Bedwyr Williams ‘A&E’
There are 3 days to go until the public consultation over the future of Lewisham’s A&E, maternity services and various other services finishes. Unsurprisingly the on-line questionnaire is deliberately obtuse in places (eg asking you what you think of services in Bexley) and doesn’t offer a full range of answering options in its multiple choice (eg no choice given to suggest that PFI contracts are re-negotiated). But luckily Save Lewisham NHS has come up with a guide to responding if you feel that the questionnaire is deliberately jargon-heavy and difficult to respond to. Check that out here:
It’s not entirely clear how much notice the Special Administrator is going to take of this - he’s closed down A&Es before in the name of progress leaving a trail of privitisation in his wake, but it’s worth giving him as many headaches as possible.
Alas signing the very worthy petition doesn’t count as being part of the consultation - so make a strong cup of tea, spare 30 minutes and get stuck in unless you want the A&E to go the way of Bedwyr’s fantastic new poster above
Ryan Gander NHS RIP
There’s a demo tomorrow (24th November) in Lewisham, 2pm from Loampit Vale roundabout to the hospital at 3pm. For some reason, an increasingly large amount of residents of South-East London are starting to think that having one A&E for 750,000 from 3 boroughs might not be ideal, let alone closing down Maternity Services.
The “public consultation” period around Lewisham’s A&E seems to consist of three visits by the Special Administrator, Matthew Kershaw, at odd times of the day to the borough, an on-line questionnaire that assumes a fairly specialist knowledge of the ramifications of the proposals and a suspiciously short time-frame. Nice. What bets that Kershaw won’t take into account the march planned tomorrow in Lewisham or dismiss is as NIMBY-ism that doesn’t fill in the internet questionnaire adequately?
So far Kershaw’s responses to criticism have been exhortations to be bold, extolling the private sector and occasionally admitting “a few” patients will be affected. Yet the report that he’s written suggests that 25,550 patients per year will be affected by the downgrading of Lewisham’s A&E. He’s also keeping quiet about his report’s note that the children’s wards at Lewisham will be shut by 2015. There’s also no detail on Kershaw is mysteriously going to clear the huge traffic jams that are experienced every evening on the A2 in order to get A&E patients from Lewisham to Woolwich in the time-frame needed in critical cases.
Ryan Gander The Bastards Are Closing Down my A&E
It’s just a matter of weeks since we were all coo-ing over Danny Boyle’s dancing-hospital-beds-and-nurses Olympics Opening Ceremony routine and patting ourselves on the back on what a decent nation we were and how we treasured the NHS. Indeed Artists for the NHS was thinking of retiring and taking up the heptathlon. But alas, grim reality, has woken us up from our brief slumber.
Lewisham Hospital is a decent local hospital that serves a population of 250,000 – that’s a similar size to a small city like Hull. It is financially stable. It recently had its A&E refurbished at a cost of £22m. That A&E, and large other parts of the hospital, are now facing closure, leaving the population of the borough to try and get to hospitals in Greenwich or Bromley instead.
Unfortunately for Lewisham Hospital, it is neighbour to the South London Healthcare NHS Trust, a conglomeration of hospitals in South London which thanks to a disastrous eight years is the most financially-screwed NHS Trust in the UK with a deficit of £65m. The reasons for the Trust’s financial meltdown are a mixture of declining revenues (in part because more patients were treated outside hospital rather than being wheeled in) and the notorious Private Financial Initiative (PFI) deals struck that provided cash up front for the Trust from the private sector. Cash which alas now has to be paid back at a blistering interest rate – imagine a Pay-Day Loan company going bonkers with the NHS and you get the idea.
The Trust is the first to be declared financially failing and to have a Special Administrator called in. And the Special Administrator’s recommendations have just been released, with a main recommendation to downgrade Lewisham Hospital’s A&E and possibly close its maternity unit, children’s wards, critical care until and emergency surgery. That way, more patients would be forced to use South London Healthcare’s hospitals driving up revenue and in the process making the failing Trust more attractive to the private firms tendering to take over running it.
Neat huh? A great, market-lead solution. Except of course this brilliant market-lead solution effectively closes down large parts of Lewisham hospital meaning that the population are, to put it succinctly, fucked. When the Accident and Emergency department of a hospital goes, so do the medical beds and general surgery beds, as the hospital management argue these are no longer necessary as the patients aren’t coming in through A&E.
Buried in the Special Adminstrator’s report are a few tables on how downgrading Lewisham’s A&E will effect time taken to get to an A&E if you live in Lewisham. A the moment if you are in an ambulance with its lights on charging madly through the roads, the average time is 13 minutes. Under the new proposals this goes up to an estimate of 21 minutes. If you are trying to get to A&E in private transport it goes up from 20 minutes to 31 minutes. If you’re on public transport it goes up from 27 minutes to 41 minutes.
The new figures border, and indeed cross over into dangerous territory: the London-wide programme to improve stroke services concluded that the journey time to hospital should be 30 minutes or less, and for major traumas should be 45 minutes or less. The conclusion is clear: if you have a stroke in Lewisham under the new proposals and the ambulance takes a bit of time getting to you and then hits traffic, it’s not good news.
And if you don’t live in Lewisham, you’re still not safe – this case is being watched as the first example of a number which are going to happen near other Trusts which are in financial trouble and need helping out to make them appear more juicy to the likes of Virgin and Serco.
Read more here: www.savelewishamhospital.com
Mark Titchner ‘A Long, Long Time Ago’
So is this it? As the Daily Mirror reports today there’s 24 hours left to save the NHS and one final, unlikely roll of the dice. Today was the day that Lansley expected the Bill to become law but Labour have forced one last emergency debate, based on the fact that Lansley still refuses to publish the Risk Register associated with the Bill. But it’s deeply unlikely that most Liberal Democrats (with honorable exceptions) will stand up against the Bill.
And when this last debate fails, that’ll be curtains for the NHS as you know it. As campaigning doctors like Dr Jonathon Tomlinson and Dr Clive Peedell, have shown, this is the culmination of a process that will change the NHS to a market economy.
A fitting day then for a great poster by Mark Titchner using one of Cameron’s most bare-faced lies: “I’ll cut the deficit, not the NHS”.
What next? The Coalition hopes that as the Bill is made law, everyone will quietly forget the protesting doctors, health workers and organizations. But as implementation takes place, and every postcode lottery screw-up and every sign of a two-tier NHS emerges, that’s probably an unlikely wish.
Steve Claydon ‘Back to the Future’
The latest two additions to opposition to the Bill are surprising. Firstly there’s the grassroots of the Liberal Democrat party who defied Nick Clegg and Shirley Williams (unfortunately playing the part of Clegg’s useful idiot) and refused to endorse the Health and Social Bill at the weekend’s Liberal Democrat Conference. As newspapers that range from the Guardian to the Daily Mail pointed out, this now means even the Conservative’s Coalition partners do not support the Bill.
The second new bit of opposition comes from perhaps even an even unlikelier source – the Royal College of Surgeons. Unlikely, because surgeons have been the most enthusiastic supporters of the Bill amongst the medical profession, because they do the most private work and stand to gain the most.
All eyes now turn to the Commons tomorrow where Labour have forced a Commons debate on dropping the Bill. If the Tories ram the Bill through the face of numerous and extraordinary-varied opposition, our NHS will be bombed back to the Stone Age – a situation aptly depicted today by Steve Claydon’s fantastic poster.
Ruairiadh O’Connell ‘London Ambulance Service’
This weekend is all about the Liberal Democrat conference where the delegates want to talk about the NHS and the hierarchy don’t. And as Clegg covers himself in more odure by threatening to ignore delegates, it’s easy to forget that the Lib Dems did well last year at conference to question the Bill and ask for amendments. Here’s a good account by former Lib Dem MP Dr Evan Harris on why the revised Bill has sufficiently taken on board those key amendments. Harris’s advice is to drop the Bill.
However the Lib Dem hierarchy, in particular Shirley Williams, have worked themselves into a lather because they think writers, bloggers and journalists are being nasty to them. And even more bizarrely Liberal Democrat peers voted against amendments in the House of Lords this week that they had previously proposed. It’s fair to say that the Liberal Democrat hierarchy right now is confused, angry and if you’re Nick Clegg or Shirley Williams filled with a peculiarly angry sort of self-loathing. The type of people you can rely on when it’s last chance saloon? Let’s face it, probably not.
So what we need to cheer us up is Ruairiadh O’Connell’s colourful image of David Cameron being strangled by a St John’s insignia.