Letter

Campaign for London

Dear healthmatters — The Tomlinson report states that technological advances and a shrinking population mean that a quarter of London’s hospital beds can be lost if GP and community services are improved. This sounds plausible but is actually a naive simplification.

Inner London has already lost 5,000 beds over the last decade and now has fewer acute and geriatric beds per head than the national average. Waiting lists in London are longer than the national average. In 1986 24% of inner London patients on the waiting list had waited longer than one year compared to 25% nationally. In 1991 the figures were 25% and 14% respectively.

GP and community services in London are, on average, inferior to those elsewhere in the country. Improving them would allow Londoners the same standard of health care enjoyed elsewhere only if the present number of beds were retained. There is no evidence that improving GP services reduces pressure on hospital beds - in fact there is evidence to the contrary.

London is a magnet for high users of medical services - the homeless, the mentally ill, HIV positive people, refugees and other vulnerable groups. Cheaper day care surgery is only possible with good support at home. The latter is less common in London than elsewhere and local authority services are continuing to deteriorate.

London GPs were promised improvements ten years ago (the Acheson report) but virtually none of these have materialised. Many London hospitals are at present on ‘yellow alert’ yet there is no influenza epidemic. We need redesignation of beds to eliminate duplication of specialities, but not closures.

The London Health Services Crisis Committee (LHSCC) is an umbrella group set up to help co-ordination between various groups involved in the debate. LHSCC can provide a pack containing a fact sheet, the ‘Londoners’ Health Charter’, a poster for waiting rooms and briefing notes for use when writing to MPs and newspapers. Since Edinburgh, Manchester, Birmingham, Glasgow, Leeds and other cities are all facing Tomlinson-style closures, the pack may have relevance beyond London. It can be obtained from me at the address below - and donations to LHSCC would be welcome!