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.