cuts plan for North Central London NHS

MQT on 2017-07-13
Session date: 
July 13, 2017
Question By: 
Andrew Dismore
Labour Group
Asked Of: 
The Mayor


A 31 page internal NHS cuts plan to plug the £183.1m budget gap in North Central London NHS uncovered by The Guardian would mean patients in Barnet and Camden, as well as Haringey, Enfield and Islington, waiting even longer for operations, patients being denied access to an increased number of treatments, cuts to financial support for patients with serious, long term conditions including brain damage, downgrading or closure of hospital units and doctors spending less on drugs. Clinicians and NHS staff have expressed deep concern, with the Royal College of Surgeons calling the changes "devastating" to healthcare provision. Will you join me in calling for an immediate halt to the implementation of these plans until a full consultation can take place and residents' views can be heard and the plans can be properly scrutinised and debated in public?


Answer for cuts plan for North Central London NHS

Answer for cuts plan for North Central London NHS

Answered By: 
The Mayor

Sadiq Khan (Mayor of London):  Thank you for your question.  Further NHS service cuts to North Central London are very concerning, especially the potential impact this will have on access to global health services.  I am advised by the NHS that the capped expenditure programme process - that is what it is called - is about improving the NHS financial position this year.  The proposals do not appear to provide a comprehensive health service for the local area.  I know that many of the financial pressures the NHS is experiencing at present result from political choices made by the current Government.


Your question asks about public consultation and service changes.  The NHS has very clear duties in this respect.  Public consultation is required for any major service changes.  Furthermore, before any public consultation takes place, proposals must have full support of the clinicians who make the decisions about service provision, have clear clinical evidence that supports them and have been the subject of robust patient and public engagement.


I propose to take this up with NHS England initially to seek assurance about this process, especially with regard to openness and transparency and the running of the local government health, overview and scrutiny committee to demand proper consultation on these proposals.  It is important to examine whether these planned changes provide a comprehensive health service in North Central London as per the statutory duty.  Additionally, I will be seeking assurance about how these changes will impact health and equalities before any implementation can proceed. 


Andrew Dismore AM:  Thank you, Mr Mayor.  Would you agree that the secrecy surrounding NHS cuts project is designed to surreptitiously sneak through improper and dangerous cuts and that such a lack of transparency can only undermine public trust?  The proposals include cuts such as patients having to wait longer than the maximum 18 weeks for planned operations, rationing of care through patients being denied some surgical treatments, and hospital units being downgraded or shut as a result of ‘service consolidation’.


I do not know if you have seen the document yourself but, if you have, would you agree that the Government has ordered the NHS, including the Royal Free and University College London, to implement draconian cost-cutting measures and to ‘think the unthinkable’ in its demand for savings?  The document says:


“We recognise that these choices may be difficult for a number of reasons [because they include] … options that impact on quality of care [and] options that would be difficult to implement.”


Sadiq Khan (Mayor of London):  Local residents in that part of London have seen for themselves the consequences of changes made over the last seven years, which are impacting the service they receive as patients and potential patients from the NHS.  To argue that because these changes are not major service changes no consultation is required is missing the point.  Any public service that is meaningful should be consulted before changes that affect users of that service.  The NHS needs to do a far better job.  As a result of your question and the points you have raised and brought to my attention, I will certainly be making those representations to the NHS.  They need to do far better. 


Andrew Dismore AM:  The fact is, is it not, Mr Mayor, that all of this is the product of the Conservatives starving the NHS of the money it needs to do the job properly and putting finances ahead of the interests of patients?


Sadiq Khan (Mayor of London):  Without a doubt, these are the direct consequences of decisions made in central Government.  A top-down reorganisation was not needed.  Cuts in real terms to NHS budgets, decisions being made as consequences of those cuts and local health providers who work incredibly hard are very conscientious, retrofitting the service they provide as a consequence of decisions made by central Government.