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

Newsgroup Newspapers Ltd/Published with permission
Show Hide image

Everything that is wonderful about The Sun’s HMS Global Britain Brexit boat

And all who sail in her.

Just when you’d suffered a storm called Doris, spotted a sad Ukip man striding around the Potteries in top-to-toe tweed, watched 60 hours of drama about the Queen being a Queen and thought Britain couldn’t get any more Brexity, The Sun on Sunday has launched a boat called HMS Global Britain.


Photo: Newsgroup Newspapers Ltd/Photos published with permission from The Sun

Taking its name from one of Theresa May’s more optimistic characterisations of the UK post-Europe (it’s better than “Red, white and blue Brexit”, your mole grants), this poor abused vessel is being used by the weekend tabloid to host a gaggle of Brexiteers captained by Michael Gove – and a six-foot placard bearing the terms of Article 50.

Destination? Bloody Brussels, of course!

“Cheering MPs boarded HMS Global Britain at Westminster before waving off our message on a 200-mile voyage to the heart of the EU,” explains the paper. “Our crew started the journey at Westminster Pier to drive home the clear message: ‘It’s full steam ahead for Brexit.’”

Your mole finds this a wonderful spectacle. Here are the best bits:

Captain Michael Gove’s rise to power

The pinnacle of success in Brexit Britain is to go from being a potential Prime Minister to breaking a bottle of champagne against the side of a boat with a fake name for a publicity stunt about the policy you would have been enacting if you’d made it to Downing Street. Forget the experts! This is taking back control!


 

“God bless her, and all who sail in her,” he barks, smashing the bottle as a nation shudders.

The fake name

Though apparently photoshopped out of some of the stills, HMS Global Britain’s real name is clear in The Sun’s footage of the launch. It is actually called The Edwardian, its name painted proudly in neat, white lettering on its hull. Sullied by the plasticky motorway pub sign reading “HMS Global Britain” hanging limply from its deck railings. Poor The Edwardian. Living in London and working a job that involves a lot of travel, it probably voted Remain. It probably joined the Lib Dems following the Article 50 vote. It doesn’t want this shit.

The poses

All the poses in this picture are excellent. Tory MP Julian Brazier’s dead-eyed wave, the Demon Headmaster on his holidays. Former education minister Tim Loughton wearing an admiral’s hat and toting a telescope, like he dreamed of as a little boy. Tory MP Andrea Jenkyns’ Tim Henman fist of regret. Labour MP Kate Hoey’s cheeky grin belied by her desperately grasping, steadying hand. Former Culture Secretary John Whittingdale’s jolly black power salute. And failed Prime Ministerial candidate Michael Gove – a child needing a wee who has proudly found the perfect receptacle.

The metaphor

In a way, this is the perfect representation of Brexit. Ramshackle, contrived authenticity, unclear purpose, and universally white. But your mole isn’t sure this was the message intended by its sailors… the idea of a Global Britain may well be sunk.

I'm a mole, innit.