Whipps gaining favour

1 December: A personal view from campaign Vice Chair and Secretary Alan Hakim.

I have been informed by a highly reliable source that the Fit for Future Financial Appraisal that took place yesterday has reported in favour of Option 4. This is the option that retains Whipps Cross as a District General Hospital. We were already aware that the non-financial appraisal had placed Option 4 as first choice; great news for Whipps Cross.

All those who stand by the hospital through this process should feel justified in their convictions. The support from our patients, the public, general practitioners, the unions, local councils, MPs, and the local Guardian newspaper has been phenomenal.

There may be some people who will say that the public campaign is just scare-mongering. They may suggest the final outcome is obviously going to be in favour of Whipps. If this is the case I ask them "Why go through Fit For Future in the first place?", and "Why are so many people expressing the same concerns, and find themselves in agreement with such a wide spectrum of the community?"

We need to be reminded however that Fit for Future is by no means 'done and dusted'. We should move forward with cautious optimism. We now need to focus on the public consultation. I do not know the details of this but assume that a formal announcement will come soon, and that the plan will be to start consultation early in 2007.

The public campaign must also remain vigilant over several other key issues.

First is the financial 'turnaround' of Whipps Cross. The hospital is being asked by the Strategic Health Authority (NHS London) to show that it has done everything it can to reach 'financial balance' by the end of March 2007; the end of the financial year. We need to appreciate that this does not mean the hospital is then cleared of all its debt. 'Financial balance' means that it is no longer spending more each month than it earns. A lot of things are happening at Whipps to try and reach this goal. Reports from the 'Turnaround' process already show that there have been significant improvements in the hospitals accounts but there is more that needs to be done.

While trying to get the finances balanced the hospital must be sure not to jeopardise the quality and safety of care; to this end clinical staff and hospital managers will continue to work closely with each other. Despite every intention the hospital may not be able to achieve the level of savings forced upon it. We should be clear that the financial deficit the hospital faces is not the fault of the local population. Patients must not be penalised should Whipps find that it cannot meet the Health Authorities expectations.

Second, in order to clear its debt and thrive, the hospital will need to improve its buildings. It will need financial support from new sources of funding to do this. Many will have heard comments about this from our local MPs. We will need their support and that of local councils, as well as support from the Strategic Health Authority to make this happen. We must also watch out for the introduction of private companies and Independent Treatment Centres. These are popping up all over the country. There is the potential for an enormous threat to the long-term survival of places like Whipps Cross if your PCTs do not invest in the local hospital and buy contracts for clinical services from private companies instead. That is not to say that hospitals like Whipps should expect favours. Whipps must provide 'value for money' and high quality. If it can (and I believe it can, and in many ways already does) it would want to be the first choice of provider of health care for the local population. Keeping it your first choice is very much down to you as a patient, and to your General Practitioner.

We also need to be aware of the Government's policy to move services out of hospitals and in to the community. For me there remain a number of concerns about the validity of such changes both in financial and clinical terms. There is very little evidence that justifies many of the changes proposed. Every time I hear about a hospital service being 'dismantled' and somehow assembled in some new form as a community care package I will be asking questions: "How does this affect your choice of being able to see a specialist in your local hospital?"; "Who will be running the community services, how will they be trained, and how will they keep up with new developments in specialist areas?"; "Will there be any negative impact on education, training, high quality clinical research, and retention of our already highly skilled workforce?"; and "Where is the evidence that this new way of practicing health care makes more sense financially and provides as good, if not better, service for patients?"

You should know that local hospital specialists and general practitioners are already working together to develop and improve on what we call 'care-pathways' for our patients. These 'pathways' help doctors, nurses, and other clinical staff, decide what to do for their patients, when to do it, and where best to do it. It requires a close partnership between primary care and hospital staff. We have lots of examples where this is already happening. These developments should be allowed to mature through proper clinical engagement, using all the evidence from what we know of 'best practice'. They should not be forced through by Government policy that changes things for change's sake.

Finally, if things are going well for Whipps, some may wonder why it is that people will still be seen at vigils or demonstrations outside the hospital. They will be supporting events such as that due to take place Nationally on December 15th. Fit For Future, Whipps Cross 'Turnaround', and local issues are not isolated phenomena. The news covers some aspect of health-care turmoil up and down the country every day of the week. Although Whipps is hopefully finding its way through this maze, many other hospitals find themselves in crisis. Health Service staff, with support from other Unions and the public will find themselves engaged in a wider, National and Political campaign that continues to question the Government's policies on the NHS.

Dr Alan Hakim, Vice Chair / Secretary of the Save Whipps Cross public campaign

Dr Hakim is also a Consultant, Chair of the Whipps Cross Hospital Medical Staff Association, and sits on the hospital's Turnaround Steering Committee. This commentary is a personal view.