Lewisham hospital: just how bad is it doctor?

Pretty bad I'm afraid...

The Special Administrator's draft report into the future of South London Healthcare NHS Trust and the NHS in SE London  has been published today. If anybody thought campaigners were scaremongering about the threat to services at Lewisham Hospital and elsewhere, they should have a read of it. Though it might take you a while to understand what it's really saying.

You won't for instance find a clear statement that Lewisham Accident & Emergency  department is to close - rather a recommendation that 'Emergency care for the most critically unwell patients should be provided from four sites - King’s College Hospital [Camberwell], St Thomas’ Hospital [Waterloo], Queen Elizabeth Hospital [Woolwich] and Princess Royal University Hospital [Farnborough]. Alongside this, services at University Hospital Lewisham, Guy’s Hospital and Queen Mary’s Hospital Sidcup will provide urgent care for those that do not need to be admitted to hospital'.

But that amounts to saying that Lewisham will no longer provide 'Emergency care', which it does at the moment. Instead it is suggested that it would provide an 'urgent care service' only for people who don't need to be admitted to hospital. In other words a glorified minor injuries clinic only able to deal with cuts, bruises and minor infections. The report claims that this would still deal with about 77% of the people who currently use Lewisham A&E. Even by the report's own estimation at least 70 of the most seriously injured people attending each day could no longer be treated at Lewisham as it would no longer have the staff or facilities.

The report neglects the vital triage role played by Accident and Emergency departments. When people turn up with an injury at A&E they often don't know how serious it is, and nor is it always immediately apparent to staff. People may turn up with what appears to be a minor injury but then need to be admitted for emergency care - trouble is they won't be able to get it at Lewisham. Not all the most seriously injured come in via ambulances which could drive them to an alternative facility. For instance, sadly in somewhere like Lewisham there are too many people who get beaten, stabbed or even shot and find their own way to A&E. The report suggests that if somebody needs emergency care they could be transferred via ambulance - but they could be dead by the time they get from Lewisham to Woolwich, a journey time which AA Route Planner times at 22 minutes assuming normal traffic.

The report has many misleading statements - it claims that the average journey time to A&E for Lewisham residents would increase by only 11 minutes by car or 14 minutes by public transport. Of course if you live at the Blackheath end of Lewisham borough, the increase in journey time may not be as dramatic. But if you live near Lewisham Hospital it's a different story - Transport for London's journey planner suggests that the quickest public transport journey from Lewisham Hospital to Queen Elizabeth Hospital takes around 50 minutes during the day, including a 15 minute walk at the Woolwich end from the 54 bus stop.

Taking away Emergency care facilities from Lewisham will cost lives. It will also radically impact on the rest of the hospital - for instance maternity services cannot be delivered in the same way without emergency care on site, and the role of Lewisham as a teaching hospital would be undermined. I will return to look at some of the wider implications of the report when I've had time to digest it properly.

A right Jeremy Hunt - Do you really want to hurt me?
(SE London homeboy Boy George tweeted tonight:
'Lewisham Hospital A&E to shut? Look at cutting the wages at the top in the NHS
 and stop destroying a wonderful institution'

Officially the report is a draft for consultation, with the final report due to be sent in January to health secretary Jeremy Hunt for final decision. But there can be no doubt that the recommendations would never have seen the light of day without the agreement of ministers. Behind the managerial rhetoric of 'securing sustainable NHS services' there are doubtless some crude political calculations. How else to explain how a report originally prompted by problems at South London Healthcare Trust, which covers Greenwich, Bexley and Bromley, ends up recommending the most direct cuts in another area altogether - Lewisham? Surely the fact that Bexley and Bromley are Conservative boroughs, and Lewisham has hardly a Tory in sight, couldn't be a factor?

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For details of the campaign to save Lewisham A&E, including a forthcoming public meeting and protest check Save Lewisham Hospital.

An online petition has also been set up here: 'We, the undersigned, note with great concern the proposals in respect of A&E and maternity services at Lewisham Hospital contained in the draft report of the Special Administrator of the South London Healthcare Trust published on 29 October 2012. We believe a full admitting A&E service and a full maternity service at Lewisham Hospital must remain'.