No matter how they’re dressed up, A&E options look bad for patients

DR Philippa Curran does a great disservice to honest debate by dressing up her clinical advisory group s suggestions for cutting the provision of A&E services in North London as part of the great advances in health care that have taken place since the 197

DR Philippa Curran does a great disservice to honest debate by dressing up her clinical advisory group's suggestions for cutting the provision of A&E services in North London as part of the great advances in health care that have taken place since the 1970s when she qualified - or in my case the 1950s (Debate is needed but the NHS must change with times, H&H Viewpoints, December 10).

We can all recognise the proposals for what they are, major cuts due to the country's disastrous financial crisis. The headline on her article rings all too true on that score - and I would go for the bloated initiative-stifling morale- sapping bureaucracy.

Her evasive references to the use of the term 'local hospital' are no less than dissembling sophistry. This designation is the one sector chief executive Rachel Tyndall of North Central London NHS used in her leaked letter last month when referring to the Whittington as a hospital to be without A&E or specialist services in all four permutations of proposals by Dr Curran's group for hospitals in the area.

Dr Curran conflates objections to the closure of an obsolete old fever hospital with those for a brand new A&E department serving 80,000 patients a year and implies that the latter are based, not on the much appreciated provision and availability of excellent medical care, but on parochial loyalty.


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The parochial shortsightedness and short term-ism is that of Dr Curran and of her political and financial masters. What would be the cost to the NHS of meeting the debts for the new Whittington building and then providing all the facilities needed for an extra 80,000 A&E patients elsewhere?

What are the implications for the environment of shipping patients round and about?

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What are the costs of providing the medical education and training for doctors in a service that, to this day, needs to fly in expensive locums from other countries?

Where are the nurses currently trained at the Whittington with Middlesex University going to come from? The availablity of hands-on nursing is already threatened by the pretentious plans for nurses to have university degrees. And above all what are the clinical implications of any reduction in the number of A&E providers in North London?

In her article, Dr Curran demonstrates a singular failure to be frank about the issues involved and studiously avoids risking an informed debate.

She has missed an opportunity to engage with the people who really count, the general public. We are the ones who will suffer from the consequences of any of the proposed changes and we, at the end of the day, are the ones who foot the bill, including her salary.

Dr Barry Hoffbrand

Cholmeley Park, N6

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