With momentum building up towards tomorrow's demonstration against the threat to Lewisham Hospital, here's some of the latest developments.
Polly Toynbee Weighs In
Polly Toynbee points out some of the national implications of the Lewisham situation in this Guardian piece today, and notes that the rules regarding making this decision, if actually followed, would prevent the closure: 'By next Friday the health secretary, Jeremy Hunt, is legally obliged to take a decision that will ricochet through the NHS. Does he agree with the administrator of the bankrupt South London Healthcare NHS Trust, that accident and emergency and maternity units at the thriving Lewisham hospital should be shut, despite monumental local opposition?
.... Hunt is obliged to follow four impossible conditions before signing any administrator's plan. First, local clinicians must agree – but none do in Lewisham, nor will they elsewhere. Second, the public, patients and local authority must have been "genuinely consulted": they were and they vehemently object, so what's "genuine" if a consultation is ignored, as so often? Even more impossible, the plan must be underpinned by "clear clinical evidence", but there rarely is any, only assertions that lives will be saved. Professor Alan Maynard, an eminent health economist, says the evidence doesn't exist to show that large A&E or maternity units necessarily do better, though it has become a managerial factoid. It may or may not be better in some places, depending, untested with genuine proof.
Lewisham will be left with a midwife-led maternity unit, dangerous on its own since more than a third of its mothers in labour are transferred with complications. Finally, Hunt must ensure any changes give patients "a choice of good-quality providers", but they can't choose a good hospital that has shut. If those are binding criteria he must turn this down, but if money trumps these he will have to say so... Lewisham is just a harbinger of what's to come'.
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| Cartoon by Tom Humberstone from the New Statesman |
Impact on Kings
The potential impact on Kings College Hospital in Camberwell is shaping up to be a major issue in its own right, barely considered in the Trust Special Administrator's report that recommended closing services at Lewisham. The South London Press quotes from a letter to the Health Secretary from Southwark and Lambeth MPs which states the position fairly clearly:
'It is now acknowledged that most of the patients who would otherwise have used Lewisham A&E will come to King’s. This will have a major impact on the service provided in King’s A&E. It simply will not be possible to maintain the high standard of service which King’s seeks to provide in A&E, and in particular in paediatric A&E.
“We estimate the following, based on NHS figures: 54 per cent of patients - or 65,000 people - who would otherwise have gone to Lewisham will come to King’s A&E - that is an increase of almost 45 per cent for King’s A&E. As it is, there is a small but concerning increase in waiting times at King’s A&E. If Lewisham A&E closes it is inconceivable that King’s would be able to maintain what is a much improved service for our constituents. Of those 65,000 extra A&E patients approximately 12,200 will be likely to be admitted to King’s as emergencies - that is an almost 45 per cent increase in emergency admissions at King’s.
That will place a further pressure on inpatient beds at a time when King’s management have raised with us their concerns about capacity at King’s. They say they are already looking to take on extra capacity at Princess Royal in Bromley to deal with outpatients and non-emergency admissions. To accommodate the additional emergency admissions even more non-emergency admissions will have to be moved out of King’s to Princess Royal University Hospital in Bromley. For our constituents - many of whom do not own a car - the journey from Camberwell to Princess Royal in Bromley would mean a journey of at least a bus and a train lasting more than an hour and costing £5.50.
We estimate that if Lewisham maternity services close then there will be 3,235 more births at King’s to add to the existing 6,000 births, an increase of 54 per cent of births at King’s. There is simply not the capacity at King’s for a 54 per cent increase in births. It would not be fair on the mothers, the babies or the staff. There are already mothers who want to give birth at King’s who have to go elsewhere - some are referred to Lewisham.”
An Olympic Effort
The Standard reports today that 'NHS nurses who starred in the Olympics opening ceremony are to lead a mass rally against cuts at a London hospital. Dozens will reunite in protest at plans to axe the A&E department and maternity wards at Lewisham Hospital to help tackle a £207 million private finance initiative crisis at two neighbouring hospitals. They will be joined by drummers from Danny Boyle’s Olympics pageant and lead an expected 20,000-strong crowd through the borough tomorrow to a rally in Mountsfield Park'.
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| Lewisham Hospital Unison members call for support |
You know what you've got to do don't you? Tomorrow 12 noon by Lewisham station.
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