And the fish-shaped topiary hedge outside a house near Mounstfield Park with the message: " Don't close Lewisham A & E or I'll be gutted" !

Great march. Great atmosphere. And 25,000 people! Let's hope Mr Hunt sees sense on Feb 1st.

I was really disappointed by how the Today programme on Saturday handled this

linking the wider issue of rationalising hospitals to the closure of Lewisham A&E - as if the researchers hadn't bothered to find out that this proposed closure had no clinical logic behind it, and a financial logic which depended solely on PFIs. So Lord Darzi made his point that London was the best place in the country to have a stroke, thanks to the centralisation of treatment in specialist hospital, while Joan Ruddock indignantly rejected the idea that in this campaign she was acting against the best interests of her constituents, and insisting that she had always been ready to follow the evidence.

It meant that two other important questions got side tracked - first how should politicians / policy makers approach those genuinely difficult cases where local hospitals / units ought to be closed, and second how many more well run hospitals are going to be sacrificed to maintain the sanctity of PFI contracts.

Agree with you Tim.
Lord Darzi and Dame Joan were talking about quite different issues, and I could agree with them both!
Joan made some good points about Lewisham Hospital.

Save Lewisham hospital are asking people to tweet:

Dear @Jeremy_Hunt do the right thing and #SaveLewishamHospital! Listen to the people!

Cut and paste into your twitter feed

THE HOSPITAL HAS BEEN DOWNGRADED

http://www.bbc.co.uk/news/uk-england-london-21269910

What now in terms of the fight?

no since the decission is finally made I am still unsure what it actually means ...... it says on the BBC that more serious cases will be refered to other hospitals, so does that mean that if I fear having a stroke or heart attack the ambulance will take me to Woolwich but if I have a broken leg I can still go to the downgraded A&E in Lewisham?

The decision about maternity has gone against all the advice they have been given about what is safe (I know because I was in some of the meetings), so I really don't understand how he can claim this decision will provide higher clinical standards. It is simply not safe to expect women in labour to travel that far to another hospital in an emergency.

Without full A&E and maternity, the heart of the hospital is lost and they know that full well....

They just want to push Lewisham residents to other hospitals to ensure those hospitals have higher patient numbers to balance their books. Who cares about the people of Lewisham, being forced to travel to Woolwich or the PRUH or Kings? Not the government certainly. They obviously have no regard for the needs of Lewisham residents and that sickens me.... I am certain they would take more notice if this was a Tory borough - Oh yes they did! Bromley is Tory.

yes, thats about it. all blue light services will go to other hospitals, but if you can make it into A&E on your own then for now at least you will be seen.

Maternity all to shut.

So the fight goes on, with an emergency meeting outside the hospital tonight at 6pm having been called (spread the word!)


This is an interesting and important read: The South London Women’s Hospital Occupation 1984-85 http://www.alphabetthreat.co.uk/pasttens...pital.html

This was the wrong decision but it could have been so much worse.

It is thanks to thousands of people who wrote, emailed, attended public meetings, and marched, that this decision was not for the full closure of Lewisham A&E. The resulting savings from the reduction in size of Lewisham A&E (without compromising clinical need) will be so difficult that it is likely to end up with no actual reduction (although the costs and the investment in neighbouring hospitals may be completely mis-targeted expenditure).

Just like the recommendations from Kershaw, the decision from Jeremy Hunt makes very little sense. Rather than taking the sensible decision to reject any chance to Lewisham, he has tried to fudge the issue. This means the people of Lewisham now have a prolonged fight to protect the hospital from each service reduction over the course of years rather than months.

It is such a waste of time and effort, when the hospital is functioning well and has had significant investment in A&E and maternity in the last few years. There was no need to make such changes to Lewisham hospital and it punishes the success of a good performing hospital.

Disagree - this is just as bad a decision as any.

The decision is designed to stop the campaign whilst achieving all initial aims. What remains of the A&E will be salami sliced to extinction over time. Now is the time to really fight over the hospital while the momentum is with us. The time for marching and petitions is over...time for the next phase

While I think that the protest action has been noticed at least, I think that you are right lillam.

I have seen an interesting observation about all this. Lewisham hospital is the sitting target as it wasn't a PFI build? The reasoning being this is because the land and buldings are not owned by PFI contractors and so can be sold off for re-development.

As for next phase, I wonder what legal case could be fought on this. Also, I think that other trusts will be very wary of what is going on here, so this is no longer just a local issue.

The transpontine blog expresses it better than i could.

http://transpont.blogspot.co.uk/
Fight goes on to Save Lewisham Hospital



Hundreds of people gathered outside Lewisham Hospital last night in the aftermath of health secretary Jeremy Hunt's announcement in Parliament on the future of emergency and maternity services. Hunt had been forced to acknowledge the strength of the opposition to cuts and modify the recommendations put to him by the Trust Special Administrator he appointed to review South London health services. He stated that the Accident and Emergency department would now be downgraded rather than closed, retaining the ability to admit some patients who need to be taken into hospital. But in real terms this still means that there will be no full A&E at Lewisham with potentially devastating implications for the wider hospital.

According to BBC Health Correspondent Nick Triggle: 'The official line is that the plan to change it to an urgent care centre has been stopped by ministers who have listened to concerns. But make no mistake the A&E - currently classed as a major type one unit - is still being downgraded. The plan may only mean a quarter of the patients using the unit are affected as the rest will still be able to get the treatment they need from the service that emerges from the reorganisation'.

'But the absence of those quarter, who will end up being treated at nearby hospitals, will have a profound impact. They will be the sickest, most life-threatening cases who are ferried to hospital in ambulances. Without them Lewisham will not need its critical care unit and perhaps a host of other associated services. Hospitals are complex organisations. Removing one thing has a ripple effect across the rest of the hospital. The plan means Lewisham starts to move away from what many would associate a hospital to be'.

'Instead, it will focus much more on planned care, such as knee and hip replacements, and non-emergency cases. Only those who are at no immediate risk will be taken to Lewisham, this could include the elderly person who has had a fall and needs a little supervision to someone who has twisted their ankle'.

Hunt also decided to go ahead with the 'downgrading' of maternity services at Lewisham which again amounts to a virtual closure. There would only be a midwife-led unit on site rather with no consultant obstetricians. Midwives do a great job and many women choose to give birth in these midwife-led units as a kind of half way house between home birth and hospital birth. But they usually do so because they have decided they want to be close to emergency clinical back up if there are complications. That wouldn't exists in future at Lewisham.

In real terms both the degraded 'A&E' and remaining maternity services would eventually wither on the vine and could then be fully closed on the basis that people weren't choosing to use them anymore. Lewisham Hospital would just be a place where people go for minor operations and no doubt it wouldn't be long before somebody said it was too expensive to keep a whole site just for that, why not just close it down and sell off the land?



Outside the hosptial last night, campaigners were clear that the fight to save Lewisham Hospital will continue. This is a financially driven cut, not a clinically-led attempt to save patient lives, and Hunt's decision is a political one. Lots of debate is now going on about what to do next, with speakers last night putting forward a range of ideas from legal challenges and political lobbying to direct action (e.g. occupations and work-ins to prevent closures). The actual closure of services could take two to three years, clearly the Government hopes that opposition will fade over that time. But possibly the strongest ever local movement against NHS cuts isn't going to melt away.

Check Save Lewisham Hospital for campaign updates. Forthcoming events include:

Friday 15 February, 1 pm - Lunctime rally for hospital workers and community campaingers to discuss the next steps, at the war memorial opposite the hospital.

Saturday 16 February - 'Born in Lewisham event' for people born in, or who gave birth, in Lewisham Hospital. Further details to be confirmed.

Every Tuesday, 7 pm - Save Lewisham Hospital weekly campaign meetings at the Waldron Health Centre in New Cross.

From the BBC

NHS safe in my hands says Cameron

David Cameron said the NHS is safe in his hands as he brought the annual Conservative conference to an end.
Mr Cameron accused Labour of mismanaging the health service and said he would be taking to the streets with a campaign to stop the cuts.
The Tory leader also hit out at those accusing him of peddling spin rather than substance.
He warned against rushing out policies and argued the Conservatives were "getting ready to serve again".
Health priority
Mr Cameron called the NHS was one of the 20th Century's greatest achievements.
"Tony Blair explained his priorities in three words: education, education, education," he told Tory activists in Bournemouth.
"I can do it in three letters: NHS."
Mr Cameron, who has a severely disabled son, continued: "When your family relies on the NHS all of the time - day after day, night after night - you know how precious it is.
"So, for me, it is not just a question of saying the NHS is safe in my hands - of course it will be. My family is so often in the hands of the NHS, so I want them to be safe there."
He promised "no more pointless and disruptive reorganisations". Instead, change would be "driven by the wishes and needs of NHS professionals and patients".

Here is an extract of Jeremy Hunt's statement:

I have written to Jim Dowd to find out how we can get hold of a copy of Sir Bruce's report.

Good idea.

Did I understand another part of his annoucncement correctly: the DoH will write off the South London Healthcare Trust's debts? If I also understand correctly that their PFI repayment is larger than their deficit, am struggling to see what the financial imperative is to involve any assets outside the trust.

Does anyone have a handle on this?

I don't see how patients' chances of survival are increased by taking them to a more distant hospital!

Sometimes it will. And we are lucky to have some incredibly good facilities at Kings (see http://www.togetherwecan.org.uk/kings-co...oke-centre).
If you are stabbed, involved in a serious traffic accident, or experience a stroke, you are very likely to be taken straight to Kings. My understanding is that this system is already in practise and does provide better clinical outcomes for these groups of patients.
But that would not apply for the vast majority of patients where a well equipped A&E department is better the quicker they can get there (without an ambulance).

And Lewisham is recognised (including by Sir Bruce) for the high quality of paediatric care, so there is probably a similar arrangement to get sick children to Lewisham in preference to other hospitals. However, the reduction of A&E services will destroy this, which is why Sir Bruce talks about 'rapid transfer protocols' to find another hospital that would be able to provide the best treatment for seriously ill children, and I suspect it will take a long time for any other hospital to get up to the standard of Lewisham. It is a similar situation with maternity. However, during any transitional phase there is a serious concern that patients will suffer.

It is a very complicated issue, and I don't claim to be an expert, which is why I want to read Sir Bruce's report in full, not just a summary by a politician with no clinical expertise. When the politician includes terms like: 'His opinion is that this is possible, but ...'
'He is clear that this will require careful pathway planning ...'
'with these caveats...'
I get very suspicious regarding the real feelings of the report's author.

lest we forget protecting NHS services was that key platform of the last Tory campaign, with posters all over the country telling the same lie