I went flying on Sunday evening after slipping on a wet manhole cover, and as a result, I’m nursing a broken ankle. So this website’s going to be quiet for a short while, or at the very least will be full of stuff that doesn’t require much work or for me to leave the house. Bloody crutches. Bloody manhole cover.
But I did learn that my neighbours in Charlton are brilliant, and so is the NHS. You probably knew all that anyway. I’ve written a little bit more over at Medium: The kindness of strangers and the NHS – the lessons I’ve learned from a broken ankle.
In contrast with last night’s meeting in Lewisham, which sounded rather lively (and where security staff reportedly tried to bar journalists), Tuesday’s meeting at The Valley in Charlton was less than half-full, with only about 30-40 people there, with barely a voice raised in anger. A large number of questioners were councillors and members of the Greenwich Labour party.
There wasn’t much new said about the report, which proposes the downgrading of Lewisham Hospital’s A&E and poses a question mark about its maternity services, but I thought I’d post some audio up for those interested, as well as audio from past meetings.
3 December 2012, The Valley, Charlton
a) The TSA’s panel is asked about Lewisham’s maternity services:
b) Matthew Kershaw is asked about the modelling of maternity services:
c) Most of the rest of the meeting:
21 November 2012, Christchurch Forum, Greenwich
15 November 2012, Woolwich Town Hall (to the public and Greenwich councillors)
(poor quality, but here’s a full post on the meeting)
For more on the consultation, which ends on 13 December, see the TSA website. For more on the campaign to protect Lewisham’s hospital services, see Save Lewisham Hospital. Shannon Hawthorne has a great summary that’s worth reading, too.
It was a night when the questions were better than the answers. About 30 demonstrators gathered to greet NHS administrator Matthew Kershaw when he arrived at Woolwich Town Hall on Thursday to take questions from a group of Greenwich councillors about his plans to revamp south-east London’s NHS, including the downgrading of Lewisham Hospital’s A&E to an “urgent care centre”. He turned up late – stuck in traffic crossing Blackheath – and may have missed them.
I had hoped to be able to give you audio from the meeting, but unfortunately, the notorious acoustics in committee room 4/5 has defeated me – people rarely speak into microphone properly and the speakers in the public area are set at a whisper level. (Update: There is now audio, see the foot of this post.) But I can show you the video shown to the healthcare scrutiny panel before the meeting. Get ready to tick off the cliches.
There was half an hour given over to public questions – some were pertinent, some were time-wasting, like the woman from an organisation called Greenwich Link who rambled on about bringing back women-only hospitals. Well, thanks for that. Others voiced dissatisfaction with publicity and the consultation process – it appears the TSA website has had 12,500 unique visitors since it launched last month, which Kershaw’s team seemed pleased with, yet seems rather low to me (it’s probably about as much as this site gets).
Chair Janet Gillman, who happens to be one of my local councillors, asked if there was any chance the consultation would be extended – a call echoed by Bromley Council – but Kershaw indicated there wasn’t.
There were also concerns that the administrator hadn’t taken into account the rise in population in Greenwich borough, which weren’t fully allayed, while Kershaw claimed that local council leaders “fully understood the aspirations” of his report, which may be news to Lewisham mayor Sir Steve Bullock.
When it was the councillors’ turn to ask questions, plenty did themselves proud. That said, Conservative Mandy Brinkhurst earned her additional cash for sitting on a scrutiny panel by asking no questions at all.
By contrast, Labour’s Danny Thorpe, Barbara Barwick and Clare Morris all expressed concern about the effects of the downgrading of Lewisham A&E on the already-overstretched Queen Elizabeth Hospital. Barbara Barwick was to the point, but Danny Thorpe put it best: “I’m amazed nobody’s mentioned transport – it’s appropriate you were late,” he told Kershaw. “It’s very difficult to believe your distance figures are true.”
But whatever the truth of the figures, Kershaw said everybody within south-east London would be within 30 minutes by blue-light of an accident and emergency department – which, apparently, is the London standard. “Care starts the minute an ambulance driver arrives,” he said, noting the improvements in the care paramedics can offer.
Thorpe also brought up the appointment of Lewisham Healthcare’s chief executive to work on a merger with QEH – before the consultation has even finished. Kershaw denied it was a “pre-emptive decision”. “We need to do planning now on the work done so far, and Tim Higginson has been asked to provide a work plan for the future.”
It was Barbara Barwick that started to really home in on the point. If someone turned up at Lewisham after suffering a heart attack, she said, what would happen to them?
Already, Kershaw said, people with heart attacks would be taken to King’s College Hospital in Camberwell or Princess Royal Hospital in Farnborough – Lewisham had stopped specialising in heart attacks and strokes some time ago.
“The way emergency care is delivered in London now,” he continued, “people aren’t taken to the nearest hospital to get the best services.” He cited the case of Fabrice Muamba, the Bolton footballer who collapsed at Tottenham earlier this year but was taken to the London Chest Hospital at Bethnal Green, bypassing two closer hospitals (although I always thought that was at the behest of the doctor who happened to be watching the match and dashed onto the pitch at White Hart Lane.)
“It does mean some people will be carried further, but on balance we think that’s the right thing to do.”
Charlton councillor Allan MacCarthy reminded Kershaw of how slow the bus network is in south London. “I had a constituent who took a bus to an appointment at Lewisham Hospital, but never made it because the bus was stuck in traffic.” Kershaw waffled his way through a response.
It’s clear he has a job to do, within limited, politically-defined boundaries – one questioner asked why south-east London was suffering when the NHS in London as a whole enjoys a £250 million surplus.
But the reality of life as we know it in south-east London, with clogged up streets and slow journey times; together with how many people find Queen Elizabeth Hospital; overcrowded, understaffed, and in a mess, does not tally with the shiny promises in his report. There were pledges to reorganise the way QEH’s A&E is run, but they were short on detail.
It was suggested that when the A&E at Guy’s Hospital in Southwark closed in 1999, it only took a couple of months for people to adjust to using St Thomas’s in Lambeth. Yet the two hospitals are barely a couple of miles apart – nothing like the lengthy, bus-changing terrain that separates Lewisham and QEH (or King’s).
Indeed, even those who seem to be agreeing with the general thrust of his comments think that Kershaw isn’t arguing his case properly. Greenwich’s cabinet member for health, John Fahy, observed that few people seemed to know the difference between an “urgent care centre” and accident and emergency; indeed, it’s possible to argue that things won’t change a great deal for users of Lewisham Hospital.
But the focus on finance (which is what Kershaw is paid to do), together with the rushed consultation, means that the real experience of hospital users is neglected – and sparks suspicions about there being a more sinister endgame for users of Lewisham Hospital.
Backbench Labour councillors in Greenwich may be be sceptical about the plans, but regular readers of this site will know that nobody even breaks wind in the “royal” borough without the say-so of leader Chris Roberts. And it turns out we’ve been here before.
Roberts ally Mick Hayes referred to Greenwich’s support for the little-publicised A Picture of Health review from 2009, which was never fully implemented, but led to the closure of A&E at Queen Mary’s in Sidcup – leaving Bexley borough residents to have to go to QEH or distant Darenth Valley Hospital in Kent. Will Greenwich’s Labour leadership listen to its backbenchers’ concerns this time, or will it back the downgrading of a second neighbouring borough’s hospital? We’ll have to wait and see.
There’s a different viewpoint from the meeting at Clare’s diary, and different sides to the argument at the TSA website and Save Lewisham Hospital. There are also public meetings, including tonight (organised by Greenwich Council) at Woolwich Town Hall.
(Tuesday 1am update: Brockley councillor Vicky Foxcroft reports the Labour group on Lewisham Council has donated £500 to the Save Lewisham Hospital campaign. Will there be an equivalent donation from their comrades in Greenwich?)
Friday, 10pm update: Thanks to Clare, here’s the (very quiet) audio from last Thursday’s meeting.
Demonstrators are planning to picket Woolwich Town Hall on Thursday evening as the NHS administrator recommending downgrading Lewisham Hospital’s A&E arrives to takes questions from a panel of Greenwich councillors.
Trust Special Administrator Matthew Kershaw will talk to Greenwich’s eight-member healthier communities scrutiny panel about his plans to deal with the collapse of the South London Healthcare Trust, which runs Queen Elizabeth Hospital in Woolwich.
He recommends that QEH is taken over by Lewisham Healthcare Trust – but that Lewisham Hospital’s A&E is restricted to “urgent care for those who do not need to be admitted to hospital”.
Indeed, never mind consulting the public, the boss of Lewisham Healthcare has already been put in place to take over South London Healthcare.
Campaigners have already had the backing of Lewisham’s elected mayor Sir Steve Bullock, who has branded the proposals “staggering” and has pledged to throw the resources of Lewisham Council into fighting the report.
But what of Sir Steve’s Labour colleagues in Greenwich? Despite the obvious effects on the already-overloaded QEH of the plans for Lewisham, Greenwich Council has so far been coy about the plans. Health cabinet member John Fahy told a council meeting two weeks ago that the report was “better than expected but with serious negatives”, and the council has pressed for further public meetings (which, to its credit, it has got – see below).
But that’s been it. Two anodyne stories have appeared in its weekly newspaper Greenwich Time to promote the report and public meetings, but with no mention of what the council thinks, despite the paper existing to do just that. (Remember: “Greenwich Time represents the views that come from the decision makers at Greenwich Council,” according to its PR chief.)
There’s also a short summary on the council website, which doesn’t mention the Lewisham proposal, and a non-committal quote from leader Chris Roberts: “We will study its recommendations for healthcare in Greenwich before responding accordingly.”
Greenwich councillors won’t even be discussing the proposals at a full meeting before the consultation closes on 13 December; while Lewisham’s will be meeting on 28 November.
It’s a sharp contrast from Sir Steve Bullock’s damnation of the plan as “complete nonsense“, and Lewisham councillor Liam Curran declaring the government “must not be allowed to divide the people of Lewisham and Greenwich”. After all, Greenwich Council seems to be doing the job well enough on its own.
As for Thursday night’s meeting, the clash between a council uncomfortable with being scrutinised and a group of highly-motivated protesters looks set to be a troubled one.
But with campaigners feeling the closure proposals are a done deal, there may be clues towards whether Greenwich Council will line up alongside their Labour colleagues in Lewisham, or whether they’re content to join Bexley Council in siding with Conservative health secretary Jeremy Hunt.
A consultation’s under way on the proposals – read more on the Trust Special Administrator‘s website (and Save Lewisham Hospital) and there’s a series of public meetings too – most of which, however, have been scheduled for when most people are at work. The first one, on Tuesday at West Greenwich House, had only around 50 people there.
In fact, it’s worth questioning how seriously the TSA is taking the consultation, with two public meetings in Greenwich borough not listed on its website. While information about the proposals should be displayed in all surgeries and pharmacies in the area, the photo above shows all I could find at Sainsbury’s pharmacy counter in Greenwich on Wednesday evening, behind a sales display in a staff area.
Evening meetings include: Woolwich Town Hall on Monday 19 November (not listed on TSA website), St Mary’s Community Centre in Eltham on Monday 26 November (not listed on TSA website), Charlton Athletic FC on Monday 3 December and and the Calabash Day Centre in Lewisham on Tuesday 4 December (all 7pm).
Update 2.50pm Lewisham Council has now come out against the proposal on its website.
I was going to write a long and involved post about the threat to Lewisham Hospital’s accident and emergency department, which is threatened with being downgraded under the proposals to clear up the fallout from the South London Healthcare NHS Trust collapse.
But frankly, the NHS isn’t my strong point, and the effects of what’s going on should be bloody obvious.
Any threat to the NHS in Lewisham will affect the NHS on this side of the border too. Essentially, it’s proposed that Lewisham’s A&E is turned into a non-admitting urgent care centre, with all the burden shifted to Queen Elizabeth Hospital in Woolwich, a hospital that’s difficult enough to get to if you live in Woolwich, never mind somewhere like Forest Hill.
Essentially, there’ll only be four fully-fledged accident and emergency units in the whole of south-east London if these plans get approved – King’s College in Camberwell, St Thomas’s in Lambeth, Princess Royal University Hospital in Bromley, and QEH. That’s not a lot of cover for an awfully huge number of people.
It’s also worth pointing out that the already-overloaded QEH currently has to deal with patients from Bexley, following the downgrading of Queen Mary’s Hospital in Sidcup. It’s a total mess, and the people of south-east London are paying for the failures of successive governments to manage their NHS properly.
I was in Lewisham the other night and couldn’t help noticing Lewisham Healthcare, which is in line to take over QEH, had spent money on ads telling locals how great they were. Perhaps they’d be better off putting that money into running hospitals, but maybe I’m just old-fashioned.
Reaction in Greenwich has been pretty muted – hey, this is the borough that won’t even run a fireworks display with its neighbour – but in Lewisham, they’re apoplectic. Lewisham East MP Heidi Alexander has set up an online petition, while she and mayor Sir Steve Bullock will be addressing a protest meeting on Thursday evening (6-8pm) at the hospital’s Lesoff Auditorium.
There’s also due to be a protest march on 24 November – more at savelewishamhospital.com. It’s going to be a big fight to save Lewisham’s A&E – but in Greenwich borough, it’s our fight as well as theirs – the importance of south-east London having a strong NHS that’s there for us is something that crosses borough boundaries. Actually, most normal people know this – but do our local politicians? We’ll find out in the coming weeks…
You may well have already seen the news that South London NHS Trust – which runs Queen Elizabeth Hospital in Woolwich – is on the brink of collapse after being warned it faces dissolution by the health secretary, Andrew Lansley. With debts of £69m recorded in April, the government has warned an administrator could be brought in within weeks, which could see the trust split up and parcelled off to other healthcare providers – including private operators.
It’s the beginning of the end of a misconceived disaster which has cost taxpayers – directly and indirectly – countless millions of pounds. QEH opened in 2001, replacing the old Brook Hospital on Shooters Hill Road and Greenwich District Hospital. GDH was to stand empty for five years before being demolished, and then the site was left empty for a further six years, blighting the community it once served.
As another example of an indirect cost, the re-routing of buses to serve QEH, a former military hospital on Woolwich Common, costs Transport for London £1 million each year.
Under the Private Finance Initiative – introduced by John Major’s Conservatives and continued by Tony Blair’s Labour government – the building was refurbished, and remains maintained by a little-known private sector firm, Meridian Hospital Company, which receives payments from the NHS Trust. This year, MHC is due to get £66.8m under the deal, negotiated in July 1998.
The sums didn’t add up, though. By late 2005, the Queen Elizabeth Hospital NHS trust was declared insolvent. The solution was to merge it with NHS trusts in Bexley and Bromley boroughs – the latter also struggling with PFI debt from the Princess Royal Hospital at Locks Bottom.
From the off, the new, debt-riddled South London NHS Trust struggled. Services at Queen Mary’s Hospital in Sidcup were cut back, with patients packed off into Kent. Finally, it seems the whole edifice has sunk. A merged Dartford-Medway NHS trust is already licking its lips and looking at services in Bexley. As for services in Bromley and Greenwich, they face an uncertain future.
An email sent to staff last night from South London NHS Trust chief executive Chris Streather reads:
We are very sorry that by the time that most of you will read this tomorrow morning, you will have heard media reports about the future of the Trust in the news. We were not told of this decision until late today (Monday) and there are certainly issues about the timing and appropriateness of telling staff before the media which we will be taking up.
In spite of the massive improvements in the quality of care – among the lowest mortality and infection rates now in England – it is true that the financial challenges facing the Trust remain significant. Our Trust, our Commissioners and the Department of Health are all in agreement that this needs to be tackled and in a way which is clear and ends uncertainty which I think has been unhelpful for a long time.
For this reason, we are now in discussions with the Department of Health and NHS London to look at the best way forward. One of those options could be the introduction of the Unsustainable Provider Regime, which would involve the appointment of a special administrator to manage the organisation and produce a report on the best way to deliver financially and clinically sustainable services to local patients.
We expect those discussions to come to a conclusion in the second week in July when a decision will be taken by the Secretary of State. In the meantime, I would like to assure you all that we are here to protect the services for patients, we have all fought hard to improve them and that is what we will continue to do.
A carefully handled intervention which maintains the improvements to safety and quality, while sorting out the long standing financial issues which have beset us and the S E London health sector may well be helpful.
Of course, PFI is a failure of our entire political class. Both Labour and Conservative are beholden to PFI, so nobody will call this out for the disaster that it is.
But I can’t help reflecting that this came a week after the Greenwich Labour Party launched a front campaign, The Greenwich People’s NHS Charter – despite their party’s government leaving our own local hospital in a perilously weak state, and facing the very real threat of private firms coming into pick up the pieces.
Nobody knows quite what will happen to the stricken, ill-conceived mess that is Queen Elizabeth Hospital. But there’s a few people, some enriched by these deals, others still holding public office, who owe its hard-working staff, patients, and the rest of us, an apology. Who’ll be big enough to step forward?
PS. I’m told one large organisation in this borough opposed the closure of Greenwich District Hospital and its relocation to Woolwich Common – Greenwich Council. See, not always wrong, you know.