Please attend the march at 12 noon on Saturday May 18, 2013, from Jubilee Gardens (on Concert Hall Approach near the South Bank Centre) to Whitehall, where there will be a rally outside Downing Street at 2pm. The marchers will cross Waterloo Bridge and walk up The Strand to Whitehall, and NHS campaigners, politicians and union representatives will address the crowd from an open-topped bus. See the Facebook page here and the website here.
The irony could hardly be starker. Across London, and countrywide, cuts begun under the Labour government and aggressively continued under the Tories are wreaking havoc on the NHS. Nor it is only politicians who are to blame, as the cuts are enthusiastically endorsed by senior NHS officials.
As I have been reporting here since October, when plans to disembowel Lewisham Hospital were first announced, across the capital A&E Departments face closure or downgrading, even though the need for them has never been greater. In addition, the closure or downgrading of A&E will have a horrendous knock-on effect for the millions of people affected — as frontline services also close, and, to give just one example, maternity services are cut savagely, as only births regarded as safe can take place in hospitals without emergency services.
This is what is planned for Lewisham, where the recently refurbished A&E Department is to be closed, leaving just one A&E Department, at the distant and already overstretched Queen Elizabeth Hospital in Woolwich, to deal with the 750,000 inhabitants of three London boroughs — Lewisham, Greenwich and Bexley — including, of course, babies and children as well as adults.
In addition, 90 percent of the 4,400 mothers in a borough of 270,000 people (the same population as Brighton, Hull and Newcastle) are being told that there is no money for them to give birth in their home borough, and they will have to go elsewhere, even though there is no spare capacity at any of the neighbouring facilities. For my archive of articles about the campaign to save Lewisham Hospital, see here, here and here, and also see the website of the Save Lewisham Hospital campaign, and the Facebook page.
The plans for Lewisham also involve selling off 60 percent of its buildings and land, and although the assault on Lewisham is specifically to pay for the debts at a neighbouring NHS Trust that went bust in part because of crippling PFI deals that ought to have been illegal, the same pattern of closures, downgrading and sell-offs is being repeated across London as part of general plans for reorganising the NHS in London.
Four of the nine A&Es in west London are to close — Ealing, Hammersmith, Central Middlesex and Charing Cross, the Whittington Hospital in Archway faces savage cuts, the St. Helier and Epsom hospitals in south west London face downgrades, and it has just been announced that A&E and maternity services at Croydon University Hospital (formerly Croydon Mayday Hospital) are also under threat. Across the country, as the Mail on Sunday reported on October 28, 2012, 32 A&E Departments are under threat of being closed or downgraded.
The Mail on Sunday‘s coverage has been excellent. On April 14, they reported, “Shock 250% rise in patients waiting more than 4 hours in A&E: Six-month total soars by 146,000 — as Labour says crisis is worst in 20 years,” and on May 11, in an article focused on what happened in Newark after its A&E Department closed two years ago, their headline was, “Shocking proof A&E closures cost lives: Death rate jumps more than a THIRD after department closes.”
On Wednesday, the problems were finally acknowledged by the government after a storm of criticism. As the Independent explained, “A survey of 131 hospital emergency departments says that A&E units are struggling to cope with ‘unsustainable workloads’ and lack of staff as new figures show the number of patients has increased by more than a million in just one year. Experts warned that the emergency care system could collapse in six months as a result of rising demand.”
The criticisms came from the College of Emergency Medicine (CEM), who “called for ‘fundamental change’ in the way emergency care is run, warning that A&E units are facing their biggest challenge in more than a decade as departments grapple with ‘unsustainable workloads’ and lack of staff,” and the Foundation Trust Network, which represents more than 200 health trusts in England, who “warned that A&E services were in danger of collapse in six months time as a result of ‘huge pressure.’”
Forced to respond, Jeremy Hunt, the health secretary, “said changes to the way GPs provide out-of-hours care have had a ‘huge impact’ on accident and emergency services,” and “admitted there were ‘huge pressures’ on accident and emergency services including a rising number of frail elderly patients with dementia.”
Hunt told ITV’s Daybreak that he partly blamed Labour for removing “responsibility for out-of-hours care from GPs,” in 2004, prompting an outcry from GPs’ representatives. Dr Clare Gerada, the chair of the Royal College of General Practitioners, said she was “aghast at the constant denigration of my profession.”
However, Chris Hopson, the chief executive of the Foundation Trust Network, who warned that, “Although performance is now stabilising, there is a danger the system will fall over in six months’ time unless we plan effectively for next winter,” broadly defended Hunt’s comments. He said A&E units “were facing rising numbers of patients including more frail elderly patients with complex conditions leading to more hospital admissions,” as the Independent put it, and added, “The wider NHS system isn’t working effectively. Patients can’t get the GP appointments they need, many doctors’ out of hours services aren’t working in the way they should and patients simply don’t know where they should be going to get the right emergency care. So up to 30 per cent of people in A&E shouldn’t even be there in the first place.”
However, he also pointed out the absurd new rules, initiated by the Tories, which financially punish hospitals facing an increase in A&E admissions, even though that is a perceived problem that is beyond their control. As he said, “Under current rules, if a hospital admits more A&E patients than it did five years ago, they only get paid 30 per cent of the cost of treating those patients. Two-thirds of hospitals are admitting more patients than they did five years ago, some as many as 40 per cent more. This means reopening wards and employing more staff to cope with this extra demand. Yet hospitals only get paid 30 per cent of these costs. Some are losing more than £5 million a year as a result, on top of the 5 per cent savings they’re already being required to make.”
The answers, he said, “include relooking at the GP contract, reconfiguring some hospital A&E departments and investing more in community facilities,” but in the meantime it is clear that more money is needed. Plans to persuade people not to attend A&E if they don’t need to may work in the long run but they are not in place now. The College of Emergency Medicine report stated, as the Independent described it, that “despite many initiatives to reduce the demand on services in the last decade, attendance rates continue to rise.”
The CEM report also made some important recommendations for the government and for health officials, which are, of course, completely at odds with the A&E closure programme that is currently underway. These include “setting minimum consultant numbers in emergency wards.” As the Independent noted, “At present, the average ward has seven full-time consultants but the College recommends that there must be at least 10 on normal wards and 16 on large wards to provide ‘sustainable cover.’”
The CEM report also “recommended that there should be a GP service at the hospital which would be more suitable for catering for as much as 30 per cent of the current traffic which is presently seen in emergency departments”; in other words, an urgent care system that would run alongside A&E rather than trying– and failing — to replace it.
I hope that the CEM report and the opinions of Chris Hopson — and the coverage they received this week — will encourage people to attend Saturday’s protest in significant numbers.
Those needing further encouragement should pay heed to the words of Dr. Louise Irvine, a Lewisham GP and the chair the Save Lewisham Hospital campaign, who said this week, “We are facing an unprecedented danger to the NHS. The threat to almost 50% of the capital’s A&E services, to maternity units, to ICU [Intensive Care Unit] places and to ambulance provision as well as opening up the NHS to privatisation, presents us with a grave risk to Londoners of all ages in every community.”
Speaking of the proposed cuts in north west London (although his words apply across the NHS as a whole), Professor Simon Shorvon, Professor in Clinical Neurology and Clinical Sub-dean at the Institute of Neurology at UCL, and Consultant Neurologist at the National Hospital for Neurology & Neurosurgery, said, “As a doctor living in West London, I am appalled by the decision to close four of our A&E’s. It will leave a huge swathe of residents far from a local casualty. Time matters in an emergency situation and being stuck in an ambulance after a coronary or stroke or life-threatening accident, in a traffic jam on the A4 or A40 trying to reach the remaining casualties — which are anyway already at capacity, will play havoc with survival and recovery rates. Furthermore, in the meantime there is no doubt planning blight and de-motivation will infect all the threatened hospitals. This is a disgraceful decision, made on grounds of cost saving only with no regard to the health or safety of the local population. The local health authority should be ashamed.”
Not just the local authority, but central government, MPs and peers, and senior healthcare officials — the medical directors whose key role in dismantling the NHS I have chronicled previously. The battle to save the NHS is real and it urgently needs support. Please attend the protest on Saturday if you can.
Andy Worthington is a freelance investigative journalist, activist, author, photographer and film-maker. He is the co-founder of the “Close Guantánamo” campaign, and 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. He is also the co-director (with Polly Nash) of the documentary film, “Outside the Law: Stories from Guantánamo” (available on DVD here – or here for the US).
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They are trashing our NHS to get the excuse needed to privatise it and then make it impossible to re-nationalize without leaving the World Trade Organisation. The sooner they are evicted from power the better.
Please amend date to Sat 18th May.
While there’s no national single payer health care here in the States, a few cities have a modified version of that (San Francisco, Boston and Houston). In many ways, it’s similar to the NHS (you need a GP referral to go to a specialist, wait times can vary both in getting an initial appt. to actually seeing a doctor once you’re there). One similarity to this privatization move in the UK is that some of these programs are outsourced by the states running them to private health care corporations. This means in some cases using only residents and not people with experience to handle complex cases.
A UK expat doctor in the Bay area tried to set up a free (yes, free) clinic to actually help low income people. What happened? The city govt. instantly shut him down. What grounds could you justify that on?
Thanks, Thomas. Yes, I agree that the sooner we’re shot of these neo-liberal idiots the better. As for the WTO, it seems that the bigger issue is how – collectively and globally – we rid ourselves of over-reaching corporate power.
Done, Catie. It was a sign of extreme fatigue on my part yesterday – as well as putting April in the title, I put March in the opening line!
Thanks for that info, Tom. Very interesting. As for your final point, that, in a nutshell, is the problem. Things done for the common good don’t need to have a profit motive to motivate those involved. They can do it because — well, because it’s for the common good. But selfish people are only interested in their own personal profit, and so the rot continues …
On Facebook, Pauline Kiernan wrote:
Dejanka Bryant wrote:
I wish I had too many lives on Saturday. I will do my best.
Thanks, Pauline and Dejanka. I was so exhausted yesterday that I put April instead of May in the title, and March instead of May in the opening line. I think everyone got the message, anyway. It’s tomorrow!
It won’t be reported in the news unless it gets out of hand and results in violence and windows getting broken, sadly.
Yes, sadly that’s probably true, Thomas. The mainstream media in the UK, across the political spectrum, have little interest in protests. I don’t know why they persist in thinking that the parliamentary system is adequate to protect us from banks, corporations and bent politicians.
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