A case of chaos in our hospitals

In Hackney, east London, one of Britain's poorest neighbourhoods, there was always one refuge whose doors never closed, even in the dead of night. The Queen Elizabeth Hospital for Children, a few hundred yards from a string of notorious council tower blocks, is an oasis. For 127 years it has been the destination of many dashes in the middle of the night by worried parents, nursing a feverish child. Some of the first x-rays and first operations on children were conducted here. Children's drawings cover the walls and toys litter the casualty department, which looks more like a creche than ER. Everything is geared specifically to children: there is even a teacher for the long-stayers.

But last week the hospital's closure was announced suddenly. Only months after Queen's was given the all-clear for the next few years, a financial crisis in the local health service means it will be absorbed within a year into the Royal London, a general hospital.

The hasty demise of Queen's, leaving children's services in the area in chaos, is typical of the rapid, poorly planned closures that are expected if NHS funding is squeezed after the general election in the way the main political parties are proposing. And the strong local opposition to the closure, led by Labour-run Hackney council, demonstrates the pressures Chris Smith, Labour's would-be Health Secretary, will face if his party wins the election.

Queen's was supposed to stay open until the next century, when a new purpose-built hospital would have been built attached to the Royal London, about a mile away, which itself is due for rebuilding. Instead, the old Queen's services will now be crammed into abandoned wards in the Royal London. That will save pounds 3m, just part of the pounds 15m annual savings that the umbrella Royal Hospitals Trust must find by spring 1998.

"It's crazy that these services are moved in this helter-skelter fashion onto what is a building site in Whitechapel," says Janet Richardson of the local community health council. "If they could not see a way last October to replace the services provided at Queen's, what has changed since then, except financial pressures?

"This hospital is very important. A Bengali mother, for example, will not telephone the emergency doctor service at night because of the language problem. She'll take a minicab to Queen's, where she feels safe, because as soon as you walk through the door, it's a secure, child-friendly environment. She will not feel like this going to the Royal London."

Vanessa Wright, clinical director at Queen's and a consultant paediatric surgeon, is resigned to the move. "The financial crisis has been like a tidal wave through east London, making the sand shift beneath all our feet." She hopes that within a few years the promised new dedicated children's unit will be built. "We would like to get our hospital back." But she knows children's services face "powerful advocates from other services. We must make sure we are not short-changed." In other words, a hasty bit of panicked decision-making could result in a long-term deterioration in children's services for a deprived part of Britain, with the highest birth rate in Western Europe. Other small hospitals should watch the fate of Queen Elizabeth's and take note.