Agenda item

A report from the Director of Health, Housing and Adult Social Care will be circulated as soon as possible. This will set the context for local health services and appraises Cabinet of the outcomes of work undertaken across the Council to date.  (Non key)

(Report No.26)

(8.50 – 8.55 pm)

To Follow

Councillor Don McGowan (Cabinet Member for Adult Services, Care and Health) introduced the report of the Chief Executive, Director of Finance, Resources and Customer Services and Director of Health, Housing and Adult Social Care (No.26) setting the context for local health services and appraising Cabinet of the outcomes of work undertaken across both the Executive and Scrutiny functions of the Council to date.

Councillor McGowan made the following statement:

“Enfield Council is playing a vital role in holding the Government and NHS to account and ensuring that the health services in Enfield meet the needs of residents and help to tackle the inequalities in life expectancy across the borough.

We have significant concerns about the current level of primary care provision in Enfield just three months before a decision is being made on the future of the A&E and Maternity departments at Chase Farm and believe significant and rapid improvements need to be made to improve the quality of GPs surgeries and the number of doctor appointments that are available to our residents.

We have written to the Secretary of State to urge him to bring an immediate halt to the process of the withdrawal of acute and maternity services from Chase Farm Hospital until these matters have been addressed.

The Council’s number one priority is to ensure the best possible healthcare for residents and we will decide in due course how we can best protect residents. Local people are overwhelmingly against the closure of these two services and want them to remain open but ultimately the fate of Chase Farm lies in the hands of the Secretary of State.”

NOTED

1.         that in order to obtain a level of clarity on the current position and plans, the Council had commissioned independent clinical experts, Hygeian to establish the current position of primary and community based services, the status of hospital services (in particular A&E and maternity) and provide a picture of what good primary and community based services should look like (as appended to the report at Appendix 1);

2.         that the NHS was working towards the date of November 2013 to implement the Barnet, Enfield and Haringey Clinical Strategy and had announced that the formal decision would be made in September;

3.         the concerns which had been highlighted in the independent report and the lack of data which had been forthcoming from the NHS;

4.         that a letter of support of the Council’s position had been received from Nick De Bois, MP;

5.         that Councillor Doug Taylor (Leader of the Council) had today written to the Secretary of State for Health regarding the proposed reconfiguration of Chase Farm, Barnet and North Middlesex Hospitals. In conclusion the letter had sought the immediate cessation of the process of the withdrawal of acute and maternity services from Chase Farm Hospital whilst the outstanding matters of concern could be properly resolved.

6.         Councillor Taylor highlighted a number of issues of concern which continued to be raised including an underestimated increase in the population of Enfield; the poor performance of A&E services in the area (second worst in London); and, concerns that large tranches of the primary care and transport strategies would not have been implemented by the target date for the withdrawal of hospital-based services.

7.         that the report was seeking approval to the delegation of authority for pursuing any and all legal action (decision 2 below refers);

8.         Councillor Charalambous drew Members’ attention to section 6 of the report outlining the Health Needs and Health Inequalities in Enfield. The statistics highlighted the need for improved health services in the Borough.

9.         Councillor Mike Rye expressed the support of the Council’s opposition Members of the actions being taken by the Council and the concerns highlighted.

10.       that an important element of concern was the lack of sufficient health data on which decisions could be based. It was noted that the local NHS had been encouraged to be transparent and make the necessary data available.

Alternative Options Considered: To do nothing and allow the BEH Clinical Strategy to proceed without external scrutiny.

DECISION: The Cabinet

1.         noted the NHS timetable for decision-making in relation to the removal of A&E and Maternity services from Chase Farm Hospital and endorsed the taking of all reasonable steps by the Council in that regard to safeguard health care services for Enfield residents, including urgent legal action if appropriate;

2.         agreed to delegate responsibility for any and all legal action, including urgent legal action to the Leader of the Council in consultation with the Chief Executive, Director of Finance, Resources and Customer Services and Director of Health, Housing and Adult Social Care;

3.         noted that the work of the Council’s appointed experts were hampered and constrained by a lack of data from the NHS bodies on activity in A&E, maternity and primary care.

Reason: The Council was seeking to act in the interest of local people, to ensure their needs and very real concerns were represented in respect of the provision of safe and accessible health care services in Enfield. Should circumstances arise in which legal action was considered appropriate in relation to Chase Farm Hospital, it would be essential for the Council to act promptly. In this context, promptness would require a challenge to be brought very quickly once a decision had been made by the NHS (i.e. within a week or two). Even a relatively short delay could risk jeopardising the success of any legal challenge. As such, there would not be time to seek approval from Cabinet with the necessary flexibility to take an urgent decision if the situation warrants it.

(Non key)