THREE London hospital Trusts have given an early sign of the likely problems that will dog the National Health Service now that the pre-election freeze on cuts and closures has come to an end.
In South east London Lewisham Hospital Trust was the first to break the phoney "peace" which had seen Trusts around the country carrying massive deficits into a new financial year rather than risk the wrath of ministers by announcing cutbacks in the run-up to polling day.
Ministers had set the tone of avoiding precipitate change by postponing until April 2006 a major change in the system of financing hospital Trusts which is certain to cause major upheavals, and is widely expected to force rationalisation, closures and even bankruptcies among the many Trusts which stand to lose out to the tune of £1.5 billion.
A day or so before polling day, Lewisham Trust bosses revealed a deficit of £8.5 million and announced the closure of two wards as part of a package to balance the books - in the clear knowledge that the savings from these cuts would raise only a fraction of the shortfall.
The opposite side of the capital, Hammersmith Hospitals Trust, staring down the barrel of a massive £19m NHS scanners stand idle while the private sector coins in profits deficit, has been thinking the unthinkable, and planning the double whammy of a rationalisation that would close Fulham's Charing Cross Hospital, and transfer services several miles away to Hammersmith Hospital in Acton.
This had been strenuously denied by managers during the election, but detailed plans have already been made. The Trust is also contemplating the more immediate closure of its Ravenscourt Park Treatment Centre, which has run up a massive £12.5m deficit as GPs in West London have complied with government pressure to refer
patients private sector treatment centres instead, leaving many of its NHS beds empty.
And in South West London, radiology consultants leaked a letter to bosses at Kingston Hospital Trust complaining bitterly that the hospital's NHS MRI scanner had stood largely idle throughout March other than for urgent and private patients, while the NHS continued sending patients for scans by private sector Alliance Medical.
The NHS service had been stymied by the lack of funds, while the private sector service, which is guaranteed funding by the government, had been shown to deliver slow and questionable quality results: but the problem would be worse in 2005-6, since the Trust had allocated the same inadequate budget for another year.
With Trusts and Primary Care Trusts across the coun try now forced to take action to resolve deficits of more than £500 million carried over from 2004-5, and ministers insisting that they will not intervene to save any Trusts that 'fail' in the new market system they have created, it seems set to be a long hard summer, in which some well-loved hospitals and services will need to be defended. • More details: www.healthemergency.org.uk