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Andrew Lansley: I’ll make sure Londoners get chance to save their local A&E
21 May 2010GPs and the public will be able to save casualty and maternity departments in London under a radical overhaul of health services in London.
Andrew Lansley, the new Health Secretary, gave the guarantee after putting a halt to Labour's health reforms. But family doctors, in consultation with patients, town halls and local health bosses, will themselves have to take tough decisions on NHS spending — which could include downgrading some services. In an interview with the Evening Standard, Mr Lansley:
* Urged doctors and patients in the capital to “leapfrog” the rest of Britain and radically improve healthcare.
* Warned that hospitals face efficiency savings of up to five per cent a year, with an axe taken to bureaucracy.
* Rejected NHS London's strategic health plan as flawed, and put a stop to signing new contracts for polyclinics.
* Admitted doctors and nurses could see job cuts, but said opportunities in other specialisms would emerge.
While the walls of his office overlooking Whitehall are still bare, Mr Lansley, a former civil servant, has wasted no time in blocking changes under NHS London's strategic health plan.
“London has an opportunity now to leapfrog the rest of the country,” he said. “Because of the nature of the problem in London, the answer is not to slow reform down, it's to be faster.”
His NHS vision has three key principles: that it be designed around patient need; that GPs and clinical experts take more responsibility for resources; and that a greater focus is placed on outcomes. “London is the sort of place that I think would respond extremely well to patients having opportunity to exercise more choice,” he added.
During the election, rows erupted over the possible loss of A&E departments at several hospitals, including Kingston and The Whittington. The Conservatives pledged a moratorium on such moves and Mr Lansley went a step further today.
Asked whether a local A&E would remain open if GPs and patients were against shutting it, he said: “Yes. GPs are going to have control of the commissioning budget.” But he made clear that difficult spending decisions, which would be made “pretty much borough by borough”, would have to be led by these family doctors.
Defending local A&Es, he added: “Most, if you look at them — Ealing, Chase Farm, Kingston — you are looking at 100,000-plus people attending each year. Even if 20 or 30 per cent fewer were attending ... on any measure [this] is a large emergency department.”
He also warned against axing hospital services that could not be better provided in the community: “If you're somewhere like Ealing, Ealing Hospital is a very appropriate location for people to access services.”
Having warned savings of more than £20 billion may be needed in the NHS, Mr Lansley added: “Almost every [hospital] chief executive I have spoken to is saying, I understand I'm going to have to achieve something like four, maybe five per cent efficiency savings each year over the next few years to ensure we can cope with demand.”
Clinical jobs could go despite a pledge to protect key frontline services. But with a need for more stroke physicians and nurses, radiographers, health visitors and cancer nurses, Mr Lansley said: “If we do what we're aiming for, there's no reason overall why the number of clinical staff should not stay broadly stable but delivering more services.”
He said previous forecasts of a funding gap in London of up to £5 billion a year were out of step with the real-terms rise in spending pledged by the coalition.
