Education And Debate

Save our service

BMJ 1997; 314 doi: (Published 14 June 1997) Cite this as: BMJ 1997;314:1756
  1. Peter Richards, medical directora,
  2. Michael Gumpel, chairman, medical staff committeea
  1. a Northwick Park and St Mark's NHS Trust, Harrow, Middlesex HA1 3UJ


    Dear Secretary of State,

    We are writing to you on behalf of the medical staff of the Northwick Park and St Mark's NHS Trust, who welcome a new government clearly totally committed to the future of the NHS, but we are deeply concerned to bring home to you the extremely serious practical problems facing doctors, nurses, and their colleagues in the acute hospital services. With the best of intentions we cannot sustain current services with even less than current resources; we cannot maintain morale without light at the end of the tunnel.

    All the points we wish to make apply to a greater or lesser extent nationwide; a few pertain particularly to our trust. Everything we have to say is based on hard evidence which we shall not attempt to present here but can produce in any degree of detail you would find helpful.

    We should preface our remarks by saying that Northwick Park and St Mark's is a large general hospital with several subregional, regional, and national tertiary services with a strong academic emphasis; of these St Mark's Hospital is the largest and best known. As a general hospital we offer an appropriately balanced range of services. A comparison by the Audit Commission of Northwick Park with similar hospitals in 1995-6 and a recent assessment by Arthur Andersen confirm that the cost per case here compares favourably with other providers nationally. These audits also show that the trust uses its beds efficiently. But the current very high bed occupancy leaves no margin for surges in demand and is putting unremitting and damaging pressure on all staff.

    You are familiar with the core problems but we and our patients are the ones who have to live with the human consequences from day to day. They include the following:

    • Accident and …

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