The health authority responsible for Borehamwood patients has hit back at criticism of its ideas aimed at saving £12million each year.

West Hertfordshire Health Authority's (WHHA) Moving Forward discussion paper -- which includes proposals to reduce Watford General to a Community Hospital -- was attacked by five local authorities, including Hertsmere Borough Council.

Hertsmere's main criticism was that the paper had ignored the cash crisis at Barnet General Hospital -- where earlier this year bosses vowed to monitor treatment of patients from Borehamwood and Potters Bar more closely.

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Borough chief executive Philip Copland wrote: "If this trust has to reduce its (acute) services, then these patients from Hertsmere will be severely disadvantaged. This is not addressed in the paper." Hertsmere also warned of the grave consequences to Shenley and Radlett residents of shutting the Accident and Emergency (A&E) department at Watford.

"Besides the inconvenience of having to travel to Hemel Hempstead ... we are concerned at the increased risk to life because of the additional time taken to reach the hospital in emergency situations."

In its reaction to criticism, WHHA's chief executive Carolyn Regan defended the principle of making radical changes to the way health services are delivered in the area.

"Your analysis of the financial context is flawed", she wrote, pointing out the authority and trusts had been ordered by the NHS Executive to prepare plans to cut the recurring deficit.

Responding to the councils' demand that no hospitals be closed or downgraded, Ms Regan wrote: "The health authority already gets more than its fair share of resources, according to the national formula.

"Continuing to implement piecemeal cuts across the board without considering the future infrastructure of services would dramatically reduce the quality of services, and for short-term gain would exacerbate existing problems."

Ms Regan's statement did not directly address the crisis at Barnet, where earlier this year bosses complained its debts were largely due to the fact it had treated far more patients -- from Barnet Health Authority and WHHA -- than it is paid to do so under its contract.

And last week, bosses at Barnet promised to gain a tighter grip on the trust's expenditure in the future.

WHHA's own figures show between April 1997 and January this year, the £6million contract with Barnet's controlling trust, the Wellhouse Trust, was 'overperforming' 32 per cent -- the vast majority in the area of emergencies.

This week a spokeswoman for the WHHA repeated earlier reassurances that there was no question of patients in its area being stopped from going to Barnet General Hospital.

She said negotiations between WHHA and the Wellhouse Trust on a new 'service agreement' were ongoing.

WHHA plans to release a formal consultation document on the proposed changes later this year.

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