On Tuesday, a High Court judge, Sir Stephen Silber, began hearing two judicial reviews intended to prove that plans to severely downgrade services at Lewisham Hospital in south east London — conceived and approved by senior NHS management and the Tory-led government — are unlawful.
The judicial reviews, submitted by the Save Lewisham Hospital campaign, and Lewisham Council, which I discussed in detail here, follow a roller-coaster eight months since it was announced at the end of October 2012 that, as part of legislation dealing with bankrupt NHS trusts, an NHS Special Administrator, Matthew Kershaw — appointed in the summer to deal with the indebted South London Healthcare Trust, in the boroughs of Greenwich, Bexley and Bromley — recommended that Lewisham, which is not in debt, and is unconnected to the SLHT, should merge with one of the SLHT’s three hospitals, the Queen Elizabeth in Woolwich, and have its A&E Department closed down, which currently receives 110,000 patients a year.
This is a drastic move that would then lead to the closure of all acute services, including the majority (90 percent) of all births in Lewisham, where 4,400 births currently take place every year, as well as Lewisham’s well-regarded children’s A&E, and other important frontline services.
With 270,000 inhabitants, and a growing population, the decision to force Lewisham’s residents to go elsewhere in an emergency is nothing short of madness. Getting to the Queen Elizabeth in Woolwich involves a journey that, very literally, can take two hours by public transport at busy times, to a hospital that is already struggling with A&E waiting times, and the other options involve King’s in Camberwell or St. Thomas’s in Lambeth, neither or which has spare capacity.
In terms of Woolwich, the most shocking statistic immediately seized upon by campaigners in Lewisham was the fact that one A&E would now be meant to serve the needs not just of the people of the boroughs of Greenwich (where Woolwich is located) and Lewisham, but Bexley as well, after the hospital there had its A&E Department closed a few years ago, thereby consigning 750,000 people to just one A&E Department.
A powerful grass-roots movement sprang up to oppose the plans, with 15,000 people attending a march and rally in November, and 25,000 in January (see my photos here, here and here), but the health secretary Jeremy Hunt, though shaken, refused to back down — hence the judicial reviews.
A big crowd was outside the High Court on Tuesday, showing their support for the hospital with a colourful campaign on the pavement outside the Royal Courts of Justice, and also by filling the courtroom where the judicial reviews were taking place.
The judicial reviews began just three days after an extraordinary event took place in Lewisham — a day-long People’s Commission of Inquiry, chaired by Michael Mansfield QC, at which medical professionals and members of the public provided the most compelling arguments for turning down the Special Administrator’s proposals, and Jeremy Hunt’s acceptance of them, for saving Lewisham Hospital, and, more generally, for saving the NHS from the existential crisis it is currently facing.
25 witnesses spoke at the Commission – patients, patient group representatives, GPs, hospital consultants and nurses, as well as Lord David Owen and Lewisham Mayor Sir Steve Bullock — and, in a press release, the Save Lewisham Hospital campaign described it as “a chance for those who felt that their evidence had been ignored by the Trust Special Administrator Matthew Kershaw and by the Secretary of State, who they believe, accepted Mr. Kershaw’s proposals for Lewisham almost in their entirety.”
For myself, the campaign has demonstrated the necessity of demanding comprehensive emergency services for every borough in London, and for every comparable population centre elsewhere. Lewisham, for example, has the same population as Brighton, Hull or Newcastle, which also need their own fully-functioning hospitals, and although the NHS is to be commended, in London, for having created four Major Trauma Centres (including King’s) and eight specialist heart hospitals (including St. Thomas’s), it is insane to savagely downgrade all emergency services in large population areas — as is planned not just in Lewisham, to reduce the A&E Departments in south east London from five to four, but also in north west London, where plans have been approved to close four out of nine A&E Departments, as well as elsewhere in London and across the country, because people will die, waiting times will increase and standards will fall.
If a transparent audit demonstrated that more money was needed for the NHS, the British public would oblige, but at present we have political ideology pushing for privatisation, and senior NHS management (the medical directors) fooling themselves — or appearing to fool themselves — that the savage cuts proposed are not about money, but about improving clinical services, when that is clearly not the case.
In its press release on the eve of the judicial review, the Save Lewisham Hospital campaign summed up what the case is all about:
The Administrator proposed that Lewisham Hospital’s A&E department and all acute admitting wards should close, its adult Intensive Care Unit should close and its maternity service should be downgraded or closed completely.
The legal action at the High Court claims that the decision to downgrade and close services at the hospital was unlawful as the Administrator’s powers, and therefore the Secretary of State’s too, related to South London Healthcare NHS Trust only. They did not extend to the Lewisham Trust.
Save Lewisham Hospital campaign argues that the hospital is a busy, well performing and popular hospital and that the alternatives being put forward by the Secretary of State instead will be extremely difficult for residents to access.
They also point to serious consequences for women who need to access emergency services during labour. Under the proposals Lewisham Hospital would provide a midwife unit but no obstetric unit. Should women require emergency services during labour they would have to be transferred by ambulance, mid-crisis, to another maternity unit, which raises real risks as to their safety and that of their babies.
The Save Lewisham Hospital campaign also referred to a new report, to be published soon, in which Prof. Allyson Pollock, professor of public health research and policy at Queen Mary, University of London, who spoke at the People’s Commission of Inquiry, “claims that the full extent and damaging impact of NHS PFI contracts, with consequent debts leading to widespread cuts and closures, threatens to engulf the South London Healthcare Trust including Lewisham Hospital,” as the press release described it. The SLHT, outrageously, had two hospitals built through PFI deals for £210 million, in a disgraceful deal that will end up costing £2.5 billion.
The press release added that the report “claims that the major closures, redundancies, sell-offs and service reconfigurations imposed on Lewisham Hospital, and more widely across the South London Healthcare NHS Trust by the special administrator appointed by the secretary of state, do not serve patient interests,” whose needs, in Prof. Pollock’s words, “have been, at best, down-played and at worst ignored.”
The report “concludes that Lewisham hospital is a thriving local hospital which serves the needs of its local community,” and that the Special Administrator “made no public health case for downgrading services and provided no sound evidence for the policy.”
Note: For another detailed analysis of what is at stake for Lewisham, and the lies of the government and senior NHS managers, please read this Guardian article by Shannon Hawthorne, a journalist and a member of the Save Lewisham Hospital campaign. And see here for my archive of articles about the campaign.
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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Apologies for the 8-hour silence, my friends. I posted this on arrival in Harrogate from London yesterday afternoon, and was then taken to Menwith Hill for the Independence from America protest organised by the Campaign for the Accountability of American Bases (CAAB), so was unable to follow up until now. I’m glad to report that it was a wonderful and inspiring event, which I’ll be writing more about soon. I’m only sorry to see that this article about the judicial reviews for Lewisham Hospital didn’t get much interest. Perhaps I posted it at the wrong time …
What timing! As the third and final days of the judicial review took place, NHS England announced a shake-up of A&E services, while MPs rounded on Jeremy Hunt for the plans to axe 8 A&E Departments across London: http://www.standard.co.uk/news/politics/jeremy-hunt-facing-full-scale-revolt-over-ae-cuts-8685043.html
Unfortunately, the Evening Standard article repeated the lie that Lewisham’s A&E was saved by Hunt, when that’s simply not true. As we were told on Saturday at the People’s Commission of Inquiry by Dr. Brian Fisher and other witnesses, Hunt’s so-called compromise for Lewisham – retaining a “small but safe” A&E Department rather than a full A&E Department – isn’t a safe option at all. You can’t actually have a “small and safe” A&E Department. You either have an A&E Department or you don’t.
Also worth checking out, Tony O’Sullivan’s report about the judicial reviews for the Save Lewisham Hospital campaign website: http://www.savelewishamhospital.com/legal-challenge/
Question. A&E stands for?
Sorry, Tom, I usually spell it out at some point in my article. A&E stands for “Accident & Emergency,” or what I believe is known as ER in America.
If we lose the NHS we’ll never get it back as we have no left wing party of any size.
Yes, we no longer have proper representation, Thomas. Our socialists are swallowed up in the Labour Party, and generally disarmed. There are a few MPs who still recall that they are there for the people, but far too few.
Investigative journalist, author, filmmaker, photographer and Guantanamo expert
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