Outer east London boroughs complain of NHS underinvestment

A committee of councillors from Waltham Forest, Redbridge, Havering, Barking & Dagenham and Essex County questioned why inner east London has “nearly three times” more acute beds than their areas.

A recent report on NHS investment in north east London lists £87.1 million worth of plans in inner boroughs and £47.5 million in outer boroughs, although the contribution to the new Whipps Cross is still unannounced.

A key disagreement between the NHS and councillors appears to be whether investment in one borough will still benefit residents elsewhere across the north east London region.

The NHS, currently in the process of merging all north east London NHS services into one, insists they have scientific evidence that “consolidating speciality care” improves outcomes for patients.

However, the joint committee of councillors remains “unconvinced” that services in “geographically distant locations will result in better standards of care” for their residents.

Read more: Redbridge councillors urge leadership not to cut voluntary sector funding

In a letter on September 30, chairman Cllr Neil Zammett wrote: “Members have noted with increasing concern developments such as the transfer of more clinical services and beds to the Royal London Hospital.

“There are two maternity departments located in Tower Hamlets compared to only one covering Barking & Dagenham, Havering and much of Redbridge.

“There are also two major hospital sites in Tower Hamlets and the overall number of acute beds in inner north east London is nearly three times that of outer north east London.

“The joint committee feels therefore that further investment in the Tower Hamlets area such as the new Early Intervention Cancer Service at Mile End and the Clinical Sciences Centre in Whitechapel should be reviewed on the grounds of location.

“The joint committee remains unconvinced by the overall argument that the concentration of facilities in geographically distant locations will result in better standards of care.”

NHS insists 'fair comparison' of beds not possible

Responding to his letter, accountable officer for the combined north east London NHS body Jane Milligan insisted a “fair comparison” of bed numbers across the region was impossible because the hospitals “do not have the same estate, clinical or workforce capacity.”

She wrote: “We know clinical evidence shows that by consolidating speciality care, and by undertaking large numbers of the same procedure every day, we will be able to ensure patients get the best possible results.

“The scientific evidence shows this leads to better outcomes, more consistent clinical standards and shorter hospital stays.

“The distinction of what is outer north east London and what is inner north east London is also drawn around borough boundaries rather than health systems.

“We know that residents have access to, and are often closer to, other hospitals depending on their choice.”

Earlier this year incompatible IT systems caused problems for Redbridge patients looking to receive blood tests in neighbouring Waltham Forest.

The scientific evidence on which the NHS is basing its decision to consolidate care was not outlined in the meeting or the letter to Cllr Zammett.

Read more: Man found dead in home three days after being discharged from Whipps Cross A&E

Responding to specific concerns about concentration of resources in Tower Hamlets, Jane Milligan said residents from other boroughs could still use Newham Hospital’s maternity service and that Tower Hamlets does not have “two major hospital sites” because Mile End Hospital is a “community-based site, not a major acute hospital”.

She argued that the new cancer centre planned for Mile End Hospital, which Cllr Zammett suggested be moved to Ilford, will be “a shared resource” for the whole area and will “ensure equity of access to clinicians for patients across all boroughs”.

She also highlighted examples of planned investment in outer boroughs, such as the £15m in Government funding to improve King George Hospital’s A&E.

Some of this funding will be spent on a “new X-ray facility”, much-needed at a hospital with a radiology department previously described as “the worst in the country”.

A possible further £12 million, which still needs approval once the NHS has developed a financial plan, would be spent on paediatric services and same day emergency care.

In Havering, the former site of St George’s Hospital in Hornchurch will become a new “health and wellbeing centre”, with £17 million of national funding and a developer who will add 300 new homes.

Underfunded for years

Healthcare in Barking, Havering and Redbridge has been historically underfunded. In the 2016/17 financial year the combined area received almost £46,000 less than it needed to treat its population.

While significant extra funding has been provided in recent years, this has only brought the area’s funding up to the same level as elsewhere in east London.

Henry Black, chief finance officer for north east London NHS, said: “This has corrected what is a historic imbalance but by no means fixed everything.

“Clearly there is a legacy of under-investment which won’t be fixed overnight but does mean we will have a much better opportunity to fix it going forwards.”

He explained that funding allocations were “largely driven by central government” and based on a “complex formula worked out using various demographics”.

The north east London NHS was asked today why this formula inaccurately estimated the need in Barking, Havering and Redbridge and has not yet responded at the time of publication.

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