• WHILE Tory and Labour politicians have been squabbling about our National Health Service being up for sale in a post-Brexit American trade pact, our local NHS bosses have quietly and secretly agreed to a forced marriage of all health services now in five separate North Central London Clinical Commissioning Groups (CCGs) covering Islington, Camden, Barnet, Haringey and Enfield.

From April 2020 this giant monopoly will be responsible for providing primary care service through 204 surgeries in the five boroughs covering more than 1.64 million people.

A single management will have a budget of over £2billion a year and I would have thought this shotgun merger would have warranted some public discussion.

Surely we patients deserve to know what benefits and improvements we can expect to see from this newly-created monopoly, even while the NHS is understaffed and overstretched. All I have heard so far is that the merger will lead to a 20 per cent cut in management costs.

Have our councillors, health committees and NHS campaigners agreed to the ending of all local and independent management of health services without telling us that our local CCG will no longer be able to decide on what services will be provided at hospitals such as the Royal Free, UCL and the Whittington?

It seems as though this bureaucratic monstrosity has been designed in yet another reorganisation by NHS England, which ruled that this merger had to be voluntarily agreed for implementation next April or it would have been imposed on them to start in April 2021.

It seems that patients are no longer being involved in the decision-making process as laid down in the NHS constitution. I wonder why.

KEITH McDOWALL CBE
Malvern Terrace, N1