Hospital Merger Chaos Threatens ICSM Students
A controversial proposal, described as the ‘result of unprecedented and unnecessarily deep cuts in public services’ has been announced, that would see Ealing Hospital Trust and North West London Hospitals Trust merge.
Discussions about the futures of several London NHS Trusts have been ongoing since 2010, and whilst no official decisions have been announced, both Trusts are said to be finalising business plans for the merger, that, if approved, would be implemented as of July 2012. In a final proposal document, the decision was hailed as offering the ‘best opportunity to provide the highest quality of care for people in Brent, Ealing and Harrow.’ The document cited ‘organisational barriers’ and lack of integrative care as fundamental drivers for the proposal, and noted that by becoming one organisation, the Trusts could provide the community with large clinical teams that deliver more specialist and better quality of care. 'Our vision is to ensure that every person in our part of London has the best possible healthcare.'
"There is a danger that after the merger, there will be a period of uncertainty due to administrative issues associated with the merger which will affect all of the hospital staff and that can affect the experiences of the students who have firms at those sites"
Imperial College Medical Students, who receive clinical training within both Trusts will no doubt be concerned about the proposals. The Medical Student spoke to Dr Bill Lynn, a consultant at Ealing Hospital working on the proposed merger, who sought to reassure the hundreds of students trained within the Trusts.
'The merger process is working closely with Imperial to ensure that the concerns of the medical students are taken into account. There are no short term impacts on the students. However, it is vital not to lose medical student numbers who are attached to the hospitals and to maintain the quality of the experiences that the students will have once the merger has occurred.'
Dr Lynn recognised, however, that with significant administrative change comes periods of uncertainty. 'There shouldn’t be an immediate impact on the learning experience on the students. However, there is a danger that after the merger, there will be a period of uncertainty due to administrative issues associated with the merger which will affect all of the hospital staff and that can affect the experiences of the students who have firms at those sites. We will aim to address any issues closely with a feedback system throughout the clinical sites and liaise closely with Imperial.'
The plans have come up against fierce competition from doctors and politicians alike, who express concerns that the move could leave Ealing Hospital with no Accident and Emergency Department and no in-patient beds, rendering 300,000 local people without adequate access to healthcare. Public dissatisfaction in the proposal was starkly reflected by a 4,000 signature strong petition, lead by Dr Onkar Sahota, a London GP and Labour candidate representing Ealing and Hillingdon at the Greater London Authority (GLA), which was presented to a full council in December. Sahota outlined his concerns with the motivation behind the merge:
'I have nothing against mergers if they reduce management costs and put more money into frontline services. However this merger is about reducing investment and threatening services.'
Indeed, hidden within the official Trust documents explaining the merger could lie the real driver for the proposals. With the NHS being forced to make £20billion worth of efficiency savings, this merger is part of the wider initiative to save money by moving services out of hospital and into the community - focusing more on primary care and disease prevention. Whilst the Trusts deny financial motives being the key motivators for the plans, they recognise that they ‘have to consider what financial benefits a merger will bring. Our services need to be affordable, as we know there will be a decline in hospital income when resources are shifted to the community. We need to match our services to this change in funding.’
Even if the proposals are approved, there will be no immediate changes to patient care. No decisions have yet been made about the form the organisational changes will take – this will be decided in a separate formal consultation with the PCT and local GPs later this year. Because of this we can only speculate about the consequences the merger will have on patient healthcare. In difficult financial times, proposals that truly save money via the more efficient use of resources should be welcomed, but never at the expense of quality of care.
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