Save our Hospitals – my letter to the IRP


The A&E units (and other services) in the four hospitals local to me in West London are threatened with closure.  An independent panel is currently reviewing the NHS’s decision and will report to the Secretary of State for Health by September 2013.  

I feel strongly that the proposed closures will put lives at risk.  Here is the letter that I have submitted to the review – please join me in objecting by emailing your comments to

To: The Independent Reconfiguration Panel, 6th floor, 157-197 Buckingham Palace Road, London

Dear Sir,

I would like to register my objection to the current proposals to close the accident and emergency units at Hammersmith, Charing Cross, Ealing and Central Middlesex Hospitals and ask you to reject the proposed closure.

My initial concerns about the proposals related to the impact it would have on myself and family.  Closing these A&E units will mean that our nearest emergency unit will be in St Mary’s, Paddington, which is at least 30 minutes drive away – and longer during heavy traffic.  Should anyone in my house suffer from a suspected stroke or heart attack, where time is of an essence, then this delay in reaching hospital could have fatal consequences.

In the last few months however, I have been going door-to-door, taking to many local residents across Hammersmith and Fulham and Ealing and Acton about the proposals.  The stories I have heard have persuaded me even further that the planned closures will put unnecessary worry and pressure on local residents, put the remaining services under undue strain and put lives at risk.  In particular, it has been the poorest and most vulnerable residents – those with sick or disabled children and the elderly – who are most worried about the plans.  For instance, I met one elderly woman who faces three bus-rides to get to the nearest A&E unit.  As her nearest A&E and GP surgery are already working beyond capacity and therefore cannot offer regular appointments to her, she is currently relying on her local vet to change the dressings on a wound she recently sustained.  This is a shameful story of the NHS in the 21st Century but is sadly only likely to be replicated if the proposed closures go ahead – three whole London Boroughs will be left without a major hospital.

 Finally, I understand that a number of clinical arguments have been put forward in support of the proposed closures.  While I appreciate that access to specialists is an important factor in the quality of emergency treatment, I am confident that you will agree that access to specialists must be balanced out with access to resources overall – and in a timely fashion.  The current A&E services are stretched, with waiting times already on the increase.  It seems difficult to argue that this can be anything but worsened by closing further units, not to mention the additional pressure that will be put on the ambulance services.  Furthermore, if there are strong clinical arguments, I hope that you will question the clinicians as to why these proposals were not put forward prior to 2010, when there was significant investment in the NHS. The coincidence of these clinical arguments with the desire to dramatically reduce costs undermines their credibility. 

 Far from being in the clinical interests of the West London population, the current proposals represent a significant downgrade in health services to the area, put forward in light of a desperate desire to cut costs quickly.  They are proposals that have little support in the community and which will put lives at risk.  They should therefore be firmly rejected.

 Yours Faithfully

Melanie Smallman




Beyond the Ringfence

science policy

The Scientific Community’s focus on research funding is not enough. Unless they engage with the wider debate on industrial strategy, the spending review will leave research and innovation on the margins, I argue in this week’s Research Fortnight:

Over the next few weeks the UK’s science community will be lobbying hard to protect the science budget, in advance of the government’s June interim spending review for 2015/16.  Already the Presidents of the four national academies have launched a statement ‘Fuelling Prosperity’, calling on the government to secure the ringfence on the science budget and provide a stable investment framework for research over the next ten years.  And rightly so. The evidence that is a driver of the economy is compelling and growing.

But while the discussions within the academies are focused on how much funding should be directed where, following the economic crisis, politicians from all parties are interested in much bigger issues – what the future of the UK economy will look like and what will be our relationship with the rest of the world. These discussions might be termed “Industrial Strategy” or “Foreign Policy”, but they are about the future of science, technology and innovation as much as they are about anything else.  These are the discussions that will determine whether the UK becomes a hi-tech innovation based economy, a low-wage manufacturing nation or a country dominated by the service industry.  And these are the decisions that will set the UK on a trajectory that will shape the nature of UK research, development and innovation for decades to come.

Take the current debate about Europe – and Britain’s place within it.  While it might appear to be about wooing UKIP voters, one half of the government is serious about withdrawing from the UK’s biggest export market and from a significant funder of UK research.  What would that mean for multinational companies looking to site their head office and attract the best talent?  Why would they choose the UK over Germany or France?  And what would happen to UK research without the 3.7bn Euros it has received from Europe’s FP7 in the last five years?

Even more interesting and challenging is the debate about industrial strategy and our future economy however. Because while this is new territory for the scientific community, it is also new territory for many politicians and economists.  And there are very few answers yet.  For the last 30 years or more both economic and innovation policy thinking has been almost exclusively dominated by free-market ideology, whereby the best role for the state (after funding expensive basic research) is to get out of the way.  The credit crunch demonstrated very painfully that markets alone aren’t the answer however.  So whether it is David Cameron talking about responsible capitalism, or Ed Miliband talking about pre-distribution, it amounts to the same – suddenly, for first time in more than a generation, active industrial strategy, and a role for the state in markets, is on the table.  This means that more than funding levels and % of GDP are up for grabs.  Research from political science into alternative economic models – such as Peter Hall and David Soskice’s work on varieties of capitalism – suggest that it is factors such as private sector financial regimes, industrial relations and models of company ownership that play the most significant roles in determining the types of industries that develop.  In Sweden, for instance, the relationship between the workforce the employers and the state is thought to have been significant in building an innovation-based economy – as the trade unions drove up wages, companies moved towards more skilled, hi-tech industry in order to justify the high wage bills and the state stepped in to provide the training necessary.  Financial systems appear to have played a similarly important role in other countries such as Germany, where access to finance that was not entirely dependent upon current profits allowed companies to invest in projects that generated returns in the longer term.   Yet despite these matters having clear and lasting implications for UK research, innovation and development, they are areas where the scientific community are entirely silent.

This is of course unsurprising – and entirely forgivable.  Such issues have been outside the scope of most science policy thinking until relatively recently. While there is some relevant research being carried out in universities and think-tanks, it is not always easy to access and there are gaps.  In the longer-term, there is lots of new research to be done.  But as a first step, the academies should set up a policy commission on science and the economy/industrial strategy, bringing together scientists, economists and science policy experts, to move the debate beyond funding and the economic contribution of science, into more fundamental issues about the innovation society. If science and innovation is such a driver of the economy, then is the best role for the state just to provide the conditions for innovation to flourish, or is there a role of the state to require it to happen? Is a real-terms freeze the best thing to be asking for or would science (and therefore the economy) benefit from government taking a counter-cyclical investment strategy, spending now to stimulate growth while interest rates are low?  Is there an innovation case for a British Investment bank? What does the government need to do to unleash the £800bn that private sector organisations are believed to be holding onto rather than investing at the moment?  What skills do the workforce need to meet such an investment?  As well as pushing science policy thinking forward, the answers to these questions could provide a very fruitful starting point for developing policy ideas for economic growth.  Armed with such ideas, the scientific community would find themselves with a place at the manifesto planning table in the run up to the 2015, rather than running behind the big boys begging to be spared the cuts.

In the next few months and years, political decisions will be made that decide whether the UK continues to see science and innovation as the icing on a service industry dominated cake, or if the UK really does become the innovation nation we hope for.  This is no time for modesty.  When politicians and economists talk about growth, they mean science and innovation.  When they say they are looking for ways of stimulating growth, they are opening the door to the scientific community’s suggestions for how to do more science in the UK. Let’s not miss this chance. Science must be THE driver of Britain’s new economy.  With so much to gain, it is time science, and science policy, steps out of the science portfolio and becomes a mainstream economic and political issue.