Lewisham: the most irrational, irresponsible hospital to cut

To cut this well-performing hospital would be to reward failure and punish success.

I was born in Lewisham hospital. My mum was convinced that she’d eaten some dodgy mackerel, but it turned out to be contractions. She was rushed in, and both of us were pretty grateful for the kindness and expertise staff showed in helping a frightened mother deliver a safe birth. So when I heard that Lewisham might be losing most of its maternity and other key services to cuts, I decided to go back and visit.

But walking through the hospital’s glass doors in the bustling heart of South London, I was determined not to be sentimental. Months of covering health news for the Guardian taught me that some closures are inevitable. The left loses credibility by not recognising that. We must be prepared to accept uncomfortable truths. The problem is that this might just be the most irrational, irresponsible hospital to cut:

“Here we are bang in the middle of Lewisham, a real community hospital doing exactly what the government wants,” consultant physician John Miell tells me in the hospital canteen. “We have great health reports from objective sources and our finances are more sound than our neighbours. Now the government are ripping the heart out of this community… If they can close Lewisham, they can close anywhere.”

The facts back him up. Lewisham has ranked in the top forty hospitals in the country for the last four years, and its safeguarding services have just been marked excellent by Ofsted (pdf). Lewisham will not be closing services because of failure; it will be closing to protect other hospitals that are too expensive to close because of bad management and botched PFI contracts. As one doctor put it: “We are victims of our success”.

Matthew Kershaw, the man leading the review, makes no secret of this. He has recommended that Lewisham shut all acute services – children, intensive care and most of maternity – simply so that they don’t compete with others in the South London NHS Trust. It’s the worst example of top-down state control rewarding failure. Weren’t the government’s NHS reforms supposed to be about introducing competition to do exactly the opposite?

If the health secretary Jeremy Hunt agrees to these recommendations on 1 February (or before if rumours are believed that he wants to scupper the demonstration this Saturday), good performance will no longer guarantee any sort of protection against closure. As Lucy Mangan says, every hospital in the country will be at risk.

Doctors are also terrified that the consequences of shutting services in a poor, densely populated inner city area with a booming population and a high birth rate have not been thought through. Campaigners say that the changes will leave the local population of 750,000 with just one A&E department.

“Hospitals to the east and west of Lewisham are already full and have been passing their maternity patients to Lewisham,” says Louise Irvine, a local GP who is leading the Save Lewisham Hospital campaign, “The system is already not coping. People are going to die. That’s what we want Hunt to know. He has been duly warned.”

Doctors told me that the local Queen Elizabeth hospital was already transferring children out as far as Margate to cope with over demand. Mums trying to book Kings hospital for births are already being told there is no space. One GP talked about an appendix rupturing in A&E because they couldn’t be seen in time. These stories came from different local hospitals, but everyone felt their position was too precarious to go on the record.

Distance is another problem. Workers for the London Ambulance Service have informally raised concerns about the closure of Lewisham’s A&E department because they know that minutes determine lifetimes. Jos Bell is one local resident who became active in campaigning to save the hospital because of an experience she had a few years ago when she was taken ill and her pulse stopped:

“I wouldn’t have got to Woolwich (the nearest alternative hospital) in time… I would have died in the cab. People will be dropping on route. They are pioneering new treatments at Lewisham. They have saved my life more than once.”

Distance is a bigger problem in poorer areas where car ownership is relatively low. If Lewisham closes its emergency service, some people in Sydenham and Crystal Palace will have to travel for over an hour to get to recommended alternatives.

“For maternity users it’s going to be the most dangerous,” says Jessica Ormerod, a local mother and head of Lewisham’s maternity committee that represents mums in the borough, “They are already vulnerable. Some asylum seekers don’t have the bus fare to get there – at least they can walk to Lewisham.”

Doctors also raised problems of integration – supposedly another key rationale for the health reforms. Right now if a birth goes wrong unexpectedly, mum can be moved to an emergency service across the hall. But under the new proposals, there would be no facilities to do that. If a baby came out with its chord around its neck, patients would have to be transferred by ambulance across town with all the extra risk that brings. I shudder to think of my mum in this position. That could have been me or my little brother.

“We know that most safeguarding failures occur because of a break down between services as people fall through the gap,” says chair of Lewisham’s clinical commissioning group Helen Tattersfield, who maintains the same problem applies to vulnerable groups like self harmers who need social as well as medical support. “If this goes ahead I’ll have patients in five different hospitals and I won’t know they’ll be in the system. It’s a recipe for confusion.”

Kershaw insists that despite extensive consultation, no “viable alternative solutions or proposals been put forward" to solve the challenges faced by the South London Hospital Trust.

If this move made economic sense, perhaps he would have a point. But the Guardian has reported that Kershaw’s proposals would cost £195m to implement, and only deliver £19.5m savings a year. At a time when Lewisham has just invested millions in services that are doing well, this seems wasteful. If you have to close a hospital, why close the one that is doing best?

For many, this is a political decision. Lewisham is a poor area and as one doctor put it, “There is very little to lose when everyone votes Labour here anyway”. The alternative is to close hospitals in Conservative-held areas like Kent, and MPs like Iain Duncan Smith, Chris Grayling and Julian Lewis have already proven that even Tories can’t justify closures in their own backyard. Some call it “fiscal nimbyism”. Patients and doctors call it understanding the consequences when you’re close to them. Me and my mum can testify to that. 

Editor's note: This piece was edited on 22 January 2013. A reference to St Thomas's hospital had been included in error; this was removed.

A porter pushes resuscitation equipment down a corridor at Lewisham Hospital. Photograph: Getty Images

Rowenna Davis is Labour PPC for Southampton Itchen and a councillor for Peckham

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25 times people used Brexit to attack Muslims since the EU referendum

Some voters appear more interested in expelling Muslims than EU red tape.

In theory, voting for Brexit because you were worried about immigration has nothing to do with Islamophobia. It’s about migrant workers from Eastern Europe undercutting wages. Or worries about border controls. Or the housing crisis. 

The reports collected by an anti-Muslim attack monitor tell a different story. 

Every week, the researchers at Tell Mama receive roughly 40-50 reports of Islamophobic incidences.

But after the EU referendum, they recorded 30 such incidents in three days alone. And many were directly related to Brexit. 

Founder Fiyaz Mughal said there had been a cluster of hate crimes since the vote:

“The Brexit vote seems to have given courage to some with deeply prejudicial and bigoted views that they can air them and target them at predominantly Muslim women and visibly different settled communities.”

Politicians have appeared concerned. On Monday, as MPs grappled with the aftermath of the referendum, the Prime Minister David Cameron stated “loud and clear” that: “Just because we are leaving the European Union, it will not make us a less tolerant, less diverse nation.”

But condemning single racist incidents is easier than taking a political position that appeases the majority and protects the minority at the same time. 

As the incidents recorded make clear, the aggressors made direct links between their vote and the racial abuse they were now publicly shouting.

The way they told it, they had voted for Muslims to “leave”. 
 
Chair of Tell Mama and former Labour Justice and Communities Minister, Shahid Malik, said:

“With the backdrop of the Brexit vote and the spike in racist incidents that seems to be emerging, the government should be under no illusions, things could quickly become
extremely unpleasant for Britain’s minorities.

“So today more than ever, we need our government, our political parties and of course our media to act with the utmost responsibility and help steer us towards a post-Brexit Britain where xenophobia and hatred are utterly rejected.”

Here are the 25 events that were recorded between 24 and 27 June that directly related to Brexit. Please be aware that some of the language is offensive:

  1. A Welsh Muslim councillor was told to pack her bags and leave.
  2. A man in a petrol station shouted: "You're an Arabic c**t, you're a terrorist" at an Arab driver and stated he “voted them out”. 
  3. A Barnsley man was told to leave and that the aggressor’s parents had voted for people like him to be kicked out.
  4. A woman witnessed a man making victory signs at families at a school where a majority of students are Muslim.
  5. A man shouted, “you f**king Muslim, f**king EU out,” to a woman in Kingston, London. 
  6. An Indian man was called “p**i c**t in a suit” and told to “leave”.
  7. Men circled a Muslim woman in Birmingham and shouted: “Get out - we voted Leave.”
  8. A British Asian mother and her two children were told: "Today is the day we get rid of the likes of you!" by a man who then spat at her. 
  9. A man tweeted that his 13-year-old brother received chants of “bye, bye, you’re going home”.
  10. A van driver chanted “out, out, out”, at a Muslim woman in Broxley, Luton
  11. Muslims in Nottingham were abused in the street with chants of: “Leave Europe. Kick out the Muslims.”
  12. A Muslim woman at King’s Cross, London, had “BREXIT” yelled in her face.
  13. A man in London called a South Asian woman “foreigner” and commented about UKIP.
  14. A man shouted “p**i” and “leave now” at individuals in a London street.
  15. A taxi driver in the West Midlands told a woman his reason for voting Leave was to “get rid of people like you”.
  16. An Indian cyclist was verbally abused and told to “leave now”. 
  17. A man on a bike swore at a Muslim family and muttered something about voting.
  18. In Newport, a Muslim family who had not experienced any trouble before had their front door kicked in.
  19. A South Asian woman in Manchester was told to “speak clearly” and then told “Brexit”. 
  20. A Sikh doctor was told by a patient: “Shouldn’t you be on a plane back to Pakistan? We voted you out.”
  21. An abusive tweet read: “Thousands of raped little White girls by Muslims mean nothing to Z….#Brexit”.
  22. A group of men abused a South Asian man by calling him a “p**i c**t” and telling him to go home after Brexit.
  23. A man shouted at a taxi driver in Derby: "Brexit, you p**i.”
  24. Two men shouted at a Muslim woman walking towards a mosque “muzzies out” and “we voted for you being out.”
  25. A journalist was called a “p**i” in racial abuse apparently linked to Brexit.