HSJ EXCLUSIVE North London service reforms take a back seat

Published: 02/12/2004, Volume II4, No. 5934 Page 9

Two major consultations to reshape NHS services across north London have been put back until next summer, following a warning from the Department of Health about 'negative' publicity in the run-up to the general election.

As reported by HSJ in September, chief executives across the patch were told that the DoH had indicated that a 'negative consultation' on changes to maternity and children's services would be 'unacceptable' before an election.

The consultation on Healthy Start, Healthy Futures has now been shelved until summer 2005 - which means it is likely to fall the other side of a general election, widely predicted for May.

A spokesperson for North Central London strategic health authority said the decision would mean Healthy Hospitals, an overlapping consultation on clinical strategy across Barnet and Chase Farm Hospitals trust, will also be delayed 'until the wider picture is resolved'.

The decision to postpone Healthy Start for the third time comes after a media offensive by clinicians at the Royal Free Hospital in Hampstead, criticising the unanimous verdict of the board of primary care trusts to move its maternity, neonatal and inpatient paediatric services to the Whittington Hospital in Archway.

This prompted an e-mail to acute and PCT chief executives from project team chair Rachel Tyndall, in which she wrote: 'The DoH have indicated that a negative [public] consultation prior to a general election would not be acceptable'.

The SHA has since drawn up a new preferred option which would have left maternity and neo-natal services at the Royal Free untouched.

But even this has been postponed while the SHA holds a further review into 'how care will be provided for pregnant women with specialist clinical needs'.

A source at the Royal Free said its clinicians now felt 'in limbo'. 'We are a bit nervous that we will get past the election and the whole thing will rear up again.

'The election was the big thing and if it rears up again [after the election] the impetus will be lost. The fear is they will reinstate what they had in the first place.' An SHA spokeswoman said: 'The timetable is the timetable. The work that needs to be undertaken can't be completed any quicker than the time we set for it.' Asked whether the decision was politically motivated, she said: 'You could look at it that way, but there is always going to be politics around.

The main consideration of the board was that the work was as robust as possible and that we had clinical and organisational support.' A senior manager in the area said: 'It is very difficult to make these decisions within the political context of the NHS. It is very difficult to make [controversial] decisions in the early part of a new parliament or at the end. You have got a very small window of opportunity, probably only a year or 18 months in the middle of a parliament to make changes.'