Councils should not try to block health reform

As the NHS celebrates it's 65th birthday there is a big shift taking place away from general hospitals towards specialist hospitals. Local council's don't run the NHS. But councils do have an interest in what it does, where it does it and how well it does it.

If there is a proposal for a hospital to stop doing something and for it to be done by another hospital then the local council will be expected to have an opinion on the matter. The danger is that councillors will be swayed more by politics than by clinical evidence.

On my own patch there is Charing Cross Hospital which is being rebuilt and the services it offers changing. Some have suggested that as the existing building will be demolished that means the hospital will cease to exist. But it is a phased rebuilding. The existing tower block at the hospital is in poor condition. £90m has been agreed for a new state of the art hospital on the existing site. At no stage during the building process will the hospital close. To say we will "lose the hospital" is like saying you would "lose your car" if you trade in a Skoda for a Rolls Royce.

At least 85% of patients at the hospital would continue to be treated there. However they would still allow for greater specialisation, which the NHS tells us would save 130 lives a year. At the moment the mortality rate is much higher for patients admitted at weekends than week days - as they are more likely to see junior doctors rather than consultants.

The Accident and Emergency Centre at Charing Cross Hospital is being renamed the Urgent Care Centre. Anyone who arrives at the hospital with an accident or emergency 24 hours a day, seven days a week, will be cared for. Usually this will be in the hospital. If a decision is made that better specialist care could be provided elsewhere they will be taken by ambulance to where this is available.

The reorganization of stroke care in London has produced dramatic improvements in life expectancy for stroke victims saving 200 lives in 2010/11 with an estimate that it will now be saving as many as 500 lives a year. Also that the outcomes for those who suffer a stroke are much better in terms of the extent of their recovery - to be able to talk and understand, to be able move.

I spoke to Tony Rudd the Professor of Stroke Medicine at Kings College about this. He is clear that switching from general hospitals to specialist hospitals could save many lives among those suffering other serious conditions.

The concern with specialist hospitals is that it takes longer to get there by ambulance rather than having everything available locally. Yet despite this lives are still saved. However which could and should be faster is time it takes for ambulances to arrive and the skill of the paramedics. They don't need to based in hospitals. They could share stations with the fire brigade, for example, as the London Assembly, among others, has proposed.

The new Charing Cross Hospital will do more of some things (for example treatment for the elderly and mental health will be expanded.) Other services will be transferred. Those who demand it should be "saved" as a general hospital miss the point that it isn't a really general hospital anyway.

There was a discussion about this at the Hammersmith and Fulham Council meeting on Wednesday evening. My colleague Cllr Marcus Ginn said:

If you have a heart attack outside Charing Cross Hospital tomorrow, you will be taken by ambulance to Hammersmith. If you have a major trauma incident you will be taken to St Mary’s. If your child
needs paediatric care that ambulance will take you from the Fulham Palace Road to Chelsea & Westminster. We already have specialist centres - and this already saves lives.

I illustrate the argument with my local example but the same principles apply elsewhere. The Mayor of London Boris Johnson was brave and right to support greater specialisation when asked about it on his LBC phone-in this week.

Labour-run Ealing Council are wrong to waste hundreds of thousands of pounds of their Council Taxpayers money on a Judicial Review. It will also costs hundred of thousands from the NHS budget. Like other Judicial Reviews it is very unlikely to succeed.

A Judicial Review of this type represents a thoroughly undemocratic approach. If you want general hospitals rather than specialist hospitals then to get enough MPs to approve such a policy - do not try to impose such a view via spurious legal technicalities. In any event the campaign against hospital specialisation - whether through legitimate democratic means or these more dubious legal challenge - is misguided. If greater hospital specialisation came to be halted then lives would be lost.