The Independent London Newspaper



Rachel Tyndall

NHS boss warns of ‘unpalatable’ decisions as £560m cuts loom

Published: 2 April 2010

THE top NHS boss driving proposals to strip the Whittington Hospital of its accident and emergency department has shrugged off mounting criticism and signalled her intent to continue as planned.

Rachel Tyndall told a meeting on Monday she would soon be making some “very difficult” and “unpalatable” decisions.

The £144,000-a-year chief executive of NHS Islington is standing firm in the face of widespread condemnation from high-profile medical experts and political heavyweights.

She told the meeting in Islington town hall that the unprecedented opposition of Whittington consultants to the plans was “unsurprising”. The thousands of marchers who took to the streets in protest at A&E closure had failed to understand fully the financial crisis facing the NHS, she added..

“We need to be having a more sophisticated debate about this – so far it is about ‘Should we have an A&E or not?’,” Ms Tyndall said.

“We need to be much clearer about what kind of trade-offs we are talking about. We are going to have less money in the future. If we choose the option of keeping the A&E at the Whittington, it means we have to take funding away from something else. I have to make the best decision for patients. 

“In the near future, I have no doubt we will be forced to make very difficult decisions. There are unpalatable options.”

More than 100 senior doctors at the Archway hospital have warned that the closure plan is “not in the best interests of patients”. But Ms Tyndall said: “Have I heard about the consul­tants? Yes. Does it surprise me? Absolutely not.”

Ms Tyndall – who is stepping down from her role at NHS Islington to work full time on the review of hospital services – said it was not possible to run the NHS with the money that was going to be made available. Whichever party won the general election, funding was about to dry up.

North Central London NHS sector – which includes five hospitals – is expected to lose £560million over the next five years, she said. 

Under hospital protocols, medical departments such as obstetrics or paediatrics cannot operate without a fully functioning A&E. Whittington’s maternity unit would also be affected if A&E closed. 

Ms Tyndall said a midwife-led maternity unit could remain at the hospital without A&E, but only for “normal pregnancies”, where doctors were not needed.

In the event of a complication during birth, mothers could be driven to a nearby hospital, she said.

Campaigners told the meeting this sounded “unsafe” and it would not be right to “put pregnant women at risk”.

Ms Tyndall added that London Ambulance Service had told her ambulances could meet journey-time targets if the Whittington’s A&E closed. She said an urgent care centre – a team of doctors based at the front entrance of the hospital – would provide a better service for many patients who wrongly attended A&E.

She produced figures showing that 230 people attended A&E each day, but only 54 were admitted to the hospital. Just two or three needed a blue-light ambulance.

Labour councillor Martin Klute, chairman of Islington Council’s health scrutiny committee, told her: “Every single remark you make is a strong argument that an A&E at the Whittington is not needed.” Ms Tyndall said: “I’m sorry to give that impression. There are three options for the Whittington A&E and no decision has been made.”

Editor's Comment

WE can now put a face to the looming decision to close Whittington’s A&E department. It belongs to chief executive of Islington NHS Rachel Tyndall.

At a meeting on Monday she sounded implacable. As she seems to see it, the A&E must go. Don’t bother me with facts – the plans should go ahead, she appeared to say.

In the 1990s experts predicted that central London didn’t need so many hospitals. University College Hospital should go, they said. The government nodded. But loud public protest made the planners back down.

Who, today, would say that hospital should close?

Like so many experts, Ms Tyndall has tunnel vision. It is she who should go – not the A&E department.


Whittington A&E

Who lead the campaign to oppose this woman?

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