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Ealing and Northfield

Please take part in the NHS consultation now

I spent 18 minutes this evening responding to NHS North West London’s “Shaping a Healthier Future” consultation document. Obviously I have previously read the background papers and discussed the issue a number of times so I haven’t included all of that time in my 18 minutes. The point is that ticking the boxes does not really take that long and you should not be easily put off.

The main thing to do in my view is to “Strongly oppose” the three options A, B and C on offer as they all three move services away from our borough (questions 24a, 25a and 26a). Under the catch all question 34 I wrote:

All three options presented are bad for Ealing. Option A is particularly inequitable. They all move services away from Ealing.

My answers are not particularly sophisticated, they don’t need to be. If you want to get inside the decision maker’s heads and make them question their assumptions then please just respond to the consultation. You don’t have to be eloquent or long-winded. Just the fact of receiving lots of individual responses will shake the decision makers.

The council has spent £56K on a very detailed, technical reponse to the consultation authored by ex-NHS trust chief executive Tim Rideout. This will be discussed at an extraordinary cabinet meeting on Friday at 3pm. See all of the papers here.

The council can do the detailed, technical stuff. You do the emotional, personal stuff.

The consultation closes on Monday. Get cracking.

7 replies on “Please take part in the NHS consultation now”

Hi Phil,
I’m a Northfields resident and went along to the Town Hall meeting last week. I left highly disappointed with the tone and substance of he debate, but judging from my fellow attendees I was definitely in the minority – if not the only attendee – who thought this way.

I’ve got a very different position on this debate than the one you are taking alongside the other elected officials of all parties in Ealing. I’m concerned that the current unified “Save Our Hospital” stance of Ealing’s Councillors and MPs on this issue will lead to a deterioration of health care in Ealing – especially for the vulnerable.

Firstly, here’s my take on the standard of health care in the little Northfields patch of Ealing. I’m a male in my early forties, who (touch wood) is healthy and I don’t need to access much health care at the moment. I like going to a GP once a year for a health checkup, and do the same with the dentist twice a year. The motivation for these visits is to get on top of any emerging issues early. I think of it as the health care equivalent of getting a car serviced annually.

To access these health services, I skip the NHS and go straight to private GPs and dentists I’ve chosen due to the quality of their services and the ability to get a set appointment. This sets me back around £200 a year, around the same amount as getting my car serviced.

Why don’t I access these services via the NHS? For the GP access component, a quick walk past Northfields Ave Surgery in the morning answers that question. People queue outside the clinic before the doors open, trying to get a GP slot. When it’s winter and people really need a doctor, the lines double and treble. I’m constantly amazed that in 21st century Ealing, we have the sick huddled out in the winter cold because they are desperate to access GP services. I choose not to do this, so instead pay £75 for my annual non-rushed full GP consultation at a time convenient to me.

Now I fully understand my “pay as you go” approach to GPs won’t work for huge sections of Ealing residents. They may have more serious medical conditions that require more frequent access to GPs, or they may be supporting large families, or they may be in a low income households. Many Ealing residents face all three of these pressures. Other residents in good health and on comfortable household incomes will also object to this approach on the principle that they don’t want to “pay twice” for health care they expect to receive for free at point of provision from the NHS.

The point being that standard of public access to NHS GP services in Ealing in 2012 is poor. It’s poor for Northfields residents, and I imagine its equally poor, if not worse, for Southall residents who may experience more complex medical requirements.

Not surprisingly, people denied GP access turn to the local hospital A&E to access medical treatment. The term A&E has become a misnomer for what the service is commonly used as – a 24 hour drop in health clinic. And once people are comfortable with understanding how to access their 24 hour health clinic, naturally they become distressed at the thought of it changing or closing.

I don’t have an issue with people using A&E as a health clinic. On the contrary I see it as true “people power” in the public feeding back to the NHS as to what sort of health care service they need in the community – which is clearly a 24 hour health clinic.

Let’s contrast the GP experience with a hospital experience. I’ve used specialist NHS hospital care once, when our daughter was born five years ago. We were given the choice of two hospitals for her birth – Ealing or Queen Charlotte’s.

Now I’ve heard plenty of good reports about maternity experiences in Ealing hospital. However were given the opportunity to have the birth in Queen Charlotte’s, which specializes in maternity services. It’s a centre of excellence in the UK for maternity services. It’s world renowned for maternity services.

Given that choice, we were always going to choose Queen Chalortte’s over Ealing for the birth. QC’s did a great job, and I felt fully confident throughout the whole experience that my wife and child were getting the best possible health care. It was a triumph of NHS world class health care service delivery.

However my family got lucky in having a choice of hospital. Many people don’t, and Ealing hospital is their only option. Again, it’s not to say that you can’t have a good maternity experience in Ealing hospital – I know plenty of people who have. It’s just that when you require access to specialist medical treatment, if you’re given the choice between the local generalist hospital and a world renowned centre of excellence for that medical specialty – most people will choose the latter every time.

How does all of this relate to the Ealing hospital debate? My take on the NHS NW London proposal is that they are putting the following solutions on the table.

Fixing the GP access issue by:
1. Re-labelling A&E at Ealing hospital as 24 hour Urgent Care Centres – covering all conditions with the exception of true serious accident and emergencies. This seems to be how people are currently voting with their feet on how they use Ealing A&E at present – so the proposal is to equip it to do this function properly and label it accordingly;
2. Investment in opening seven new health networks across Ealing and improved local health centres to provide easier GP access outside of hospital. Give people confidence they can get access to GPs and nurses outside of A&E.

Fixing the hospital issue by:
Centralising specialist services to get the best health care talent and the best equipment in a single site to ensure 24/7 quality specialist health care. London already a world class maternity hospital in Queen Charlottes, so why not create the same for treatments for trauma, for stroke, for cancer.

For mine, the above approach from NHS NW is eminently sensible way forward for health care for Ealing residents for the next 10+ years. They offer Ealing people better access to localised general GP services, and better quality centralised specialist services. This resonates with my health care experiences in Ealing, and addresses the challenges I see in the Ealing health care framework .

Yet it is opposed by all the parties involved in Ealing politics.

Further, the politicians don’t seem willing to enter into discussing the broader health care debate beyond hospital A&E services. NHS NW aren’t consulting narrowly on hospital A&E, they are consulting broadly on a blueprint for health care provision in the community beyond hospital services. Yet the political dialogue seems focused on A&E services.

Why are our politicians keen to twist the debate into a simple, dumbed-down referendum on Ealing A&E services? I can assume for Labour and Lib Dem position, is broadly ideological and also required by large sections of their support base. For the Conservatives, the motivations may be more to avoid being wedged on a current day version of the “No Tram” debate. A unified front from Ealing’s politicians to maintain the status quo at Ealing Hospital makes sense as it meets their short term political interests.

However it is the Ealing people that suffer from a lack of vision around health care reform. The status quo offers no solutions to people queuing up in the cold outside Northfields Ave surgery in winter trying to see a GP. No solution to Southall families who front up at A&E because its their only chance to see a GP or nurse. No solution to the patient in Ealing hospital requiring specialist care at 2am when there are no specialist staff on site or on call.

Retaining the status quo does mean however Ealing politicians can claim Ealing hospital has be “saved” and “people power” has triumphed. Watch your letterbox for future brochures capturing these heroic deeds!

Local government has no significant role in health service provision, and local politician contribution to this debate should reflect this fact. However local government can assist in related matters within its remit, such as transport. A valid complaint that arose at the Town Hall session regarding centralied specialist hospital was around the time and cost involved for local people to visit a sick family member in a centralised hospital. Local government could help with with improved transport services to centralised hospitals – my own thoughts turned to how Sky manage the problem of shuttling their workforce in mini buses to and from Ealing public transport hubs to their relatively cut-off HQ.

Ealing people deserve better from this debate. The volume of local politicians needs to be turned down and the voices of our full time, NHS health care professionals amplified so they can have a proper conversation with the people around 21st century health care.

I just don’t see it happening through, and hence I just don’t see health care in Ealing improving. I’ll keep paying my £200 a year to opt out of the system when I need to, and I’ll keep wondering who will truly stand up for the health care interests of the low paid and vulnerable in our community now that we’ve decided to turn our backs on the NHS’ attempts to reform the system in their favour.

Andrew,

Thank you for your well thought through comment. You are correct to point out that there are a lot of good features in the NHS NWL consultation. The move to 24/7 care and the up front cash for better community services are both particularly attractive. Many people I think would buy the arguments about fewer, better acute services. I think it is the speed and size of the changes proposed that has has pushed all of the politicians into the anti camp. The preferred Option A effectively closes Ealing Hospital and moves the acute services of three hospitals serving the west of our borough much further away.

It is not quite an A&E only debate. The changes essentially push all acute services out of Ealing and further away from us. A&E is merely the most obvious part of that move and hence iconic and a useful hook to hang the debate on. If NHS NWL had come up with a staged plan it might have looked a lot more attractive. If NHS NWL had come up with one that did not affect Ealing so much more than other areas it might have looked a lot more attractive.

The Burnham Challenge (as it should properly be called) probably is a sensible top level approach to the problem of doing more in a resource constrained world. The current NHS NWL plans drop straight out of the Burnham Challenge and the Labour politicians in Ealing have been particularly venal in failing to acknowledge this. Labour’s approach of highlighting the £20 billion savings part of their own policy as cuts without mentioning that the £20 billion is to be reinvested in new services is howlingly dishonest but they seem to get away with it all the same.

NHS NWL will have to decide whether to stick to its plans in the light of the consultation or to modify them to address the fairly obvious inequity they inflict on our area. If NHS NWL can come up with a more attractive proposal for our area the parties may well split. But, the current proposals pile too many negatives on our borough. It is not really a hard decision to be against this set of proposals.

Mr Arnison,

Firstly no casual amateur poster posts over 1,500 words on a blog, so I am assumimg that yours is a ‘professional’ post.

Here’s my response:

1. There are other GP surgeries in and close to Northfields. Elthorne Surgery in Elthorne Park Road I’m sure has some spare capaicity. I live close to it and I’ve never seen the poor and injured queing outside it at any time.

2. Like many I gave up trying to find an NHS dentist and have had to go private for dentistry for decades as a matter of necessity, not choice.

3. Healthcare services must be ‘shaped’ locally to suit local needs. For decades Southall has needed a massive 24 hour GP facility at Ealing Hsopital. So, let’s provide and maintain one.

4. We all need good local hospitals. Queen Charlotte’s? My eldest son was born there 34 years ago. The agency nurses were barbaric. The baby was presenting the wrong way up. He was twisted and wrenched out of my wife using forceps to his head. To what extent that caused his mental disablement in later life no-one will ever know.

5. Oh please…no references to ‘world class health care service’ and ‘world renowned delivery’.
It’s undefined bullshxt.

6. Your proposed fix?:

– Ealing care homes have been told for weeks by the NHS not to refer their residents to Ealing Hospital A& E. As for ‘voting with their feet’, some or many much of it is ‘doing what they are told’.

– What are ‘health networks’? Apart from the private health care company InHealth considering taking space on the ground floor of Lovelace House in W13, I know of no new planned land use for healthcare facilities n Ealing eccept for the new healthcare centre planned as part of National Grid’s Southall Gas Works plans.

– Trauma/Accident/Emergency/Urget/Maternity care facilities need to be local for all 20 million north west London residents.

– Non Trauma/Accident/Emergency/Urgent/Maternity centres of excellence is what I think ‘ve been paying fori n National Insurance payments for 51 years.

7. NHS North West London discussing proposals? What public meetings has it set up. I can count three – yes three – for 2 million residents across 100 square miles.

8. A&E shutdown is significant re hospital survival. After A&Es were closed at St Mary’s, Roehampton and St Mary’s , Sidcup the hospitals’ closure soon followed.

9. ‘..queuing up in the cold..’ and ‘… no specialist care at 2:00am…’ all very colourful, emotive suff. The status quo leaves alot to be desired. Many of us know this.

10. Local governemnt has no contriol over regulated public bus services. That’s Transport for London’s role and trying to get them to create new routes or modify routes or increase capacity on routes is as difficult as flyng to the moon on a snowflake.
The Sky office bus service involves short, low capacity, point to point, daytime services. Laying on 24 hour bus services from all parts of Ealing to Northwick Park, Hillingdon and West Middlesex Hospitals is a completely different proposition.

11. ‘Voices of our full time NHS professional’? On 24 September I asked the author/architect of the NHS NW London proposals – Dr Mark Spencer – to name two NHS clinicians based in West Ealing who supported his proposals. 13 days later I still await his response.

I don’t wish to lie in an ambulance with severe chest pains on a Friday afternoon in rush hour with the rain pouring down, wondering if I am ever going to get to a hospital and knowing that the demolished A&E at Ealing might be saving my life because this more easily accessible hospital is on an East West through route which is how much of this part of London is laid out.

If Ealing Hospital was good enough to meet residents’ needs (including population expansion) in 1979 why is it not good enough now? I suspect the population increase has exceeded old predictions. We have a baby boom now. We will be guaranteed another one in say 20 years. It’s just plain wrong to destroy this hospital which is in the main what will happen long term if A&E goes.

The closure is bad for business as so many jobs will be lost. Long distance travel by relatives will reduce GDP. Lack of visits from relatives will in some cases slow recovery in hospital.

The infrastructure needed to support patients and relatives is just not there in the consultation document – which in itself is good enough reason to reject the proposals.

I understand the Urgent Care Unit now sorts out the people who historically have gone to Ealing’s A&E – and many get sent home from the UCU. But that does not stop the need for continuing with the A&e dept.

I don’t know about the surgery and its queues in Northfield, but I have never seen that when I pass other surgeries and I can get an appointment usually in a couple of days.

If we have hospitals of specialism and excellence, which in theory sounds brilliant, how are we to know that future cuts in those places will actually work against our interests? And how are we to know that if we do see closures now, that there will be sufficient service provision to meet the needs of the 2M+ people of West London? And when we do need a new hospital in Ealing in 20 years time where is there a suitable and easily accessible site which would accommodate a new hospital?

My vote is for Ealing to become a major hospital – and nothing less.

I had another think over the weekend as to why this Ealing hospital issue has such a grip on me – I agree that being moved to write a 1500 word view on the topic was a little extreme.

So here’s another 2000 words to try and justify it. However I won’t be offended if that puts you off and you read no further.

First things first – I’ve got no dog in this fight apart from being a local resident, rate payer and tax payer. I’m not a party member, NHS employee, activist or hold any other position or interest in the hospital debate. I’m just a Northfield local who was curious enough to go along to the Town Hall debate the other week and came out with a different viewpoint on the topic than the other people at the session, and thought it would be good to try and kick off a slightly broader debate on the topic.

My decision to post on Phil’s site was based on my view that he seems to take the time to analyze local issues in a little more depth than the sites I’ve seen from other Councillors / local MPs. Consequently I thought his readership may share a similar interest in looking at local issues in a little more depth.

So over the weekend I had another think about the issue – aided by a couple of glasses of red wine – to think about what aspects of the Ealing hospital debate continue to sit uneasily with me. I came up with two.

1. We set our standards too low on health care outcomes

It seems pretty clear that the NHS NW plans will be rejected under an avalanche of negative consultation feedback, and this will be seen as a victory for local people. The hospital will be saved and its current size and shape retained. This may well be the best democratic outcome, as it will reflect the clear view of the majority of local people, local politicians, and local community groups. However I still don’t see this as victory to be savored.

I was pleased to see the Ealing Council had commissioned an independent report – the Rideout review – to examine the NHS NW proposal from an expert health care perspective and measure its impact against Ealing’s specific local factors.

Phil references the report on the Council website – Appendix 2 here:
http://www.ealing.gov.uk/meetings/meeting/128/cabinet

The report is well worth a read – but at 100+ pages, the 5 page exec summary could be a good bet.

The good news for the anti-NHW NW perspective is that the Rideout report provides a strong argument against the NHS NW’s proposals. It finds flaws in the NHS NW methodology, identifies concerns with Ealing’s health system ability to adapt to the proposed changes, and finds insufficient work has been undertaken to understand the impact the proposals on local people and their health care. You might conclude case closed.

However the Rideout report does make some other findings. It concludes that the intentions of of the NHS NW review are appropriate – i.e. the report’s objectives around “improving service quality and reducing unwarranted variation, improving the health of local people through the provision of better care, and ensuring that organisations are financially viable for the long term” were appropriate. I interpret this finding as Rideout concluding the intent of the NHS NW report was sound, just the execution of the recommendations flawed / sub-optimal for Ealing.

However, the Rideout report goes further and raises concerns with the current standard of local healthcare provision:

“The current provision of local healthcare is not acceptable, as it is too often characterised by unacceptable levels of quality and service and unwarranted variation, substantial health inequalities, and an unsustainable financial position”.

When the NHS NW reform proposals are defeated, this is the status quo health care position Ealing will be left with – an “unacceptable level of quality and service”, as concluded by the Council’s own independent review.

My big beef around this issue is who in Ealing deems this health care status quo to be acceptable? If other public services in the borough were failing to this extent – say our education services via schools, or our law and order via our police, or our garbage services (!) they’d be outrage. People would be out on the street demanding action, demanding change. But somehow failing healthcare services is acceptable, and the failing Ealing hospital / GP / health care service status quo is preferred to opportunities for change and reform in the system.

I take the point that my original post may have come across too emotive – but I feel the points I was raising are still valid. People do queue up in the cold outside my local GPs surgery – I’ve seen them. Since my last post, I found a website “NHS Choices” where people can leave feedback about their experience with NHS GP services. The Northfield surgery feedback is contained here:
http://www.nhs.uk/Services/GP/PatientFeedback/DefaultView.aspx?id=41742&nacs=41742&pageno=0&sort=1&recordpp=0&tag=

There are 11 pieces of patient feedback, some people happy, some not so. Three people make reference to having to queue outside the surgery waiting for it to open. Here’s a sample of their feedback from January this year:

“I visited the surgery twice in January. On the first occassion I stood in the rain from just after 8-00 a.m. until the surgery reception opened at 8-30. Two weeks later I sought medical attention to confirm the previously identified ear infection was clear and about an unrelated medical condition. On a freezing cold morning I decided it was not wish to queue outside from 8-00 a.m and presented at reception at 8-45 a.m. to be told that I was too late to see a doctor.”

To their credit, the surgery has written replies to the negative posts outlining surgery procedures and highlighting ways to avoid queuing. Now it could well be the case that this experience is not repeated across other Ealing GPs, and perhaps it is a case of Northfields surgery patients not understanding the processes of the surgery. I picked this surgery not to imply all Ealing GPs had this problem – only that it was my local GP surgery and I took it as a data point to use in a bigger argument – namely if it was tricky to get access to GPs in Northfields – supposedly one of the least deprived wards of Ealing – it must be diabolical if you lived in a deprived ward.

Again, it doesn’t impact me personally – after seeing the Northfields winter surgery queues it was a no brainer decision for me to book a private GP when I need one. However I still feel frustrated on behalf of people who financially don’t have this option open to them.

Overall I see the problem as a failure of standards the public set for health care services. The public are not demanding enough of the standards provided to them by public health care to the same extent as they are for other public services. We should be leaning into the NHS demanding change, rather than vice verca.

I don’t think it’s drawing a long bow to set a target of “world class” for our health care standards. Britain has fine pedigree in world-wide advancements in medical practices and process and care. Arguably Britain’s medical community used to set the international “gold standard” for their skill and service. This seems to have has fallen away. People are proud of the NHS and its ethos – but I’m not sure how many people in Ealing would claim to be on the receiving end of world class health care on a day to day basis.

Looking at this from another angle, here’s what can happen if you are very clear and precise in setting a world class standards for all aspects of public life. Singapore gained independence in 1965, and inherited all their medical training and knowledge from Britain. They refuse to accept anything except world class standards, and have evolved all aspects of their society – especially their health care and education services – from third world standards to world class standards in a short period of time – not much longer than when Ealing hospital became Ealing hospital.
Have a read here of The Telegraph’s overview of the Singapore health system:
http://www.telegraph.co.uk/health/expathealth/8831080/Expat-guide-to-Singapore-health-care.html

It’s amazing what a little ambition can do!

A great triumph of modern public policy is that we refuse to accept the outcome of schools failing kids. It’s never been acceptable for parent to have their own kids receive a failed education, but there is now across the board acceptance of the erosion of social and financial capital that results if you let any kid receive a defective education. That’s even before you get to a morality dimension of the debate. This is a bipartisan view – the Blair government pushed strongly against vested interests with the Academy programme, the Cameron government continues the direction with the addition of Free schools. Most parents today I’d wager don’t give a hoot about the school model – they just want their kid at a good local school that sets high standards and delivers, rather than makes excuses about why it can’t perform..

I think great things happen when you set high standards. The reverse is also true. Poor standards are no longer tolerated in public education. Why are they in health care?

2. We need to encourage rather than discourage the NHS to consult and engage with our community

I find the NHS big and slippery. I’m not sure where it starts and finishes. I don’t understand how to use it as a customer, and I don’t know how to engage with it as a community stakeholder.

Let’s contrast this with education. My 5 year old goes to Little Ealing primary. Last Wednesday they had a parent night, and I went along. Over 2 hours I listened to a presentation by the chair of the school governors, discussing the strategic issues facing the school and how they were being addressed. The headmaster gave an operational overview. Feedback was invited, questions were asked and answered. I walked out feeling I was on top of all issues impacting that school.

I’ve never attended to a police / neighborhood watch surgery, but I know they’re around and feel comfortable that if I had concerns about the local law and order situation, or wanted to better understand local police priorities, I could engage with local police and find out, and have a say.

When the NHS came to town the other week, I thought this would be a great chance to learn about the the strategic and operational challenges impacting on local health. I thought the initial briefing given by Dr Mark Spencer was logical, he presented a there’s-a-problem-and-here’s-how-we-fix it story. Equally I was impressed by Dr Jenny Vaughn from Ealing hospital who argued against the NHS NW proposals, but I thought in a more balanced way than the other SOH representative.

The audience wasn’t in the mood to listen to Dr Spencer’s case – they were angry at the idea of changes to the local hospital, which was understandable as the issue is emotive.

Although the audience also spent time complaining about the complexity of NHS NW consultation process – with good reason, the consultation document is one only Sir Humphrey himself could be proud of – but I’m not sure anyone was really interested in engaging into the spirit of two way consultation. The focus was more around broadcasting maximum anger back to the NHS NW regarding there reform proposals. And that’s the bigger point – there is a real risk of throwing the baby out with the bathwater by the community refusing to engage with the NHS NW in reform proposals with an open mind. Perhaps they don’t bother consulting next time – who wants to face an angry mob on a Wednesday night? – and instead people sit on their hands until things are so dire it is beyond consultation and straight into emergency implementation.

If the Ealing community doesn’t like the specifics of the NHS NW proposals, perhaps we could at least agree on the direction of travel of their proposals – namely you get better health care outcomes by re-shaping the NHS to deploy broader general health care delivered predominantly outside of hospitals locally in the community, and specialist services via concentrated specialist hospitals to ensure 24/7 cover and consistent high standards.

Perhaps there is no broad local consensus on this direction by the public. If not it would be good to have a calm dialogue between the public and the NHS to better understand their reasons for wanting to move in this direction, and for them to better understand the local impacts on people from such a change.

It would be also good to discuss the role of hospitals – what jobs are we hiring hospitals to do? Which parts of health care are best provided from inside a hospital vs outside? I think there may be a wide gap between the role the community expect hospitals to play in the health care mix – i.e. that all care must start and stop in hospitals – which may be in stark contrast to the NHS view – i.e. that hospitals are a last resort and that the vast majority of health care should be provided in the community facilities outside of hospitals. We should be talking about these issues with the NHS.

We run the risk of damaging the NHS care provision with our determination to “save” it. (Save it from whom? Itself?). It needs to evolve to meet the specific challenges of the future, the future needs of its customers, yet its attempts to change are resisted by its customers. We run the risk of “loving” it to death.

I think the public needs to better understand how the NHS reads the current health care lay of the land, where it sees challenges and opportunities, what it sees its direction of travel as being. We need to hear this directly from the NHS – in an unfiltered direct manner rather than through the prism of party politics from politicians.

We should be talking to them, not fighting them. We should welcome the NHS to come to our Town Hall and talk with us. Not chase them out of town with pitchforks and torches, hoping they never come back.

Dr Spencer and the rest of the NHS NW leadership team need our encouragement to continue planning reform to the NHS. If they’ve got this proposal wrong, they should be given measured feedback and constructive guidance on how to come up with a better proposal. Sooner rather than later. Because the alternative is we get stuck with the status quo – a continuation of the current “not acceptable” local health care outcomes concluded by the Rideout report. I’d like to think we can do better than “not acceptable”.

Hopefully the London hospital & health care debate still has an opportunity to broaden beyond the current narrow narrative around local A&E.

These comments tonight from the outgoing head of the NHS in London are pretty damming.

“Hundreds of people died or were left with lasting disabilities after delays in changing stroke care, the head of the NHS in London has said.

Dame Ruth Carnall said the pace of change in the NHS was too slow and controversial plans were often compromised by political interference.”

“There is a political aversion to major changes as we’ve seen with the debate over A&Es.”

http://www.bbc.co.uk/news/uk-england-london-19916547

We urgently need a bigger and broader discussion on re-shaping London health care. I’ve got no idea how this will happen though in the current SOH environment.

Here’s some other cheery reading.
London hospitals are going broke:
http://www.bbc.co.uk/news/uk-england-london-16880196

And if you get diagnosed with cancer, best clear out of London and move to York.
http://www.bbc.co.uk/news/uk-england-london-19408829

Is everyone still on board with sticking with the current London hospital & health care status quo?

I suspect the unified political approach on this is simply politicians trying to gain/hold on to votes in Southall.

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