Lewisham Hospital: 'smaller' A&E plan branded a sham

Following the administration of the South London Healthcare Trust (SLHT), that trust will be dissolved before October.

In the House of Commons today, Mr Hunt announced that he was approving the trust special administrator Matthew Kershaw's recommendations in full, with some modifications to the Lewisham plans.

It means £74.9m of savings will be made at the SLHT hospitals in Farnborough, Sidcup and Woolwich, while excess PFI debts will be paid for by the government.

Mr Hunt said he had consulted medical director of the NHS Professor Sir Bruce Keogh over the plans before making a decision on Lewisham.

He claimed Lewisham Hospital would remain open as an A&E treating up to 75 per cent of the patients currently using it. Mr Kershaw had used a similar figure when he recommended downgrading it to an urgent care centre.

But it still means people with serious conditions and higher risk pregnancies will not be taken to Lewisham but to neighbouring hospitals.

The hospital will also be stripped of its obstetrician-led maternity unit, with a midwife-led service dealing with just 10 per cent of the births currently seen at that facility.

Mr Hunt said: "The public campaign surrounding services at Lewisham Hospital has highlighted just how important it is to the local community.

"I respect and recognise the sense of unfairness people feel because their hospital has been caught up in the financial problems of its neighbour.

"However, solving the financial crisis next door is also in the interest of the people of Lewisham because they too depend on the services which are currently part of South London Healthcare Trust."

"Shambles"

Shadow health secretary Andy Burnham branded it "a proposal that never should have been made in the first place but which has cost £5m."

Lewisham Deptford MP Joan Ruddock said the announcement was "an absolute sham and a shambles."

She said: "They're completely unacceptable to all of us that represent people in Lewisham."

London Assembly Member and Lewisham councillor Darren Johnson said in a statement: “We need all of the A&E service at Lewisham Hospital, not just bits of it. Why downgrade the successful Lewisham hospital services, in order to bail out a failed PFI scheme in a neighbouring hospital? 

Mike Davey Lewisham Nurses and UNISON Branch secretary said: "The Secretary of State for Health needs to urgently clarify what is meant by a smaller A&E,  as the London Ambulance Service will be reluctant to bring patients to an A&E that does not offer a full range of A&E services. Is this proposal just an Urgent Care Centre or a fully fledged and supported A&E Department? The Secretary of State has caused more confusion and the whole process is a shambles"

Lewisham East MP Heidi Alexander said: "Today’s announcement by the Secretary of State may look like a life-line for Lewisham’s A&E but I am not so sure that it is. I am far from convinced that it will deliver the sort of emergency and maternity care the people of South East London deserve. Despite £5.2m being spent on the Special Administrator’s report to Government, there is little detail in the Secretary of State’s announcement as to what a “smaller A&E” means in practice. What we do know is that Lewisham’s full A&E and full maternity service will still go. 

"The NHS Medical Director, Sir Bruce Keogh, had to be brought in at the 11th hour to review the clinical evidence, and he is saying that this smaller A&E will treat 75% of patients who currently use Lewisham. Yet at the very start of this process we were told that an Urgent Care Centre would treat 77% of current patients. This is completely confusing for the public and leads to little confidence in the process. There is also a big legal question about whether the Secretary of State has the power to axe vital services at Lewisham based on the administration process that has taken place."

Old Bexley and Sidcup MP James Brokenshire said: "I welcome the Secretary of State's confirmation of proposals which will secure Queen Mary's. It will provide the hospital with a solid backbone of healthcare services and I am already exploring options as to how additional facilities can be added in the future.  We now need to get on with the work to make this happen as quickly as possible. It is right that Lewisham's A&E has been preserved. Legitimate concerns were raised by me and others about the original proposals for emergency care."

Mayor of Lewisham Sir Steve Bullock: “The Secretary of State is riding roughshod over the people of Lewisham. These plans have been roundly rejected by local people, by the staff who work in the hospital and by local GPs. The Secretary of State has pressed ahead regardless by downgrading maternity services and emergency services at Lewisham Hospital. But let me be clear, this is not the end of the matter. I do not believe that the TSA had the statutory power to make recommendations about Lewisham Hospital and the Secretary of State therefore has no power to implement them. I will be talking to our lawyers and we will also of course need to talk to our colleagues at Lewisham Hospital in order to fully understand the implications of Mr Hunt's statement."

Leader of Lewisham Lib Dems Cllr Chris Maines said: “I cannot hide my anger at the way thousands of Lewisham residents have been ignored. I will not accept any final decision that does not have the support of the Lewisham GP Commissioning Group. In addition to continuing our fight for Lewisham Hospital, I will calling on Liberal Democrats in Parliament to get the government to address the huge costly failure of PFI projects which are now crippling the NHS.”

Eltham MP Clive Efford said: “This is a political fix by the government in an attempt to avoid having to admit they have closed another A&E in southeast London after saying they would not close any if local people opposed it. How can it be safe for the minister to call Lewisham’s emergency service an A&E when it will not be able to treat a quarter of the people who would attend a fully-functioning A&E?  That is bound to cause confusion and put people at risk.”

Dr Helen Tattersfield, chair of Lewisham Clinical Commissioning Group, said: "We are disappointed with the Secretary of State for Health’s decision.  As a membership organisation covering local GP practices, we recognise the need to respond effectively to the challenges faced by the NHS and will not shy away from difficult decisions.   We maintain our aspirations to improve patient care and health outcomes for our residents but we remain unconvinced that these changes will improve the quality of services for the vast majority of local people.  

"We are keen to ensure that the additional clinical safeguards announced today will have a genuine impact. It is important to stress that services at Lewisham Hospital continue to operate as normal.  There will be no change to services until alternative arrangements are in place.  It is anticipated these changes will be implemented over the next three years. "

Bromley and Chislehurst MP Bob Neill said: "There is a £200m problem to tackle here, so we need to be realistic about expectations.  It was always going to involve compromise and tough decisions to balance conflicting pressures. The proposals set out today offer a practical way forward and I am particularly optimistic about King’s College Hospital NHS Foundation Trust taking over the running of Princess Royal University Hospital.  For this to work, it is important to get an early resolution on the funding arrangements for the link up. This is an issue I have raised with the Secretary of State for Health and I am glad that he has recognised it as a priority. I shall be following this up."

Dr Chidi Ejimofo, Lewisham A&E consultant, said: "An A&E of the type described is little more than an Urgent Care Unit – patients will still have to be transported to other hospitals because we will no longer have acute provision here."

Dr Louise Irvine, GP Chair of the Save Lewisham Hospital campaign said: "Hunt tells us that he has accepted the recommendations on the basis of ‘100 lives per annum saved’ but this is just a snapshot figure of a national assessment – not locally accurate in the context of the model proposed. As a GP I can state unequivocally that these proposals are going to cost lives."

Lewisham lead paediatrician Dr Tony O’Sullivan said: "Mr Hunt stressed that this will involve careful handling and careful planning. This is politician’s cover for introducing these measures without any consultation with local paediatricians or the College of Paediatrics. He repeatedly said that these measures would improve standards.  The destruction of our exemplar childrens’ service is the not the way to do that and we will be addressing this at the earliest opportunity."

Consultant physician Dr John O’Donogue said: "This is a travesty – a dangerous injustice. Taking a high performing hospital out of the heart and soul of our community is nothing short of vandalism."