Local NHS merger is a farce

An NHS England consultation event (credit NHS England)
NHS England says there is no need to consult local people about plans to merge five clinical commissioning groups in North London (credit NHS England)

Enfield Over 50s Forum president Monty Meth expresses concern over plans to merge five CCGs

Patients have been an integral part of the NHS decision-making process since its inception 71 years ago. Until now.

In September, Enfield NHS Clinical Commissioning Group (CCG), the body responsible for delivering primary care in the borough, was given an ultimatum; support a merger with four other local CCGs from April 2020, or have a merger imposed upon them in April 2021.

NHS England wants to merge the CCGs in Barnet, Islington, Camden, Haringey and Enfield, creating a much larger body called North Central London CCG. The 15 voting governing body members – eight of them Enfield GPs – had to approve the merger without seeing the structure or constitution of this new bureaucratic monster allegedly being created to meet the health needs of more than 1.6 million patients spread over 204 doctors’ surgeries, with a £2.1billion budget to provide all their primary care needs.

No commercial company would be allowed to contemplate a similar venture without first producing a detailed structure, together with the benefits and any downside envisaged, for consideration by all those affected. But NHS England has set only one public target for this ‘shotgun marriage’ – to cut management costs by 20%. To secure this objective it has ruthlessly abandoned its duty to consult local people on the merger decision, stating that “public consultation is not required to merge CCGs”. Neither has it sought approval from Enfield Health and Wellbeing Board or Enfield Council’s health scrutiny panel. Therein lies the danger – voices of Enfield patients will be silenced as the new mega-CCG railroads through ill-conceived and controversial service-cutting plans.

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Moreover, Enfield Council has supported the merger without any public scrutiny and, it is claimed, NHS England has agreed in return to set aside the local authority’s £80m deficit built up over many years – which they have no hope of reducing while Enfield’s public health budget remains under-funded.

In a letter to Enfield GPs calling for feedback on the draft constitution for the North Central London CCG by Monday 21st October, local NHS bosses said it was important to maintain strong relationships with voluntary, community and patient groups and to “not lose vital touch points that allow us to listen to local voices”. Yet, it has no place for a non-voting patient on the governing body – unlike the present Enfield CCG. There’s a place for just one patient and public engagement representative for the five boroughs, one Healthwatch rep, and just two Enfield GPs to represent our 47 surgeries.

The total lack of public accountability by this new NHS body – likely to be based in Camden or Islington – has to be resisted and challenged. It is a farce.

The next Enfield CCG governing body meeting is on Wednesday 18th December from 1.15pm at Holbrook House, Cockfosters Road. To sign the petition to stop all NHS England’s proposed CCG mergers:

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