The mayor of London has used an HSJ interview to vow to back hospital reconfiguration projects that have the support of clinicians.
Boris Johnson also revealed the recently created London Health Board − which he chairs − would look to improve primary care, mental health care and the early detection of cancer, and that he wanted to explore how “to make better use of NHS land in London”.
The mayor’s office does not have direct control over anything more than a topslice of the public health budget handed to the capital’s local authorities.
However, Mr Johnson told HSJ he would use his position as a “bully pulpit to make improvements to primary care”.
And Mr Johnson, who has previously defended contentious hospital reconfigurations, said he would proactively support them again.
He compared the issue to his pushing through of the closures of 10 London fire stations, something he insists can save money without endangering lives.
“I am willing to be helpful on that,” he said.
“What I think I can be useful in doing is standing up and making a general point. Don’t freeze things; you have got to change the configuration and people have got to be open minded, they should listen to what clinicians are saying.
“I’m not directly responsible. But the test for me [is] − what are the people who are really dedicating their lives to [this] telling me? It’s a similar argument to fire stations. There’s a lot of emotion.”
Referencing soldiers who take up exposed positions on military advances, Mr Johnson added: “I can make that general point but I wouldn’t want to be the point man in every single row.”
Last month the High Court overturned health secretary Jeremy Hunt’s decision to downgrade services at Lewisham Hospital as part of the rescue plan for South London Healthcare Trust.
Another judicial review will be heard later this year into a separate decision to downgrade three emergency departments in north west London.
Mr Johnson told HSJ: “I think I have been pretty consistent” on supporting reconfigurations backed with clinical evidence. However, footage exists of him in 2008 opposing the downgrade of Queen Mary’s Hospital in Sidcup where A&E services were subsequently closed “temporarily” in September 2010 due to safety concerns relating to short staffing.
The mayor also discussed the work of the London Health Board, which also features NHS England information director Tim Kelsey, NHS England regional director for London Anne Rainsberry, the leaders of four councils and the chairs of two academic health science centres.
In June, HSJ revealed Mr Johnson had appointed former NHS London chief executive Dame Ruth Carnall as executive adviser to the board.
Mr Johnson said: “The mayoralty has responsibility to tackle health inequalities but it doesn’t have many of the levers that it could have.
“The mayoralty should have a bigger role in healthcare. If I was appointing the head of NHS London it would be a very good story.
“One of the reasons I was keen to bring Ruth in is she has a wealth of experience and can help us to escalate some of the issues we want to push up the agenda.
“I want Londoners to live longer, for them to be healthier, for justice in the outcomes. There are parts of London that have radically different outcomes.”
He said his public health priorities were “fatness, childhood obesity… cancer, getting people to report symptoms earlier and mental health, which is an issue the police are very concerned about”.
“The [mental health service] coverage in London is pretty patchy and there are all kinds of implications for us as a city,” he added.
Mr Johnson also said part of his role was to “talk up” London as a centre of health innovation and research to equal or even surpass that of Boston in the US.
He cited the concentration of research facilities on the city’s Euston Road and pushing the idea of “Med City” as a brand similar to “Tech City” − a name attached to the concentration of new media technology businesses in the Shoreditch area of the city.
Dame Ruth told HSJ the mayor would be making representations about the reallocation of medical training and research funding to trusts outside London.
She also said changes to the funding formula for clinical commissioning groups that would disadvantage the capital - by prioritising age rather than deprivation - would be resisted.
The mayor said: “I’m worried about Londo-phobia. I’m worried about prejudice against London. This thing has huge health needs.
“There’s this mindset developing that London’s the only really very successful part of the UK at the moment and it deserves in some sense to be punished − [it’s a] complete misconception.
“What’s good for London can be shown to be good for the whole health economy in the UK. I will make that case.”