The saga of Chase Farm Hospital is a long running one. I’ve lived in the area for years, rarely has a weekend passed without volunteers shouting about saving it in Enfield town. Under Labour, Chase Farm’s A&E and maternity departments were threatened with closure, and the hospital trust itself was merged with nearby (ish) Barnet Hospital, to loud criticism. The Save Chase Farm party had council members elected to Enfield Council and lobbied the Labour MP at the time, Joan Ryan, against the changes. The problems they identify include concerns about increased travel times to the alternative hospitals, Barnet and North Middlesex, both of which are situated at some distance from Chase Farm, along busy roads. One Enfield resident says ‘it’s just irresponsible; the other hospitals aren’t viable alternatives’. However, this week it all came to a head with the announcement by health secretary Andrew Lansley that Chase Farm would, after all, lose its A&E and maternity care facilities. Cue great furore. The facilities will be replaced by increasing capacity at North Mid and Barnet hospitals, and at Chase Farm by a midwife-led birthing unit, and a 12 hour urgent care department.
Far from being just a local issue, this announcement has potentially serious repercussions for the coalition government, because in 2007 and 2010, David Cameron and Andrew Lansley respectively visited the hospital pledging in strong words to protect it from those who would dismantle it. In the light of this week’s decision this is inevitably being seen as merely a hypocritical attempt to get votes. Immediately after the 2010 election, all decisions on hospitals were halted and asked to answer four essential tests in order to go ahead, which are: the existence of clear clinical evidence in support of the changes, support of the GPs, promoting choice for patients and finally making sure the local people have been engaged with the decision making process. Arguably, only the first of these tests can actually be measured empirically, as the others are subjective; many local people would argue that they have not been properly involved in the decision making process.
However, what happened was that the local IRP, the consortium made up to test the proposals, advised that in terms of safety and sustainability it was unadvisable to let Chase Farm remain the same, without altering the stasis that it has been in for the last few years. So this seems simple, the consortium, made up of Doctors, NHS managers and lay people had decided this, so why was everyone else so furious about it? Why do they think they know better than the doctors?
I spoke to Nick de Bois, Enfield North’s current Conservative MP and leader of the Hands off our Hospital campaign. He argued that the PCT had conducted meetings with Enfield GPs, but also Haringey and Barnet GPs in the consortium. Switching the A&E competences around means that both Haringey and Barnet will benefit from more patients, and therefore more government money. De Bois says, ‘the consortia was not robust enough [to make the decision], because it was too new and not fully formed at the time’. The issue of GP-led consortia is central to the coalition’s plans for the NHS because it is GPs who are being given control of budgets instead of the now defunct PCTs. The argument against this is that GPs don’t have the time or the resources to make these financial decisions, so they are farmed out to bureaucrats and private companies – privatisation by the back door.
The issue is huge locally, and was a major consideration in 2010’s general election – probably helping the Conservatives win in Enfield, so I asked de Bois whether he was worried about how the decision would affect his own votes. ‘I’m not concerned about votes, I don’t work like that. If you worry constantly about votes you get nothing done’. He has challenged the Prime Minister on the issue, and makes no secret of the fact he entirely opposes the government on this decision. But will it be enough to neutralise the ‘breathtaking hypocrisy’ of the government?
 ‘Lansley agrees to downgrade Chase Farm A&E’ North London Newspapers Wednesday 14th September 2011