleepers who have a high level of unmet health needs and already a disproportionately high level of A&E attendances because they lack alternative means of care.

At the other end of their residents' lives, Brent Council proposes to close ten of its seventeen children's centres. As well as providing facilities for play and education, children's centres often host health services for under-fives including baby and child clinics and advice on health and diet for parents and their small children. Brent has a very poor record on child immunisation, dental health, child mental health and obesity. If these facilities are lost, the NHS primary care services will be put under even more strain.

 

Submissions should be made to: Peter Smith, Clerk to the Commission, at Hammersmith & Fulham Council. Submissions should be addressed to him at Room 39, Hammersmith Town Hall, London W6 9JU or sent by email to peter.smith@lbhf.gov.uk. Later submissions will be forwarded to the Commission but may not be given the same attention as those received by the deadline.