Analysis: What future for the Whittington Hospital, its services and its patients?
PUBLISHED: 18:09 02 April 2013 | UPDATED: 18:09 02 April 2013
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Flora Drury looks at what the future holds for the Whittington Hospital and its patients - whether the board realises its plans or not.
Lynne Featherstone, the Liberal Democrat MP for Hornsey and Wood Green, has a reputation as a politician who stands up for a cause. Which is why her absence from the front line of the recent march on the Whittington Hospital – the local hospital for almost all her constituents – may have surprised some.
Unlike in 2010, when everyone pulled together to stop the Whittington’s A&E being closed down, Ms Featherstone is not supporting the Defend the Whittington Hospital Coalition (DWHC)’s campaign to stop the sell-off of nearly half of its land, hundreds of job losses and a move to push care out from hospital wards into the community.
Instead, she and her supporters have struck out on their own, with the less catchy demand “that no hospital services are lost until equal or better replacement services have been put in place”.
The Whittington’s plans are intended to get it out of a very tight spot: a healthy balance sheet is one of many requirements laid down by the government for any hospital trust wanting to survive beyond April 2014.
If it doesn’t meet all the tests and become a “foundation trust”, a contract to run the Whittington will be put out to tender and another hospital trust – or even a private firm – will take the reins.
In truth, Ms Featherstone’s campaign and that of the DWHC are not so different. Both agree that no services should be lost, and that the board of trustees overseeing the Whittington behaved naively and failed miserably to communicate. Both campaigns also have serious concerns about how the hospital plans to transfer care into the community.
But beyond that they divide: DWHC says the sell-off should be stopped at all costs – even if that means the Whittington can’t balance its books and is swallowed by another hospital trust. Ms Featherstone’s camp think this has to be avoided. She strongly believes it will be worse for the hospital, and its patients, than losing land which is currently under-used.
“If the hospital does not make changes, and their foundation trust application fails, then they will certainly be taken over by another hospital trust,” she said. “This would be devastating for the communities of north London: services would almost certainly be lost, community focus and accountability reduced and the viability and continued existence of the A&E put into doubt. We would lose local control.
“We cannot let this happen – and that’s another reason why I cannot support the DWHC campaign, which calls for no changes at all.”
But are her fears grounded in reality? As the government deadline is the same across the country, it is difficult to find examples similar to the Whittington that have already been played out. But there are places where takeovers are being mooted.
Dame Ruth Carnall, who until last Friday was the chief executive of NHS London, talked about the future for the Whittington should its application for foundation trust fail. Speaking at City Hall in Febraury, she said a failure would put the Whittington “between a rock and a hard place”.
“We would look at potential partners,” she continued, citing Homerton, the Royal Free and University College Hospital (UCH) – although the first two she dismissed, noting that Homerton faced different challenges in east London, while the Royal Free already had its hands full.
The reason the latter would be unlikely to consider a takeover is because it has already thrown its hat into the ring to take over Barnet and Chase Farm hospitals, neither of which is in a position to achieve foundation status. A business plan is being put together for the merger which is likely to include some ‘rationalisation’, although at this stage it is impossible to say what this might amount to.
Supporters of Barnet and Chase Farm are concerned, though. In December, Kate Wilkinson, from the group Save Chase Farm, said she feared the process could amount to an “asset-stripping exercise”.
Could that, conceivably, be the future for the Whittington, should UCH move in? Privately, some in the know are whispering about the Whittington becoming little more than a “dormitory hospital” under its control.
But, it may not be UCH which steps in. It could, Dame Ruth posited, be a private firm. It is not impossible: George Eliot Hospital in Nuneaton, West Midlands, is welcoming bids from both public and private providers to run it in future.
Yet John Appleby, chief economist at The King’s Fund, an independent charity working to improve health and health care in England, sees neither the sell-off nor a potential take-over as necessarily bad. In fact, he believes that both sides of the argument have forgotten one very important thing: those at the top are thinking about the community they serve.
“What would be in the interests of the patients; that is at the heart of what the managers are thinking,” he said.