The Royal Free Hospital in Hampstead

AN alliance of senior medics at the Royal Free has launched a fightback against a plan to shut down the Hampstead hospital’s maternity unit.

The New Journal has been leaked an official letter – signed by more than 50 consultants and a group of specialist midwives – raising “significant concerns” that the proposals are “sidelining the welfare of women” and putting lives at risk.

NHS chiefs unveiled recommendations to close the unit before Christmas, saying staffing shortages and Camden’s plunging birthrate had left them with an “unsustainable” situation. They argue that scarce funding would be better spent upgrading maternity units in four other north London hospitals.

But the Royal Free consultants hit back with a detailed take-down of the plans while urging them to reconsider.

“The only clinically justified and safe option is to keep the Royal Free maternity unit open, expand it and upgrade the neonatal unit on site,” said the letter, written on official ­Royal Free-headed paper.

It ends with a sobering quote from the late professor of obstetrics and gynaecology, Mahmoud Fathallah: “Women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving.”

North Central London Integrated Care Board (NCL) – the unelected body that decides how NHS funding is spent in Camden – unveiled its “Start Well” maternity shake-up in December.

At the time, officials presented the proposal as a progressive consensus reached after two years’ work and more than 500 interviews with hospital staff and managers.

But the consultants’ letter warns:
* “Our concerns are that maternal mortality rates within NCL may increase were the Royal Free maternity to close…”
* Mothers with complex medical conditions – like HIV, bleeding disorders and liver disease – will be put at risk
* Managers have not considered the dangers of closing a maternity unit that is linked to a wealth of specialist units, resources and clinics
* The consultation has attached too much significance to babies’ health at the expense of women’s health
* While acknowledging a falling birthrate, the letter suggests “healthy babies are born from healthy mothers”
* The closure would not “align” with national ­policy on maternal safety.

The letter says many maternal deaths elsewhere in the country could have been avoided had the women been cared for by a “multi-disciplinary team” of physicians, obstetricians, midwives, nurses, psychiatrists and other specialists – such as those at the Royal Free.

It said the unit had for 30 years been a pioneer of care for high-risk pregnancies – managing 1,703 births in the past five years in this category.

The Free has unique specialist services – like a haemophilia care unit, 24-hour radiology, renal and liver services – that do not exist in any other North Central London hospitals.

“In simple terms, 25 pregnant women could only have been looked after at the Royal Free,” said the consultants’ letter.

The maternity unit has been struggling in recent years to meet the tough standards set by the Care Quality Commission, which rated it “inadequate” in 2021 following the death of a pregnant woman.

It was in 2023 upgraded to “requires improvement” in a report that noted how “nurse vacancy rates and turnover rates were significantly higher than trust targets and services relied on temporary staff to fill shifts”.

There was also criticism of the “culture within the service” that has been singled out for the chop by NCL. The health authority said the number of babies born in the Royal Free has been falling by around 12 per cent each year since 2018/19. The falling birthrate is having a knock-on effect on schools, which are struggling to fill admission rolls.

Meanwhile, University College Hospital – one of London’s most popular maternity units – remains “overstretched”.

MP Tulip Siddiq says the baby unit must be saved

Labour MP for Hampstead and Kilburn, Tulip Siddiq, whose children were born at the hospital, launched an online petition last week to “Save the Royal Free Hospital Maternity Unit”. It said: “Closing the unit would leave many of my constituents a long way, and several different public transport links, away from their nearest ­mater­nity services.”

In an open letter this week, the board of NCL ICB said that staff were too often stretched thinly in the five units that were in ageing buildings and did not “meet modern best practice”, adding: “We will be investing approximately £40million into estates and facilities to provide the best possible environments for parents and babies, as well as our staff. These proposals represent a real-terms investment in maternity, neonatal and paediatric services.”

An NCL statement said: “We are grateful to Royal Free staff for their detailed response to our proposals, which we will consider as part of the consultation feedback. We value their expertise and commitment to looking after pregnant women and people. “Our proposals are designed to improve the quality and accessibility of maternity and neonatal services in North Central London to give every child the best start in life and improve parents’ experiences. We are committed to significant investment to modernise our facilities irrespective of which site is selected.”

The consultation is open until March 17.