Sunday, October 08, 2006

Future of Health Care in Barnet

For too long the health service in this country has struggled from one crisis to the next as different political parties have continually reversed previous ideas about how best to run the NHS. In Barnet this has led to many difficulties with the quality of health services. This includes the closing of Edgware Hospital, for which I remember the controversy while I was at school. While Labour were unable to keep Edgware Hospital open I agree they should be given credit for the Community Hospital which is on the current site. However, as many of you will agree with this does need expanding given the size of the current local population, which is continuing to grow.

That is why I am pleased that the leaders of the local political parties in the Council and MPs have come together to issue a joint statement (below) calling for improved health facilities (and not closures) in Barnet. This is so that the Primary Care Trust, which is responsible for delivering health care agrees a future programme that is best for Barnet and its residents.

From tomorrow you can give your views at

Joint Statement on Barnet, Enfield and Haringey NHS Clinical Strategy

We thought it would be timely if we jointly set out a statement about the development of the above strategy from a Barnet perspective. Starting first with context about Barnet

• Barnet is the 2nd largest borough in London whose population mainly uses the acute hospitals of Barnet, the Royal Free and to a lesser extent Northwick Park and Chase Farm.
• Barnet is the fastest growing London Borough outside of the Thames Gateway with an expected increase in its population of about 40,000 in the next 10 years, especially along the A5 corridor, the furthest part of the borough from Chase Farm.
• The local NHS has been bedevilled with mixed performance ratings.
• This has been particularly the case for our main Acute Trust of Barnet and Chase Farm Hospital which was formed by a merger 5 years ago. The merger took place despite Barnet Hospital’s main clinical links, at the time, being with the Royal Free and not with Chase Farm in Enfield.
• There is one A/E department in the borough at Barnet Hospital. Barnet residents also extensively use the Royal Free A/E department. Additionally there are two very popular Walk In Centres at two community hospitals.
• One of these community hospitals, Edgware Community Hospital, was highlighted by the Department of Health in July as an example of a 21st Century style community hospital. The other, Finchley Memorial Hospital, is by contrast in a poorer condition, but is well used by the community.
• Barnet Council has a programme of joint working with Barnet PCT, which has been held back this year by top slices of the PCT’s budget allocation.

We understand the issues that are driving changes in acute services. These have been well articulated by leading commentators such as the Chair of the BMA. We support increasing provision of care nearer people’s homes and much more in partnership with social care. Such transfers of services from hospitals with costs falling on social care should be partnered with the transfer of resources. This is not a matter for London NHS alone.

However, it does appear from a purely Barnet perspective that many of the problems in outer north London which the clinical strategy is trying to resolve have arisen because of the Barnet and Chase Farm merger.

The clinical strategy sets out a number of scenarios, which we understand are now being short listed to 4 or 5 options for more detailed analysis before consultation. A few of the scenarios are clearly not feasible, such as turning North Middlesex into a community hospital or for that matter ceasing emergency services at Barnet Hospital. This would not be acceptable to Barnet. Decisions on provision must be made solely on clinical, access and financial grounds, based on the evidence. Barnet Hospital has recently benefited from a major rebuilding programme and these brand new buildings must be used by the NHS for planned and emergency treatment. Good access to NHS services for Barnet residents is of vital importance. Barnet residents’ use of local hospitals follows public transport and road links. Chase Farm is poorly accessed from most of the borough.

We support a change in provision in Barnet, as the current pattern of services will not continue to meet the needs of our residents. We also support increasing choice for users of NHS services. However, we wish the change process to be managed constructively with local representatives, as otherwise there is a risk that the level of opposition being generated will freeze decision making and result in a continuance of the status quo. This will not serve us well in the medium to long term. For these reasons we suggest an approach which demonstrates the following:

• Ensuring there is the necessary investment at Barnet Hospital to meet any increased activity due to changes in Enfield
• Redeveloping Finchley Memorial Hospital, including the Marie Foster Centre, as a modern 21st Century community hospital to help support the changes and bring care nearer to people’s homes. London NHS will be receiving a Strategic Outline Case for its redevelopment this December
• Supporting the development of improved community and primary care services in Barnet, including further developments at Edgware Community Hospital.
• Recognising the impact on health services infrastructure of the growth in Barnet’s population, including the changing demographic profile and fully resourcing this as it occurs.
• Enabling appropriate transfers of resources into social care where activity is being transferred out of hospitals and the costs are falling onto Council budgets
• Recognising the principle of Patient Choice as the driver of changes in the system.
• Reinstating and, in addition, developing stronger clinical links between Barnet Hospital, local community services and the Royal Free Hospital.

Additionally we could well envisage, that the possible changes in Enfield could in due course lead to the need for acute trust reconfiguration with the creation of a Trust encompassing Barnet Hospital and the Royal Free. This would create a Trust that more closely reflects the actual patient journeys of Barnet residents and could more effectively focus on Barnet’s needs. The London Borough of Barnet has the largest number of patients using the Royal Free of any London borough. However, organisational reconfiguration must be secondary to getting services in the right shape to serve our community.

Cllr Mike Freer, Leader of Barnet Council

Cllr Helena Hart, Cabinet Member for Public Health

Cllr Brian Coleman, London Assembly Member for Barnet and Camden

Cllr Alison Moore, Leader of the Labour Group, Barnet Council

Cllr Monroe Palmer, Leader of the Liberal Democrat Group, Barnet Council

No comments: