Healthcare services in London face being downgraded or closed altogether as the capital struggles with looming potential real-term cuts of £5 billion by 2017, warns the British Medical Association.

According to the Association’s new report London’s NHS ON THE BRINK, healthcare services in the capital are on course for a “major financial and organisational crisis”, stemming from the widely expected National Health Service budget freeze from 2011.

The BMA claims that the brunt of cuts will fall on the capital, but its report has slammed NHS London for a “lack of transparency” over the way it plans to deal with the looming financial drought, which some reports claims could leave a funding gap of a whopping £5 billion by 2017.

NHS London has publicised certain measures designed to make efficiency savings, such cutting the number of people going to accident and emergency departments by 60% and to hospital outpatients by 55%, slashing the length of GP appointment times by 33%, and farming out care to polyclinics with acute and trauma care at only a handful of selected acute hospitals.

However, the organisation has reportedly refused Freedom of Information Act requests for access to a report by consultancy group McKinsey “effectively denying interested parties any opportunity to scrutinise its underlying assumptions or supporting evidence”, notes report author John Lister, Information Director at London Health Emergency.

“While we recognise that there are problems with healthcare delivery in London, we are extremely worried that plans to cut services are being kept secret,” said chairman of the BMA’s London Regional Council, Kevin O’Kane, and he called for “full disclosure of the proposals so that there can be a public debate” on the planned local cuts and service alterations.

As well a facing a higher proportion of cuts than elsewhere in England, NHS London has a whole set of challenges weakening its chances of steering through the turbulent times ahead unscathed. For one, nine London Trusts and a primary care trust have already been classified as “financially challenged”, which puts them on a much weaker footing to deal with the crisis.

'Expensive PFIs
In addition, a number of hospitals have been built or are under construction under “extremely expensive” Private Finance Initiative contracts, with repayments totalling £16.7 billion, “averaging more than six times the basic cost of the buildings”, the report claims.

Moreover, the caseload and demand on services is expected to increase throughout the period of financial constraint, potentially further pushing trusts into the red, and the challenge now is for hospitals “to juggle a whole series of pressures in the context of a frozen – but in real terms reducing – budget”, it concludes.