Points-scoring Cameron wrong on London’s stroke units

In a speech today David Cameron set out the Conservative vision for the NHS. This centres on some key principles with which few would demur. For instance, health services should be judged on the outcomes they achieve – improving survival after heart transplant, or reducing deaths from stroke. He also emphasised that clinicians should make decisions on service delivery, without political interference. There should be outcome measures, rather than process targets.

Unfortunately, hopes that a coherent picture of how the Conservatives would implement this vision foundered by the fourth sentence, where Cameron showed how his health team are happy to put their own short term political interests before clinical considerations.

He said:

“This weekend the Conservatives were out fighting for our NHS. Andrew Lansley was in Greater Manchester campaigning for maternity services. Maggie Throup was in Solihull doing the same.

“Chris Philp was campaigning in Hampstead and Kilburn to save the stroke unit at the Royal Free Hospital.”

A few factual points should be explained here:

1. The stroke unit at the Royal Free is not being closed. Here is a map of proposed configuration of stroke services in London, taken from a recent North Central London Cardiac and Stroke Network (NCLCN) presentation (page 10). Discerning readers will be able to find Royal Free beside a blue dot denoting it a ‘stroke unit’:

2. A clinical expert panel, not politicians, proposed centralising hyper acute stroke care at University College Hospital (3 miles away).

3. Patients will be cared for at Royal Free in their stroke unit after emergency treatment at UCH. So ‘the stroke unit’ does not need saving.

4. The new clinical model is being proposed by clinicians to improve outcomes (ie what they are meant to be in favour of) by providing scans and clot busting drugs, after audits found that many patients in London were not receiving the best care.

5. The majority of the public consultation respondents agreed with the proposed changes.

So why are Cameron’s shadow health team campaigning to ‘save’ a facility that is not even under threat? To promote professional autonomy and improve patient outcomes? Or to make political capital out of an independent clinical decision?

See Healthcare for London and the NCLCN website for more.

The author has asked to remain anonymous