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08 March 2008

A Picture of Health

The Forest Hill Society urge our members and others with an interest in the health of Lewisham residents to complete the consultation at http://www.apictureofhealth.nhs.uk/. The least worst option proposed for Lewisham is OPTION 2, however there are significant problems with aligning Lewisham Hospital with hospitals in Bromley, Bexley, and Greenwich rather than closer hospitals used by residents in Forest Hill such as Kings, Guys and St Thomas's. We would prefer that this realignment of hospital services in South East London were reconsidered.
We asked a local resident and doctor to provide a summary of some of the key points for Lewisham residents.

Response to consultation on “A Picture of Health”

By Dr. Penelope Jarrett, Member of Forest Hill Society Executive and Lewisham GP

“A Picture of Health” is a plan produced by the Primary Care Trusts of the 4 boroughs Lewisham, Greenwich, Bromley and Bexley (outer south-east London or “OSEL”). You should have had a document through your door (also available at surgeries, leisure centres etc). It seems that the main reasons for change to NHS services in OSEL are:

    1 Financial: the current level of overspending, mainly at the PFI sites in Woolwich (QEH) and Bromley (PRUH).

    2 Clinical: the European Working Time directive (which sets sensible limits to the number of hours doctors may work) and other changes to doctors’ training and the provision of medical care which mean that overall larger teams of consultants are needed to provide care to the highest standards throughout both day and night.

Since change is proposed, it seems sensible to try to accommodate reported areas of concern to patients such as access, quality of care etc

These seem generally laudable aims, but I think the proposed changes will fail to achieve them for a variety of reasons. Furthermore, and of particular interest to us in Forest Hill, most of the consultation is around what would happen at Lewisham Hospital, and it could be that we would lose acute services because of the overspends at QEH and PRUH.

There is more detail in the longer version of my response, but I will try to summarise the reasons I think it would not work as planned, and services for people in Lewisham will be worse than at present.

Financial: the preconsultation business case (140 pages – on their website) does not convince me the plan will save money. A lot of up-front investment in community services would be required, as well as investment at the hospital sites. If Lewisham A&E were to shut, many patients would go to Kings, Guys or St Thomas’. The PCT would still have to pay for them, and money would go out of “OSEL”. Some areas where they say they will save money could occur without the reorganisation.

Clinical: Lewisham performs better than the other hospitals on many indicators, and has the lowest level of MRSA and Cdiff. They already separate elective and emergency services, but on the same site. Expertise and rotas are already shared, with Kings, Guys and St Thomas’. These sorts of models could be expanded. There would be unintended consequences: the top rated paediatric service cannot be just relocated. Expertise will be lost. Similarly the highly regarded GP scheme would go, and so no more locally trained GPs.

Demographics and travel: Lewisham residents are more similar in their health needs to residents of Southwark and Lambeth i.e. inner not outer London. 57% have no access to car or van, so rely on public transport to access healthcare. Transport links to QEH and PRUH are not great, and if these are the only A&E and maternity sites that will mean a lot of travelling. So much for care closer to home!


Click here for the full text of Dr Jarrett's submission to the Picture of Health Consultation.
A letter from Sir Steve Bullock, Mayor of Lewisham (and Forest Hill resident), to every house in Lewisham can be viewed here. Now it is your turn to respond to the consultation.

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