Help save our local NHS

IMG_0120Nearly three hundred people turned up listen to the borough’s three MPs give their reactions to proposals from the Government-appointed Trust Special Administrator’s proposals for our local health services.

The government has placed the Administrator directly in control of our local hospitals and he is charged with reconfiguring local services to deal with the budget deficit in our healthcare trust. Clive told the meeting that he was opposed to the whole way that this process has been imposed on our local Trust, the South London NHS Healthcare Trust (SLHT) which was responsible for managing our local hospitals, Princess Royal in Bromley, Queen Elizabeth in Woolwich and Queen Marys in Sidcup .  This trust had only been established in 2009 and it was already implementing its own long-term plans to deal with the deficit.

Several years ago local doctors, nurses and midwives drew up a set of proposals called ‘A Picture of Health (APOH) to reconfigure our local services.  These plans were consulted upon and many people contacted me indicating that they were broadly supportive of the clinicians’ recommendations even if they disagreed with some aspects of it.  Unfortunately these plans were delayed by the new government, at a cost of some £22 million, and then scrapped altogether when the administrator was parachuted in and given wide-ranging powers to run the trust as he saw fit. Clive told the Administrator that the SLHT had made significant improvements in its performance in the three years that it was in existence and had set out a radical set of proposals based on APOH to reduce the deficit over the next four years.

The Trust should have been supported by the department in its attempts to address the deficit rather than be undermined by the installation of the Administrator.

The administrator has now produced his recommendations and if implemented they will be the most drastic changes in our local health services since the formation of the NHS.

Below are listed the report’s main recommendations, followed by an outline of Clive’s objections and concerns: The Administrator proposes changing Queen Mary’s Hospital into what he calls a Health Campus where a range of services would be provided through a “range of organisations” although the actual Campus would be owned by Oxleas NHS Trust. His proposals go on to entirely dissolve the SLHT, proposing that the Queen Elizabeth Hospital site should come together with Lewisham Healthcare NHS Trust and that the Princess Royal University Hospital should either be acquired by King’s College Hospital NHS Foundation Trust or failing that, to allow any provider from the NHS or independent sector to bid to run services on the site.

In regards to maternity care he lists two options under consideration:  Obstetric-led deliveries could be centralised in line with critical emergency care across King’s College Hospital, St Thomas’s Hospital, Queen Elizabeth Hospital and Princess Royal University Hospital; alternatively, there could also be a ‘stand-alone’ obstetric-led delivery unit at University Hospital Lewisham.  All other maternity care will continue to be provided in a range of locations across south east London.

IMG_0122Elective care – An elective centre for non-complex inpatient procedures (such as hip and knee replacements) will be developed at University Hospital Lewisham to serve the whole population of south east London under the Administrator’s proposals.  Alongside this, elective day case procedures should continue to be provided at all seven main hospitals in south east London; complex procedures should continue to be delivered at Kings’ College Hospital, Princess Royal University Hospital, Queen Elizabeth Hospital and St Thomas’ Hospital, and specialist procedures at Guy’s Hospital, King’s College Hospital and St Thomas’ Hospital.  Outpatient services should be delivered from a range of local locations.

Clive’s comments:

“There are many other recommendations in the report which are important but I would like to concentrate on just these four at this stage. In regards to the proposals for Lewisham I do not believe that the closure of another local A&E is safe or in the interests of local people.

Recent figures from the London Ambulance Service show an alarming increase in ambulances waiting for space at A&E centres across London.  This situation will get worse if the government continues with its plans to close A&E departments across London.  One problem now is that following the announcement, doctors and specialist nurses will vote with their feet and work elsewhere without waiting for the official closure.

That is why I have called for the Administrator to remove this part of his proposals without delay, warning him not to wait until the end of his consultation exercise by which time it might be too late.

I do not believe that the loss of another maternity unit can be justified in any way.  Recent population rises in Greenwich are due to a rise in the birth rate and over 4,500 babies were born in Lewisham Maternity Unit in the last year.  It is impossible to see how the remaining services can cope with the additional demand in these circumstances and this must call into question the safety of mother and babies under this proposal.

I also strongly oppose the loss of the elective surgery proposed at QMS in APOH.  A high proportion of Greenwich’s elderly population live in the south eastern part of the borough and they welcomed the plans to develop elective surgery on the QMS site.  Plans for Lewisham to become the centre for elective surgery for the whole of southeast London seem unsustainable.  Lewisham Hospital is not easily accessible for people from places like Coldharbour and New Eltham so is not suitable as the elective surgery centre for this part of London.

The TSA also proposes that Dartford and Gravesham Trust should operate elective day surgery at the former QMS site and that after one year the service will be put out to tender.  These plans are inconsistent with the claims that there is not enough money in the health economy of southeast London.  This can only lead to money from the health economy being lost to outside providers and I fail to see how this makes local health services more economically viable. 

In regards to the ‘health campus’ on the former QMS site I believe that this could have a very serious impact on the long-term future of health services in this part of London.  This may facilitate new providers – many from the private sector – moving in to cherry-pick the local health economy, which could undermine the viability of existing services to the detriment of patients.  This can only add to the problems already identified as a consequence of contracting out elective day surgery at the former QMS site.

The TSA has laid out very ambitious plans to find massive savings in the day-to-day running of the local hospitals.  I have grave doubts that these plans for savings can be achieved in the timescale he has suggested without adversely affecting patient care.

In particular, the TSA wants better community based services, such as the provision of care packages and better intermediate care homes to prevent patients spending unnecessary time in hospital beds.  I am sure we would all like to see this but I am aware that we have been here before and yet there are still problems in joining up social and health care.

I have therefore told the Administrator that I want to see these improvements being consistently delivered before any “efficiency” cuts are made in our local health services.

It was clear from the reaction of both audiences that these plans are opposed by many local people.  So the most important job to do now is to ensure that as many people as possible take the time to take part in the consultation exercise being held by the Administrator.  Hopefully you will have already done this but if not, please click here where you will be able to fill in the consultation questionnaire.  You only have until December 13th to do this.

The decisions reached over the next month will affect our local health services for many years to come.

So please make sure you voice is heard.”

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