Yesterday evening, following on from the demonstration on November 24 that attracted 10,000 to 15,000 supporters, many hundreds of Lewisham residents converged on the Calabash Centre, on George Lane in Catford, in the London Borough of Lewisham, to hear — or mostly to confront — Matthew Kershaw, the NHS Special Administrator appointed to deal with the financial problems not of Lewisham, but of the South London Healthcare Trust, in the boroughs of Greenwich, Bexley and Bromley. Faced with crippling debts as a result of PFI deals that ought to have been illegal, the SLHT was put into administration in the summer, the first NHS trust to be subjected to the government’s “Regime for Unsustainable NHS Providers.”
Under that legislation, Kershaw was appointed to come up with solutions. His report was published on October 29, and in it he and his team proposed that the trust’s “historic debts” should be absorbed by the Department of Health, so that its new owners are not “saddled with the issues of the past”, and also proposed that the Department of Health should “pay £20 million to £25 million a year to cover the ‘excess costs’ of the PFIs for the two hospitals until the relevant contracts end.”
This was a least a recognition that the SLHT’s PFI contracts are a disaster, which is certainly true, as they involved a £210 million deal for two hospitals that has so far cost the trust £500 million, and will end up costing £2.5 billion, for hospitals which they don’t even own. However, Kershaw’s report also recommended that the trust should be split up, with King’s College Hospital NHS Foundation Trust recommended to run the Princess Royal, in Orpington, and a merger involving Lewisham Hospital and the Queen Elizabeth Hospital in Woolwich.
With the closure of the A&E department at Sidcup, Queen Elizabeth, on a remote, blasted heath in Woolwich, is already catering for the A&E needs of two boroughs, but if Kershaw’s proposals go ahead, Lewisham, with its 250,000 inhabitants, will also lose its A&E, and there will be just one A&E — at Queen Elizabeth — for the 750,000 inhabitants of three boroughs — Lewisham, Greenwich and Bexley.
As the Save Lewisham A&E campaign’s website explained, Kershaw also “proposes children’s wards, critical care, complex/emergency surgery and perhaps maternity services be closed by 2015/16, and the hospital’s Victorian buildings be sold off for £17million,” as well as converting Lewisham into a centre of elective surgery for the whole of south east London.
Perhaps some of that sounds good to you, but to me it all stinks.
Every London borough needs its own fully functioning A&E Department, and Kershaw’s proposals will essentially disembowel Lewisham Hospital in a very short period of time. Without being able to deal with emergencies, the hospital will steadily be starved of patients, and, in any case, a hospital that has had 60 percent of its buildings sold, and is giving over most of the rest of its capacity to elective surgery — private surgery, in other words — is clearly not even a cottage hospital and certainly not one that can provide for the needs of a population that is as big as Brighton, or Newcastle, or Hull.
At the consultation, the majority of the people who attended — either those protesting outside, or those who attended the consultation to be, for the most part, patronised — were extremely angry, and with good reason, I believe, as these plans are being sold as a necessity to improve clinical care across south east London as a whole, when, in reality, they are driven by the need to dig the SLHT out of a hole, and by the demands of the government to make savage cuts and financial savings. Money can be found to support the NHS as it needs to be supported, if the political will is there.
From what I could see, no one in the borough believes that it is even remotely possible that services for the people of Lewisham could improve as a result of the proposals, and with good reason, as there is clearly no spare capacity at any neighbouring hospitals — or even those far-flung places like the remote corner of Woolwich inhabited by Queen Elizabeth Hospital — for any of the accidents, emergencies and complicated births that will be begging to be seen elsewhere if the proposals go ahead.
Kershaw and his colleagues, who included Dr. Jane Fryer, his chief medical advisor, Dr. Mike Marriman, the medical director of King’s, and, alarmingly, Dr. Andy Mitchell, the medical director for the whole of the NHS in London, were left in no doubt by the audience that they were regarded as liars and as devious operators who had already made their minds up, that their consultation was a sham, and that people will die if the plans go ahead.
The proposals regarding journey times to Woolwich were accurately dismissed as a fantasy, and there were numerous important contributions from audience members who pointed out the cost, for poor and elderly people, of having to travel elsewhere, and who gave examples of how a degraded A&E, turned into an Acute Care Centre but unable to deal with genuine emergencies, would be revealed as a dangerous absurdity if a sudden emergency occurred — if, for example, a seemingly straightforward birth turned into an emergency because a baby was strangled by its umbilical cord, for instance, let alone if there was any kind of major disaster in Lewisham as a whole.
For myself, however, the issue that kept being raised, but that was never adequately addressed by Kershaw and his colleagues, was the fact that they have exceeded their remit, and that their proposals are probably illegal. The government, Kershaw and his colleagues have all decided that it is appropriate for the “Regime for Unsustainable NHS Providers” to extend from the SLHT to the whole of south east London’s hospitals, even though no other trusts in south London are in financial difficulties. This, we are told, is both financially necessary and prudent in terms of ensuring the best services possible, but even if this were true — and it’s a very big if — it is unclear why everyone involved presumes that they can strike out across the whole of south east London when their remit is to deal with the SLHT.
The ridiculously short time provided for the consultation — just five weeks, ending on December 13, after which there are just another two months until the health secretary, the terminally tainted Jeremy Hunt, makes his decision — is timing included in the legislation for the “Regime for Unsustainable NHS Providers,” but, again, is an insult when presented to the people of Lewisham, who are right to ask why the plans to destroy their hospital are only subjected to five weeks’ consultation as part of legislation tailored for a failed trust, and not one in sound financial health.
There are already lawyers looking at these questions, and I very much hope that if the proposals go ahead, there will be the opportunity to launch a judicial review.
In the meantime, the best way to keep the government and the executioners of the NHS worried is for people to keep fighting. Keep signing the petition launched by Heidi Alexander MP (which currently has nearly 22,000 signatures), download the “Don’t Keep Calm, Get Angry and Save Lewisham A&E” poster here, and display it prominently, and, before December 13, when the consultation closes, fill in the consultation form made available by Matthew Kershaw and his team.
An important guide to cutting through the deliberate attempts to put people off, when filling in the consultation form, has been provided by the campaigning group, Save Lewisham A&E. Please also follow Save Lewisham A&E on Twitter and on Facebook — and see the Twitter hashtag #thankslewisham, where people are telling their moving stories of how staff at the hospital helped them into the world, or saved their lives.
And also remember that it is not just in south east London that hospitals are threatened. In north west London, four out of nine A&E Departments are under threat, and the Lewisham campaign has already made contact with the campaign there, called Save Our Hospitals. In total, as the Daily Mail explained, 26 A&E Departments will be “closed or downgraded across England and Wales as part of a policy to centralise services — despite fury among patients and scepticism from medical experts.”
Anyone interested in working to bring together all those affected is encouraged to attend an NHS Campaign All London Co-ordinating Meeting convened by Labour MP Andy Slaughter on Thursday December 6, 2012 (tomorrow) to plan a London-wide — or national — NHS demonstration early next year. The meeting is, ironically, in the Thatcher Room in Portcullis House, opposite the House of Commons, from 6-8 pm.
Andy Worthington is the author of The Guantánamo Files: The Stories of the 774 Detainees in America’s Illegal Prison (published by Pluto Press, distributed by Macmillan in the US, and available from Amazon — click on the following for the US and the UK) and of two other books: Stonehenge: Celebration and Subversion and The Battle of the Beanfield. To receive new articles in your inbox, please subscribe to my RSS feed — and I can also be found on Facebook, Twitter, Digg, Flickr (my photos) and YouTube. Also see my definitive Guantánamo prisoner list, updated in April 2012, “The Complete Guantánamo Files,” a 70-part, million-word series drawing on files released by WikiLeaks in April 2011, and details about the documentary film, “Outside the Law: Stories from Guantánamo” (co-directed by Polly Nash and Andy Worthington, and available on DVD here — or here for the US). Also see my definitive Guantánamo habeas list and the chronological list of all my articles, and please also consider joining the new “Close Guantánamo campaign,” and, if you appreciate my work, feel free to make a donation.
On Facebook, Walt Sawyer wrote:
Our local A&E was closed down during the last govt despite years of consultation and protest. The nearest is now Watford and they just turf people out in the middle of the night regardless of where they live, or whether they only have access to public transport. If you’re on benefits or can’t afford a £30 taxi fare, each way, tough! Shameful.
Thanks, Walt. Shameful, indeed, and a warning to anyone who cares about the NHS, and about accessible, fully functioning hospitals, that we all need to fight to save our health service!
David Knopfler wrote:
Just remind me again which short-term opportunist it was in Government who thought flogging off public assets and then leasing them back was a good way to pay bills? But those “terrible” Victorian buildings will mysteriously make splendid hotels and private flats once passed to the private sector.
Yes, exactly, David. But the madness of claiming that services that everyone needs can be run by companies whose raison d’etre is to make money, not to provide services, continues, and will, I suspect, until we wipe these people out – electorally, that is! Labour’s Andy Burnham makes the right noises, but his party is also thoroughly marinaded in the austerity mentality these days, and will need to make some great Keynesian leap if we’re to get out of the economic death spiral that George Osborne has visited on us.
Dejanka Bryant wrote:
Thank you, Walt Sawyer, I live in the same area. It is astonishing what previous Labour led government did to us. Now, we have to travel miles and miles to the nearest hospital in Watford. It is overcrowded and I have my utmost respect to doctors and nurses who are working overtime to treat large amount of patients at this time. You are so right about our A&E in Hemel Hempstead. How on earth those disabled non- drivers can reach them during weekend?
Walt Sawyer wrote:
Yes Dejanka, it causes so much distress.
Thanks, Dejanka and Walt. And this will be happening across London if these butchers get their way. The NHS is the number one priority of the British people, so politicians need to put it first. Find the money. Raise taxes specifically for the NHS if necessary. It can be done. Ministers need to know that this will be the No. 1 reason they lose the next election, unless they think again. And the senior NHS bureaucrats backing these cuts? Well, I’m reminded of Judas Iscariot …
For anyone who doesn’t already know. Selling off major assets is also happening in the States. When I say major, I’m not talking about just an office building downtown somewhere. We’re talking about city governments going bankrupt. Laying off cops and other public sector people. A governor appointing a “guardian” for a bankrupt city to essentially run it for them. One person makes ALL the decisions. As Andy says, the money has to come from somewhere.
Has Cameron ever publically said he supports the Stateside private corporate health system? If he has, that just shows how really disappointing Clegg and the Lib Dems are by their coalition. No surprise there.
Thanks, Tom, for both the comments above. Private, unaccountable ownership of towns and cities – a disturbing thought, but absolutely on the cards, it seems.
Regarding Cameron – not to my knowledge, Tom, although, as I explained when Jeremy Hunt was appointed health secretary in September, “Back in August 2009, the Daily Mirror reported, ‘Three of [David Cameron's] Shadow Cabinet — Michael Gove, Greg Clark and Jeremy Hunt — called for the health service to be dismantled. They claimed it was “no longer relevant” in a book, Direct Democracy, co-authored with Tory MEP Daniel Hannan.’ Mr. Hannan, the Mirror explained, ‘sparked outrage last week by calling the NHS a “60 year-old mistake” on US TV.'”
If, as you say, it might not be legal for Kershaw to exceed his remit to Lewisham, is there a way to challenge it in court? A judicial review or something like that? I know it is probably really expensive but as a last resort, would that have a chance?
I think so, Yael, yes, but as you correctly note, it’s very expensive. My hope is that, behind the scenes, lawyers are preparing their arguments to persuade Hunt to drop the plans without risking being humiliated legally.
What we need the time to do is to mobilise people – and health professionals – to defeat the more pernicious part of the argument, currently being made by Kershaw’s NHS colleagues and advisors more than him; namely, that although the problems of SLHT precipitated these planned reforms, the timing was actually fortuitous, because severe cuts need to be made to the NHS in south east London. The spurious reason is that fewer and better facilities will improve care overall – which I don’t believe would actually happen – but the real reason is savage cost-cutting. I believe the British people want money sent on the NHS more than on almost anything else, and on that basis closing hospitals by shutting A&E Departments and then winding them down so that they cease to function as genuine hospitals for those they were previously serving is not the answer. As I keep saying, money can be found, if necessary, through an increase in taxation specifically for the NHS, but only if absolutely necessary. The reality, of course, is that the Tories squander eye-watering amounts of money on what they think is important – the Olympics, Royal marriages, Trident, war, and not pursuing the staggering amounts lost through corporate and individual tax evasion. If austerity is posited as the only solution provided by those maintaining the status quo, then we need to start suggesting that revolution might be a different and more equitable solution.
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