The Accident and Emergency (A&E) unit at Trafford General Hospital in Greater Manchester, England is faced with closure along with the loss of its Intensive Care Unit (ICU) and the ending of children’s services and acute surgery. Local health bosses formally announced the plan in July. A final decision is expected later this year following a consultation process that ends October 31. The measures would take effect early next year.
The threat to Trafford General highlights the far-reaching consequences of the dismantling of the National Health Service (NHS) at the hands of successive governments. The hospital is recognised as the birthplace of the NHS. It was where the universal health care system was launched back in 1948 and treated the first patient and delivered its first baby.
Government health minister Simon Burns stated, “I know that Trafford is the birthplace of the NHS and where [Labour’s] Nye Bevan famously launched the NHS. But unfortunately history is not enough. Every corner of the NHS needs to be on sound financial footing so it is viable for years to come.”
It is precisely because of its history that the government is determined to show it will not be spared. Trafford General is one of several hospitals across the country whose A&E units face the axe. In London a sweeping closure programme is planned. In northwest London alone four of its nine A&E units are earmarked for closure following an announcement by NHS North West London. These are Ealing, Charing Cross, Hammersmith and Central Middlesex. This is based on making £1 billion of cuts over the next three years. Three others in the capital are faced with a similar fate. A&E units closed at hospitals in Yorkshire, central and north east England last year and the A&E unit in Llanelli, Wales has been added to the growing list.
The official rationale for the downsizing is the claim made by local health bosses that the closures are to reorganise emergency care in fewer but better resourced units. NHS Trafford also claims that the closure of A&E unit at Trafford General—which treats around 38,000 a year—is part of “A new health DEAL for Trafford” aimed at improving primary health care facilities in the community.
The closure is part and parcel of the £20 billion worth of “efficiency savings”—read cuts—to the NHS budget demanded by the Conservative/Liberal Democrat government by 2015. Throughout the country objections from local people dependent on these services—as well as clinicians—are either met with evasions or arrogantly dismissed. The NHS in north west London has spent £32,000 on adverts in local newspapers backing closure plans and discrediting concerns.
The plan for Trafford General would involve closing the A&E unit overnight and its replacement with an “urgent care centre” operating between 8 a.m. and midnight. Within two to three years this would be further downgraded to a minor injuries and illness unit.
According to an NHS document leaked to the Mail on Sunday, “urgent care centres” are legally forbidden from treating a wide range of serious and life threatening conditions—including shock, internal bleeding, breathing difficulties and heart attacks. They are even prevented from treating patients suffering “severe pain.”
Those in need of emergency treatment would be diverted to the nearest alternative A&E unit. The inevitable delays that would result in sending patients to Wythenshawe Hospital or Manchester Royal Infirmary would undoubtedly put lives at risk. University Hospitals of South Manchester estimate that the closure of Trafford General A&E would lead to an extra 7,600 A&E attendances and 1,900 unplanned admissions a year at Wythenshawe Hospital. The Wythenshawe A&E unit already treats 88,000 in a unit designed for 70,000. Therefore the emergency treatment for those local residents would also be compromised.
Trafford, with a population of more than 211,000, is also the location of Manchester United Football Club, which regularly hosts games with more than 75,000 supporters in attendance. Also nearby is the Trafford Park industrial estate employing more than 30,000. In the event of an emergency requiring urgent hospital treatment, the safety and well-being of such huge numbers would be enormously compromised.
The closure of the A&E unit also puts a question mark over the future of the hospital itself. Trafford General already lost its maternity department in 2010. Dr John Lister from Save our NHS has stated, “Nearly every hospital closure since the 1970s has begun with the closure of an A&E department.”
Under these conditions the consultation process is bogus. The consultation summary and return forms rule out a priori the option of keeping the A&E unit open. Setting out the downgrading measures the summary intones, “Change is not an option.” Even so, health officials have not kept to their promise of ensuring it was delivered to every household served by Trafford General. A month after it was promised, as many as one in four residents had not received it based upon a survey of people in Urmston.
Hundreds of people came out on the streets of Trafford in July to protest the closure plan and thousands have signed the petition of the Save Trafford General campaign. But this fight cannot be taken forward through appeals directed to the political establishment, whether Conservative, Liberal Democrat or Labour, in the form of petitioning and calls, to sending letters to MPs and councillors. The campaign is headed up by local Labour councillor Jo Harding.
The attempt to portray Labour as opponents of the closure is belied by the position of local Labour MPs. Kate Green for Stretford and Urmston and Paul Goggins for Wythenshawe and Sale East issued a joint statement that supports the closure of the A&E unit, while trying to placate opposition through peddling illusions that extra resources and funding will be found for the ambulance service and the Wythenshawe A&E unit. The message is unmistakable: Labour would act no differently in government. The £20 billion cuts to the NHS now being implemented were originally put forward by Labour prior to its leaving office.
Unison, the largest health service trade union, has blocked any opposition to the closure. The comments section of the Save Trafford General web site has received messages from angry Unison members. One commented, “The truth is my union, UNISON has been invisible on this issue. They are keeping their heads down because they have absolutely swallowed the management line. They have become apologists for the cuts....”
Matthew Finnegan, Save Trafford General campaign chair, has stated, “If these changes go-ahead it will put patients’ lives at risk and be the death sentence for the birthplace of the NHS.”
But the Save Trafford General campaign provides a convenient platform for local Tory councillors to posture as opponents of the closure while the government seeks to deliver such a blow in the shape of the Health and Social Care Act.
What is required is an independent political movement of the working class that challenges the false premise that there is no money or resources to supply health care provision for all. When it came to bailing out the banks, money was no object. Some £1 trillion was diverted from public coffers into the private sector—enough to fund the entire NHS for a decade.
The Socialist Equality Party is for generalising the fight against the closures of the A&E units—to unify it with the struggle against the dismantling of the NHS and the destruction of the jobs, pay and conditions of health workers who deliver the services on which millions depend. Such a struggle must be independent of the unions and conducted by committees of action linked to a wider struggle against social inequality and the vice-like grip the financial and corporate elite exercises over every aspect of public life.
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[5 September 2012]