CHRIS PHILP: Madness to lose expertise of Royal Free stroke unit

Every year, 250 people are treated by the Royal Free s specialist stroke Unit. It is one of the best in the country. In fact, according to a recent study by the Royal College of Physicians, it is the best unit in the UK. The Royal Free has developed a uni

Every year, 250 people are treated by the Royal Free's specialist stroke Unit. It is one of the best in the country. In fact, according to a recent study by the Royal College of Physicians, it is the best unit in the UK.

The Royal Free has developed a unique new approach for stroke and heart attack patients - basing treatment around tackling the underlying 'thromboembolism'. A paper submitted to the Royal Free's board last month said their approach is "novel, highly effective and could be a future model for every local hospital". And let's be clear about the importance of this: strokes are the third largest killer in the UK, causing 60,000 deaths per year.

So what are the Government plans for the country's leading stroke unit, which is pioneering a whole new way of treating one of the country's biggest killers? Expand it? Use it as a model for other hospitals? Give it more funding? No. None of these things. The Government plans to scale it down, and move the most important parts of the service - the crucial initial treatment - elsewhere. To UCH, to be precise, in the south of the borough. Needless to say, UCH's stroke unit is not as highly-rated as the Royal Free's.

This plan is worrying for several reasons. Let's start with the two most obvious. Firstly, it's staggering to learn that the country's most successful stroke unit is about to be downgraded. Secondly, it means that journey times for patients in places like Hampstead, Highgate, West Hampstead and Fortune Green to their first treatment will be much longer. Patients coming in from Barnet and south Herts (as some do) will face even longer journeys. This is critical when every minute makes a difference.

There is a third problem too. Under the Government's plan, London will have eight specialist stroke centres. The Royal Free will not be one of them, despite its incredible track record. London will also have three or four new specialist trauma centres, and it may be that the Royal Free is not one either. If this happens, the Royal Free's status as a leading research, teaching and general hospital may be uncertain. It would be easier for future bureaucrats to argue that the Royal Free is no longer a centre of specialism and cutting edge medicine, and withdraw further services, leaving it vulnerable.

It is important that we have a leading hospital in our area. Many residents, especially our more elderly neighbours, depend on it. And we have paid for this service. I estimate that residents of the north half of Camden pay a total of about �2.2 billion per year in tax. I think that's enough to justify keeping cutting-edge stroke services local.

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It may suit the bureaucrats to downgrade the country's best stroke unit, but it doesn't suit local people. We don't want to have to travel further for time-critical treatment. We don't want to see the UK's best stroke centre marginalised. And we don't want our local hospital undermined.

This brings me to my main point. This episode illustrates a wider problem with the way public services have been run in the last 10 years. The Government believes its army of expensive bureaucrats know how best to run services like education and hospitals. I disagree. I think doctors and front line specialists - like the ones who created the Royal Free's innovative approach to stroke treatment - do a much better job. The choices made by users (in this case, patients) should determine which services expand and which do not. In this case, I think we'd choose to keep the UK's best stroke service open.

The same is true in education. For example, we desperately need a new primary school serving Belsize Park and Swiss Cottage. Yet central government regulations and interference make it very hard for the local council or local parents to set one up.

It's time to trust professionals on the frontline - such as doctors and teachers. It's time to trust local people to make choices for themselves. Service providers would then respond to these choices, not to the bureaucrat's diktats. If we make this change, the age of the centralised statist bureaucracy could soon be over. Our services will be better for it - the Royal Free included.

Cllr Chris Philp is the Conservative Parliamentary Candidate for

Hampstead & Kilburn