Showing posts with label lewisham hospital. Show all posts
Showing posts with label lewisham hospital. Show all posts

31 July 2013

High Court quashes decision by Jeremy Hunt to close Services at Lewisham Hospital

The High Court today (31 July 2013) found that the Secretary of State for Health, Jeremy Hunt MP, had acted outside his powers and therefore unlawfully, in deciding to substantially cut services and close departments at Lewisham Hospital.

In today’s judgment Mr Justice Silber said that the decision of the Secretary of State must be “quashed” as he had acted outside his powers as Secretary of State, and in breach of the National Health Service Act 2006, when he announced to Parliament that services at Lewisham Hospital would be downgraded and closed.

Law firm Leigh Day, representing the Save Lewisham Campaign Group, successfully argued that the decision of the Secretary of State was unlawful. They also successfully argued that the decision of Trust Special Administrator, the first to be appointed under new health service guidance, was also unlawful.

The High Court today found that “The TSA did not have vires [the power] to make his recommendations relating to LH [Lewisham Hospital]; The Secretary of State did not have vires to make his Decision relating to LH.” (Para 208) ‘Therefore the Decision of the Secretary of State insofar as it relates to LH must be quashed as must the recommendations of the TSA also insofar as they relate to LH.’ (Para 210)

Details above taken from where you can find the full press release from the campaign team.

The Forest Hill Society has consistently supported the campaign to protect services in Lewisham Hospital and welcome today's judgement. We hope that this is an end to the matter and that the Department of Health do not choose to appeal against this judgement.

26 June 2013

Lewisham gets its day in court

This Saturday, 29th June Michael Mansfield, one of the most eminent QC's in Britain, will lead the ‘Peoples Commission’ at the Broadway Theatre, Catford from 9:30am to 5:30pm.

Michael Mansfield has mounted an investigation into the Government's plans to close Lewisham Hospital, but is also examining them against the wider implications of the new Law which will effectively dismantle the NHS. It is a whole day BUT it is a one off chance to be part of a historic moment and to see him in action with his team, who have all donated their time and expertise for free.

The theatre and it's facilities have been made available for the day; there will be breaks and all the rest and refreshment areas will be open for your use - you don't have to just sit in a seat for the duration. The event is being filmed, so it would be good to ensure that there are no empty seats. If you can only do the morning or afternoon, why not share your ticket for the day? Tickets are only 50p, with donations being taken at the door. Please reserve your place using the booking form on the Save Lewisham Hospital website.

Immediately following the Commission is the formal Judicial Review, which is challenging the legality of the Government's decision to close the hospital. This will take place at the High Court in the Strand (nearest station Charing Cross/Waterloo/Holborn) from Tuesday, 2nd to Thursday, 4th July, between 9.30am and 5.30pm each day. The Save Lewisham Hospital campaign has been advised by their legal team that it would be beneficial to fill the Public Gallery, which may result in the review being moved to a larger Court. Campaign organisers, top clinicians and Inter Faith leaders will be there, but your support is crucial.

Please go along and show your support; the Press will be there at 9.30am on Tuesday, 2nd July and we need to show the strength of support for the campaign.

10 March 2013

Lewisham Hospital under Threat

At the end of January, members of the Forest Hill Society joined 25,000 other people to march through Lewisham in support of our local hospital.

The South London Health Care Trust (SLHT) has been having serious financial difficulties, primarily as a result of costs of their PFI deal. As a result a Special  Administrator was brought in to propose changes to improve their financial viability. Although the SLHT does not include Lewisham Hospital recommendations were made to close the A&E and maternity services at Lewisham, as a way to save money and keep the other hospitals more viable.

Apart from the questionable legality of the Special Administration making recommendations of reorganisation beyond the scope of the SLHT, this will have serious consequences for the people of Lewisham. Lewisham is recognised as providing excellent quality of care and is performing well financially—unlike the hospitals in Greenwich, Bexley and Bromley, which form the SLHT. This high quality of care in Lewisham is being put at risk by the proposals.

On 31st January Jeremy Hunt, the Secretary of State for Health, announced that the hospital will keep a reduced A&E department - a concept that exists nowhere else in the NHS. In addition the maternity unit will be midwife led only, rather than having the support of obstetricians. These changes will put huge pressure on Kings and Woolwich hospitals, which will see a significant increase in emergency admissions and births.

Lewisham is rated excellent and provides services to an area of London with high rates of deprivation. It is being sacrificed to bail out the neighbouring hospitals which generated huge PFI debts. 

Jeremy Hunt claimed in parliament that the changes to Lewisham will save 100 lives per year. These figures are disputed by the hospital and the local authority. We  believe that these changes at Lewisham will only reduce the quality of health care provided to people in Lewisham, increase journey times to good hospitals, and put more pressure on hospitals in Southwark and Greenwich.

Lewisham Council has sought legal advice and will be  challenging the decision of the secretary of state. This is not a cheap action but is clearly in the interest of the people of Lewisham. They have set up a fund to help with the costs that will be incurred in the legal challenge. If you would like to contribute to Lewisham's fund, you can do so at:

The costs of the reorganisation are massive and will take at least three years to be implemented. From a financial perspective it is questionable whether the proposed changes at Lewisham will actually save any more in the medium to long term.

In the meantime, the fight will go on, and we would encourage you to use Lewisham whenever you need hospital facilities. All services at Lewisham continue to operate as before and it will continue to be an excellent hospital for now, but a serious threat remains over the future of services at this hospital.

22 January 2013

March with us to Save Lewisham Hospital

Act Now!

Defend yourselves from having one A&E between 750,000 residents.

As you hopefully know, various services at Lewisham Hospital are under threat due to the recommendations of Matthew Kershaw, the TSA appointed to review the South London Health Trust. The South London Health Trust was created in 2009 to try and solve the problems of the Princess Royal in Orpington, Queen Mary's in Sidcup and the Queen Elizabeth in Woolwich which were losing money. The trust has since accrued debts of more than £150M. The TSA has made a series of recommendations to the Secretary of State for Health on how he would deliver access to safe, high quality, affordable health services and a long-term sustainable health economy for the people of south east London. These incluse closing parts of Lewisham Hospital, selling off land and expecting us to go to King's College Hospital in Camberwell or Queen Elizabeth in Woolwich.  We, and many physicians, disagree with his conclusions.

Save Lewisham Hospital is a community campaign fighting against the proposed closure of Lewisham Hospital including its new A&E department, Intensive Care, maternity and children's services. We will be joining them in a demonstration on Saturday 26th January to show Jeremy Hunt that the people of Lewisham are determined to SAVE LEWISHAM HOSPITAL! Jeremy Hunt, the Health Secretary, will make his decision at the start of February.

If you would like to join us, please either meet us at The Capitol (JW Wetherspoon's) on London Road at 10:45am or at Catford Bridge station, where we will be catching the 11:38am Southeastern train service towards Lewisham and London Cannon Street Rail Station. The march will start at Lewisham Roundabout (by the station) at 12 noon on Saturday 26th January and march past the hospital to Mountsfield Park for a rally, music and giant petition (about two miles). If you are planning to travel to the march independently, there are four buses from Forest Hill to Lewisham; routes 122, 185, 75 and P4. However, based on experience from the previous demonstaration, we would recommend either walking from Catford or catching a train to Lewisham as traffic in Lewisham was severly delayed.

Over 10,000 people marched through Lewisham on 24th November 2012 – young, elderly, families and people from every background, so we have allowed for delays in getting to the march. We need a huge turnout, so encourage everyone you know to come and march with us on Saturday 26th January. We will be easy to spot - we will have placards and hi-vis jackets on.

18 November 2012

Lewisham Hospital Public Consultation Meeting

The Sydenham Assembly Coordinator's Group and the Sydenham Society have arranged a Lewisham Hospital Public Consultation meeting at Sydenham School, Dartmouth Road starting at 7.30pm on Thursday 6 December. Dr Jane Fryer, Chief Medical Advisor to the Trust Special Administrator, will present the draft recommendations set out in the TSA report.

Please come along to this public consultation meeting - the TSA will be bringing along the short video and consultation packs - so please make your views known through the feedback forms as well as asking questions, giving comments and offering any alternatives.

07 November 2012

Lewisham Hospital Threatened

The Forest Hill Society asked Dr Penelope Jarrett, a local GP and Forest Hill Society member, to provide a briefing on the TSA proposals for the closure of A&E services at Lewisham Hospital.

South London Healthcare Trust (SLHT) was formed in 2009 by the merger of 3 hospital trusts: Queen Mary Sidcup (QMS), Queen Elizabeth Hospital (QEH) at Woolwich, and Bromley Hospitals NHS Trust, whose biggest hospital is the Princess Royal University Hospital (PRUH) at Farnborough. The main reason for the merger was the year on year deficits they were accumulating, which by then had added up to a debt of £149 million. Sadly, the merger has not solved the problems, and SLHT continues to operate with a loss of over £1 million per week. It is predicted to have a further debt of £207 million by the end of this financial year. The total cumulative debt will be £356 million. This is on an annual income of about £440 million.

In July, the Secretary of State for Health appointed Matthew Kershaw as the first ever Trust Special Administrator (TSA). The SLHT Trust Board was dissolved, and the TSA is running the Trust, and developing proposals for the future. His draft proposals were published last week, and we have until midnight on 13th December (30 working days) to comment on them.

The full report is 84 pages long, and lists many failings within the SLHT including that it is the bottom 10% Trusts for A&E wait times, recent non-compliance with Care Quality Commission  standards (now improving) and high expenditure on temporary staff. The TSA says there is evidence of poor leadership, poor record keeping, and poor financial governance. The PFI contracts cost £70 million each year.

The proposals are presented under 6 headings. Unsurprisingly, the TSA suggests the hospital should be run more efficiently, outsource various services and lose many jobs, including 140 doctors. Less expected are the recommendations that the debt be written off, and some extra money be given to QEH and PRUH to cover some of the excess costs of the PFI. I think this is to be welcomed, but we do not know if the Department of Health will agree.

The TSA proposes the break-up of the SLHT, with the PRUH possibly taken over by Kings Healthcare partners, or put out to tender. The suggestions here are very vague.

The concerns for those of us in Lewisham are the detailed proposals for the Lewisham Healthcare NHS Trust, which is not even part of the SLHT. It should “join with” QEH, and Lewisham A&E should be downgraded to an urgent care centre. A&E itself is not particularly expensive, but patients who are admitted to hospital need emergency surgery, ITU, X-rays and scans...

The TSA suggests developing a centre for elective surgery at Lewishan, but even if you have elective in-patients, critical care services quickly become non-viable. This raises the question of whether is is safe to deliver babies at Lewisham, and so the TSA suggests closing the delivery ward. The future of children's services, which are particularly good at Lewisham, are not clear. The TSA points out that reduced services at Lewisham would mean that some of the land there could be sold off to raise money.

Unexpected consequences would include loss of the GP training scheme, which is based at the hospital. Many graduates of the scheme, such as myself, stay on to work in the area. Typically, GPs train in medicine, surgery, paediatrics, obstetrics and gynaecology, A&E and mental health, so need a hospital site with all these departments.

Lewisham is a very well run hospital, which had a small deficit a few years ago, but it has worked to turn this into a surplus. In the last year they have opened a brand new A&E, costing £12 million, without using PFI. It works well with local GP commissioners and the council, and new collaborative pathways have been developed (e.g. musculoskeletal, memory service). All this is threatened: Lewisham commissioners will not be able to plan services for the people of Lewisham. There is also a real risk that instead of Lewisham Hospital improving the management of QEH, the link could ruin the finances at Lewisham.

It would seem that Lewisham is being penalised for not having a ruinous PFI contract!

The report does not contain enough information to convince me that the financial modeling is correct.  Is the TSA is assuming that the 70 people admitted each day to Lewisham Hospital will instead go to QEH?  The report claims it will only take residents of Lewisham an extra 14 minutes to reach QEH A&E by public transport. I think it will take longer.  I do not think that most people would go there anyway: as a GP I have spent the last 6 years asking patients which hospital I should refer them to. Only one person chose QEH!  If Lewisham were to close, I personally would go to Kings.  There are very significant questions about the capacity of Kings or QEH to cope with extra A&E attendances, and indeed with taking on the 4,500 babies that are currently delivered at Lewisham. Obstetric services throughout London are severely stretched, partly due to a huge increase in the birth-rate in the capital (Lewisham, schools are learning about this, as they have to build more classrooms) and partly due to a chronic shortage of midwives. The report says nothing about this, but I have heard many stories about how A&E and obstetrics at both Kings and QEH  are already struggling to cope.

There are a number of other areas of discussion in the report. I will briefly consider two general areas which the TSA uses as clinical arguments to support his proposals.

The first is the idea of care in the community, or in people's homes. This is generally thought to be a good idea, and many people would wish to be so supported. However, there is no good evidence that supporting unwell people at home is much cheaper than doing so in hospital: the nurses have to spend time travelling from one place to another, and monitoring someone's condition is difficult too, especially if they live alone. Sensible interventions do not always prevent admissions: I remember seeing an elderly lady who was unwell on a Friday. She had a urine infection, I prescribed the right antibiotics, and got the pharmacy to deliver them that day. But she was still admitted to hospital the next day by SELDOC as the infection made her confused and she was not remembering to take the antibiotics. Primary care is being cut in the same way as other parts of the NHS.  There are not really enough GPs, and certainly not enough district nurses or health visitors. We have been significantly understaffed in Lewisham for some years, and services are really struggling with the existing workload. It would require very significant up front investment before community services could even hope to make any real difference to hospital admission rates.

The second clinical area he refers to concerns consultant rotas, especially cover at nights and weekends, in A&E, medicine and obstetrics. There is reasonable evidence that having more senior staff, more involved in patient care, improves outcomes and reduces death rates somewhat. However, if you make people work at weekends, you have to give them time off during the week, thereby downgrading current weekday services, which might end up with the same number of deaths but just spread evenly during the week. Merging hospitals does not necessarily solve the problem, because you are then making one consultant responsible for more patients. Of the 70 patients admitted daily at Lewisham I would estimate that about 50 of them are medical patients. The on-call consultant can only spend a short time with each one as it is. The report actually refers to recommendations that each patient is reviewed twice in the first 24 hours. Assuming the consultant did not eat or sleep, and did not spend any time walking from one bed to the next, that is 14.4 minutes per patient review. This does not seem feasible! If you then merge hospitals and expect one consultant to cover double the number of patients, it quickly becomes ludicrous. You need more consultants!

I am aware that for many people arguments about health service policy can seem abstract and remote, but if you do nothing else I would urge you to consider where you would go if your felt you were seriously ill, and there were not A&E at Lewisham, and then tell the TSA about it.

To comment on the proposals go to There you can read a summary of the proposals, and comment on the online response form.

03 November 2012

Save Lewisham Hospital A&E

The Forest Hill Society supports the campaign to keep a fully functional A&E at Lewisham Hospital. To find out more about the campaign please visit

You can support the campaign by signing the petition at

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 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.