Hunt's verdict on Lewisham A&E: Liveblog

Jeremy Hunt is due to address Parliament in a few minutes, announcing his decision regarding the fate of Lewisham Hospital and the South London Healthcare Trust. We'll report the result as soon as it's in.

Brockley Councillor Darren Johnson tweeted this morning:

Jeremy Hunt's letter to Council talks about "difficult decisions". Politician's never use that phrase unless something bad is due to happen.

11:34 - Hunt's statement begins...

11:35 - Uh oh, he's reminding us that health care costs money.

11:35 - He says the SLHT has the worst financial problems of any in the country.

11:36 - He's thanking Kershaw and says he supports his analysis.

11:38 - So far he's accepted all the recommendations other than the reconfiguration that would effect Lewisham

11:39 - He's talking about the public campaign - says he respects their feelings, but that Lewisham needs the other hospitals to work well too

11:41 - Says there has been sufficient clinical input in the recommendations and that no one will be put at increased risk of Lewisham A&E closure.

11:42 - He reckons (and this is patent bollocks) that the extra journey time as a result of closures will only be another minute, on average.

11:45 - It looks like A&E will stay in reduced form. The rest of the recommendations to be adopted.

11:48 - It's not clear yet what a 'smaller A&E' actually means. The hospital was always due to keep some emergency care facilities.

11:50 - The Guardian reports that "Up to three quarters of those curently attending Lewisham A&E could attend the new service at the hospital, he says. Patients with more serious conditions could be taken to other hospitals. This will require careful planning. The NHS medical director believes that, with these caveats, care could improve. The new system could save up to 100 lives a year, he says."

11:52 - The Twitterspehere is still trying to grapple with what this all means. It looks as though all but the most serious A&E cases will be able to get admitted at Lewisham. That could make sense, since those cases will be handled by ambulances.

11:55 - Here's the Department of Health statement:

With regard to the proposed service changes within the new merged Lewisham-Greenwich provider, the Secretary of State asked Professor Sir Bruce Keogh, Medical Director of the NHS, to consider if they would improve patient care.

On the basis of Sir Bruce’s advice, the Secretary of State has accepted the recommendation to centralise very specialist emergency care at four sites in South East London because this will significantly improve the quality of care and save the lives of up to 100 patients a year.

The Secretary of State understood the financial rationale for downgrading Lewisham A&E, but in the interests of local patients has imposed some additional clinical safeguards proposed by Sir Bruce. Lewisham Hospital will retain its ability to admit patients with less serious conditions, and will continue to have 24/7 senior medical emergency cover, allowing it to remain open as a working A&E department treating up to 75% of the patients who currently use it.

Patients with much more serious conditions or higher risk pregnancies will be taken to Kings, Queen Elizabeth, Bromley or St Thomas’ because they are more likely to have a better result. To get to this higher standard of care, patients across South East London will only spend on average 2 more minutes in an ambulance to access specialist emergency services and on average 2-3 minutes in a private car or public transport to access consultant led maternity services.

With these additional safeguards in place, the Secretary of State has agreed that the Trust Special Administrator should proceed to implementation, with South London Healthcare NHS Trust expected to be dissolved between June and October 2013.

12:02 - Hunt says patients with heart attacks and strokes already go elsewhere for more specialist care and argues the principle is no different.

12:05 - Heidi Alexander says she remains concerned about maternity services. Hunt says there are sound medical reasons for women with high-risk pregnancies to travel a little further.

12:06 - Simon Hughes says he doesn't understand why maternity can't stay if there's still to be an A&E department.

12:12 - The details will be picked apart in the coming days. It is not clear at this stage how much this is simply a rebranding of the original plans or whether the A&E will continue to be a useful asset to the people of Lewisham. What is certain is that - as the BBC reports - Lewisham A&E and maternity services have been downgraded due to the mismanagement of other hospitals in the area.

79 comments:

AliP said...

I actually feel sick

SoniaK said...

Watching live BBC Parliament online and hardly anyone there!

Essael Bosch said...

I have no hope for a good outcome here, I'm afraid.

DLH said...

Thanks for doing this - at work so can't watch...

Sue said...

Listening on Radio London, feeling very queasy...

Pete Thornton said...

He has accepted most of the recommendations subject to some changes which I didn't really understand.

endwell said...

What about the maternity services?

Dex said...

Lewisham to retain a smaller A&E department

Pete Thornton said...

He said that maternity services would be downgraded although they would still look after 10-60 percent of cases. Quite a few of the details went over my head though.

Mezzer said...

Shocking - I really do feel quite ill....

I think the "smaller A & E" is just another way of phrasing what was proposed to happen anyway...

Dex said...

Those are probably the low risk cases - so for any high risk birth would still have to go to another hospital

Mezzer said...

I hope Lewisham Council are on the phone to the lawyers, as they promised they would be....

Pete Thornton said...

Could have done without the Tory MP from Bromley chipping in with his comments that it was a great idea. So long as his constituents are looked after the labour supporting proles in Lewisham can all go to hell. 

Futura 2000 said...

perhaps i am missing something, but 75% of A&E to be retained is surely an okay result considering what the recommendation was?

Jac said...

 Bob Stewart (Tory) from Beckenham just stood up in opposition though. That was fairly heartening

Mezzer said...

I don't see how it differs from the original proposal that Lewisham's A&E unit be downgraded to an urgent care centre, meaning emergency cases would have to be be seen at nearby hospitals.

Pete Thornton said...

Maybe - it's not that clear what all this means to me yet. 

Hannah said...

It's UP T0 75 per cent. That means anything from 0 to 75%. The BBC is reporting it as a downgrade.
http://www.bbc.co.uk/news/uk-england-london-21269910

SoniaK said...

someone could have what is classed as a low risk birth but when the time comes, somehting goes wrong - what then?

Max Calò said...

Lewisham has not received ambulances with people suffering from heart attack and other serious conditions for years.  Can we take that the 25% downgrade in those terms has already happened?
Anyway, good to hear that Lewisham will retain an admitting A&E but as it's been pointed out, why then downgrade maternity? And where's teh extra capacity for all these women overspilling from a downgraded Lewisham maternity?

Woodman said...

I'm still trying to figure out how the difference between my 16 minute trip to Kings and my 3 minute trip to Lewisham is only 1 minute. Is Mr Hunt proposing changes to the speed limit too?

Anon said...

Let me explain....

If many destined for A&E already go to Kings (or whereever) then the average time is already greater than if they were taken to Lewisham. 

anonymouse said...

What was that bit about ambulance journeys on average taking 2 minutes longer, and patients travelling by car taking 2 - 3 minutes longer? My car can't go thru red lights or speed, and no one gets out of the way for me.

david said...

In fairness, he means 1 minute longer in an ambulance.

If you're capable of self-presenting you'll take yourself to Lewisham and probably be in the right place. If you're too badly hurt or ill to make it yourself then the paramedics will call where to take you.

david said...

The emergency teams will try to stabilise you and then blue light transfer you to either Woolwich or King's depending on where the expertise is available for whatever your problem is. That's an extension of what already happens when a local hospital has a patient it can't cope with. What it means for Lewisham is the range of incidents it can't cope with will go up.

Relief said...

Well done everyone, we managed to save the A+E! This is a big victory against the Tory cutbacks. We have to be vigilant though.

david said...

Up to 75% is the key phrase. It will almost certainly be less. Plus, the claims that senior emergency medical staff will be on hand is a little disinegenuos as only Majoe Trauma Centres (King's is our local one) have 24/7 consultant cover on A&E. What oit really means is that they won't really junior or non-specialty Trainees doctors plus sone experienced nurses.

Which is not to rubbish trainees or nurses but rather to point out how the language is being used to fudge the point.

bilko6 said...

And presumably the  16 mins to Kings is based on arriving at the station as the train arrives .No waiting etc

Kershaw was asked at meetings how would someone knocked down by a car in Catford get to QEH in the then quoted 14 mins and he surprisingly didnt have a proper answer( remember travel times were taken from the tfl website and paid no attention to times waiting for an ambulance or road conditions, congestion etc) 

david said...

Max, it will be a 25%+ downgrade from current levels which already excludes heart attacks, strokes and major trauma (ie a car accident). Basically, if you can walk in, they'll probably be able to sort you out otherwise you'll be taken elsewherem

bilko6 said...

The real problem with this is that we are now presumably having to be experts at self diagnosis .People arriving at A and E themselves generally dont know whats wrong , and also can get progressively worse after arrival .

What is an urgent case can easily become a serious emergency- as is the situation with many parents and small children who need an expert diagnosis / opinion.(Eg Is it a cough and cold or a chest infection/beginnings of pneumonia  ? )

Also ambulances are regularly being turned away from other hospitals anyway as they are at full capacity - and QEH regularly sends people to Lewisham ! 

Dekanube said...

This is precisely why I am so angry ' Lewisham A&E and maternity services have been downgraded due to the mismanagement of other hospitals in the area' - so absurd

Robert said...

I really don't think we should be ready to accept this as a victory. It sounds far from it to me. They should not be cutting an ounce of our local hospital's service. It is a priority - find the money from elsewhere. Very depressing indeed.

ChrisOB said...

It's frustrating to see the Guardian correspondent reporting a "partial victory". As Nick rightly said, summarising the crux of the BBC report:

What is certain is that - as the BBC reports - Lewisham A&E and maternity services have been downgraded due to the mismanagement of other hospitals in the area.

Kate Gould said...

trouble with his maternity argument is that a lot of women will decide they don't want to risk giving birth in a place where there isn't emergency back up - so then that department will see fewer women coming in and then govt will say they are closing it due to lack of demand. His argument is flawed. No-one wants a medical emergency when they are giving birth but some text book pregnancies end up that way. Some labours start off OK and then major complications start - basically all labours are different and this is being done to frighten women to going elsewhere

Mezzer said...

As I read elsewhere:

He hasn't stopped the closure, he's just put a door closer in, so that it closes slowly.

Ed said...

A friend of mine works locally for the NHS. She said that a lot of people will get sick as a result of this, as Lewisham has an excellent record of dealing with heart attacks and strokes, whilst Woolwich has one of the worst. So patients in Lewisham will be travelling further for worse treatment. She also said that Lewisham is basically being mothballed so it can be privatised at a later date. Many more hospitals in the country are to suffer a similar fate. Just like the recent NHS bill the Governement is using smoke and mirrors to dismantle the NHS before the general population realise what they're up to.

Daniel Woods said...

hopefully rupert murdoch will have a heart attack when driving through Lewisham …...

Malyons said...

This is clearly the beginning of the end for Lewisham hospital as others have   stated. Anyone who claims this is a victory is in for a shock. The  Tories are trying to simmer down the demonstrators by saying ' up to' 75% of A and E services will continue. Even if it starts at 75% it will surely be cut more and more till services are phased out completely and the hospital is sold off to a private company. The demonstrations should continue more fiercely than before. The Mayor of Lewisham has a duty to get the lawyers involved and defend our highly regarded hospital.  

chickencounter said...

Extremely clever by the government. They get what they want out of it, whilst not committing to the worst of peoples expectations ie full closure. So it can be reported as a 'partial victory'. Looks like a good compromise. But I think we'll see Lewisham's A+E get smaller until it's closed. 

The_Local_Crackhead said...

Every time I've been to A+E it's full of smashed up drunks and alcoholics shouting and crying. Speaking from experience maybe if there was better treatment for long term abusers in the first place they wouldn't have to spend so much patching people up.

Max Calò said...

There's a good summary of what the A&E downgrading means here:
http://www.bbc.co.uk/news/health-21275823

Anon said...

Hopefully Jeremy Hunt will.  And hopefully the staff will send him to Woolwich with a flea in his ear

Tamsin said...

Don't think it stays up very long - but currently the statement is on-line in Hansard:
http://www.parliament.uk/business/publications/hansard/commons/todays-commons-debates/read/unknown/322/

I quite like the last exchange.

Very clever political fudging to make any Judicial Review application less clear cut, so in some ways the worst possible outcome for campaigners.  Support and focus will be lost in the inevitable confusion - as well as the party political mud-slinging (the PFIs for the Queen Elizabeth being negotiated under Major and signed off by New Labour).

The retention of some A&E at Lewisham was always in the report - Hunt has just notionally increased the proportion - although with the weasel words "up to".

Kate said...

Just seen a car drive past with a loudspeaker: inviting people to a demonstration outside the hospital tonight at 6pm

Aricana said...

Good coverage on BBC London tonight.  The NHS is definitely not safe in the hands of the tories.  Hope any future legal action can at least delay the downgrading long enough until we can get the tories out.  

Jimbo2010 said...

On the buses it takes a lot longer than this and this is still how most people arrive at a@e. 

Sarah said...

Jeremy Hunt has been proven truly worthy of his James Naughtie renaming. Just drove past the demonstration. It looked like the Police were turning people away from joining. Really good crowd and TV vans in amongst them.

Oh Boy said...

Jim Naughtie sure pitched it just perfect. There really is a C in Hunt.

Oh Boy said...

Jim Naughtie's 'moment of madness' here: http://www.youtube.com/watch?v=YS5mVoqJpUk. Can we give him a knighthood for services to language.

Mezzer said...

Dr Chidi Ejimofo, Lewisham A&E consultant, said: "An A&E of the type described is little more than an Urgent Care Unit – patients will still have to be transported to other hospitals because we will no longer have acute provision here."

Tamsin said...

Thanks for this link. Really useful. Was able to copy and print and hand it out to people at the demo.

Danja said...

Seeing that a big proportion of South East London will have zero change in their average travel time, the average of 1-2 minutes across the whole of South East London must turn into a pretty significant number for the smaller population who are nearest to Lewisham and therefore the only people affected by this change at all.

Slick statistics

Guest said...

You've got Tony Blair to thank for this.  It's his PFI legacy!

Anon said...

I was surprised Jeremy Hunt wasn't picked up on his line '100 lives a year will be saved'.

Is he saying currently 2 people a week needlessly die at Lewisham A&E, or that an extra 100 lives a year will be saved?

If the plan is going to take 3 years to implement is he knowingly allowing 300 people to die ?

Then there were his comments about stroke victims which are at odds with his statement London is the best place in the world to have a stroke. If Lewisham A&E already does not take stroke victims how will they benefit from yesterday's decision?

 

Anon said...

The Health Service Journal has some interesting background information.

Apparently the PFI at Woolwich only amounted to about one third of it's financial woes. Ignoring the PFI Woolwich was going to be financially up the duff from the outset, why did the Lewisham MPs allow such a wasteful situation arise?

It would seem the previous Labour government set the ball rolling with Foundation Trust hospitals and the 'failure regime' they introduced in 2006.

The Foundation Trusts lead hospitals to seek merger partners, that elective treatment is where the money is made not A&E.

Lewisham HealthCare Trust announced last year it was putting its Foundation Trust application on hold while it awaited the "changes to the health economy in south east London."

Sir Bruce Keogh who advised Jeremey Hunt has written a report that advises a shake-up of A&E's accross the country, is Lewisham set to be the experimental model of his proposed '111' A&E?

Calypso said...

Sadly, both the government and the media have missed the point for the whole thing: The way the proposals were presented to hospital staff, there was never an issue of closing the A&E - the suggestion had always been to downgrade it to an urgent care centre, so we have won no partial victory there. The consequence of this is that we won't only lose maternity services, but also critical care, all medical and care of elderly services. The highly accredited stroke unit will be downgraded to an intermediate care unit. Lewisham will in effect turn into a cottage hospital with facilities for non-complex surgery. Where will patients go? The so-called 'specialist' centre, Queen Elizabeth Hospital, will not be expanded but will undergo further staff cuts. Make of that what you may.

Mezzer said...

Indeed. 

"The secretary of state is trying to redefine what an A&E is. This is an
urgent-care centre by another name," said Dr John O'Donoghue, a consultant
physician at Lewisham.

Anon said...

Reading Sir Bruce Keogh's advice to Jeremy Hunt, does anyone know if 'unscheduled attendances' includes the Urgent Care Unit?

If it does, then the 75% figure could represent all those existing patients and the remaining 25% represents the entire number of patients currently treated by A&E?

Sir Keith describes the paediatric unit as 'respected high quality', but from his advice this appears to also be under threat?

Any alternative should be designed to be even better in terms of clinical outcomes and patient and parental experience.

Does 'alternative' imply the unit at Lewisham will close? He further says....

This is possible is possible but is dependent on very clear protocols for primary ambluance conveyance, an ambluatory paediatric urgent care service at Lewisham and rapid transfer protocols for any sick children who would be better treated elsewhere.

Is he saying these don't currently exist or that they need to be introduced because Lewisham will no longer be able to deal with such patients? 

Brockley Nick said...

"Sadly, both the government and the media have missed the point for the whole thing: The way the proposals were presented to hospital staff, there was never an issue of closing the A&E - the suggestion had always been to downgrade it to an urgent care centre, so we have won no partial victory there."
Playing Devil's Advocate for a second, is it the "government and the media" at fault for presenting the issue as a partial victory? Or the campaign, which presented the issue as being about the closure of the A&E Unit? There are very good reasons for the campaign to have focused on the "closure" of the A&E, even though it was always only a downgrade. But we can hardly complain if the media now present a downgrade as a partial victory. That is the price of a black-and-white debate.

Anon said...

Sir Bruce Keogh provides the answer to the +1 or +2 minutes travel time?

He points out the whole population of South East London will continue to be within 30 minutes of a blue light transfer of an A&E Department.

It's a bit like on the railways were a train is not late because it arrived within 60 minutes of that shown on the timetable. 

Tamsin said...

I think you are very right - and moderate voices in the campaign were constantly trying to keep things accurate and on the rails - but herding cats was nothing to it. 

It is very difficult to engage large numbers of people with their own busy lives with anything other than a relatively simple message.  One of the reasons why the Health and Social Care Bill got through last year - the issues involved were just too complicated.

In many ways this is the worst outcome - purely political and saving his and Kershaw's face, Hunt has nicely managed to fudge everything.

Two or three years down the line the proposed sell off of two thirds of the hosptial site will go through with hardly anyone noticing.

Anon said...

Statement from Lewisham Healthcare Trust...

"We are disappointed today to hear that Jeremy Hunt, Secretary of State, has accepted the proposal to downgrade A&E and maternity services at Lewisham Hospital. He has proposed Lewisham retains a smaller, limited 24/7 emergency department, and a stand-alone midwife-led birth centre.

"Clearly, we need more information on Jeremy Hunt’s proposals before commenting in detail. The Trust Board response to the consultation was clear that we believe Lewisham needs full emergency and obstetric services.
“I would like to thank patients, local people, staff, GPs, MPs and partners for the support we have received.”

MickeyMouse said...

No more voting for the local Tories for me after their pathetic disappearing act during this campaign, that only leaves UKIP... 

Anon said...

Regarding the land sale hasn't that been on the cards for years?

I think the matter was raised during the seconary school farce in 2006/7.

Aren't staff going to think what's the point of improving if a minister can come along and downgrade the service. By restricting Lewisham to an  Urgent Care Centre won't there be a high turnover of staff as they move on to somewhere with an A&E?

I didn't realise all hospitals must become foundation trusts, if they don't then they will have to become part an existing foundation trust.  In the scheme of things, the hospital could revert to just housing the sort of inmates that used to occupy the workhouse. 

Tim said...

So is that better or worse than people expected? #confused

Max Calò said...

It's one of the expected outcomes really. Within a range.
The fact that A&E remains an admitting centre may actually save money compared to the initial proposal because otherwise you'd have many more ambulance calls for people that can make their way to Lewisham but not to Woolwich.

Tamsin said...

IMO it's the worst possible outcome for the campaigners.  There's enough alleged concession to really confuse people and also make an application for a judicial review more difficult (but not out of the question).  The BBC article referred to below (updated so the link no longer goes to it - here's the new one http://www.bbc.co.uk/news/health-21275823 ) highlights the fact that there is no material difference between what Kershaw was proposing - and Urgent Care Centre - and what Hunt has conceded to the campaigners - the A&E staying open but down-graded to level 3 rather than level one (as it currently is).  What's in a name.  A rotten rose still stinks.

But the efforts are continuing...  Rally on February 15th at 1pm by the War Memorial outside the hospital and a "Born in Lewisham" event on 16th - no details yet.

Max Calò said...

It is a bad outcome indeed, and btw, what about the 4 tests? What a farce. What a disgraceful attitude towards the public that they are supposed to represent and that has spoken loud and clear.

Iain said...

The 4 tests were always spurious and unaccountable- the idea that the tory government could arbitrate their own criteria for service re
-organisation has been proven to be a scam, which they can manipulate by citing a patsy like bruce keogh.

Not only that, hunt has sent a message to private healthcare that when the government appoints a TSA, any obstacle to the decimation, privatisation and asset-stripping of a hospital will be ignored/removed.

Yesterday was brutal, the retention of a few hospital admissions is meaningless and should be resisted, not celebrated

Siggy Robson said...

It is true, the campaign shot itself in the foot a bit by having the 'no closure of A&E' slogan, but a 'no downgrading of A&E' wouldn't have sounded quite so catchy. Maybe a simple 'hands off our A&E' would've worked better.
However, if the media had done its research, i.e. read the proposal, it would've seen that it was about downgrading A&E to a simple urgent care centre. As for the government, it has no excuses - it did read the proposal. Not surprisingly though, it used the campaign's slogan to put spin on the whole thing. Now the rest of the country believes that all is well.
The other unfortunate thing is that the consequence of downgrading A&E and maternity services, this being the loss of all all acute medical and care of elderly wards as well as critical care, has been completely overlooked.

NAT said...

Siggy, completely agree that 'Hand's off A+E' might have made a better slogan in hindsight, but then proper doctors might be at a bit of a loss when faced with spin doctors.

Iain, I'll post this up as someone who , until recently didn't know the four tests from the 39 steps.

NAT said...

Or not post it up as the case may be.
healthpolicyinsight.com/?q=node/517

Penelope Pissdoff said...

Jeremy Hunt has used smoke and mirrors to convince certain sections of the media and public that he's listened. In his attempt to justify his dangerous decision he says he drew upon "medical evidence"... Well, Mr Hunt, what evidence have you got to substantiate the "100 lives saved" argument you put across? How did you reach that figure, or did you pluck it out of thin air?  The "consultation" itself was a flawed document which put many off from even trying to attempt it. That's aside from the wasted money spent on it, from the public purse (talk about adding salt to the wound!). Also, no mention of the dire effect this decision will have on paediatric A&E admissions and in terms of safeguarding children. Make no mistake - the Tory party are on a mission to downgrade the entire NHS for the purposes of profiteering. Be afraid, be very afraid, because they won't stop until the NHS doesn't exist at all.

Max Calò said...

Dr Louise Irvine interviewed by the News Shopper said:
"Hunt tells us that he has accepted the recommendations on the basis of ‘100 lives per annum saved’ but this is just a snapshot figure of a national assessment – not locally accurate in the context of the model proposed. As a GP I can state unequivocally that these proposals are going to cost lives."
http://www.newsshopper.co.uk/news/lewisham/10197019.Lewisham_Hospital___smaller__A_E_plan_branded_a_sham/

Penelope Pissdoff said...

Thanks for providing the link, Max. No surprise the figures are not locally accurate in the context of the model proposed. I especially like Lead paediatrician Dr Tony O’Sullivan's quote: "Mr Hunt stressed that this will involve careful handling and careful
planning. This is politician’s cover for introducing these measures
without any consultation with local paediatricians or the College of
Paediatrics. He repeatedly said that these measures would improve
standards.  The destruction of our exemplar childrens’ service is the
not the way to do that and we will be addressing this at the earliest
opportunity."As the parent of a child with anaphylaxis it concerns me that the downgrade of adult A&E will have serious repercussions for children's A&E too.

King Canute said...

I guess people don't like change. 

But the days of centralised A&E departments are numbered.  They, along with other departments of big General Hospitals, will be broken up and their responsibilities distributed between amongst smaller specialist centres. That is the writing on the wall and it is not necessarily a bad thing, the idea is to provide a better health service.  It is the future.

It is pretty sad that this is not explained to the general public and every change becomes a political issue for people with axes to grind.

Max Calò said...

I think that people understand those concepts actually. The matter of the debate is that some services work better centralized, some others are better offered localized and it is a widely diffused opinion to think that A&E and maternity are better delivered closer to the users rather in bigger centres further away.

Tamsin said...

At the forefront of the campaign are doctors whose concerns are clinical rather than political.  It is perhaps unfortuately very difficult to restrain those who have equally passionate convictions, are offering a great deal of assistance - in tramping the streets and making placards - whose motivations are largely political.

The report and modified acceptance of it are not actually about providing a better health service but about trying (with possibly even some small degree of honesty) to deal with disastrous earlier decisions - by governments of every hue - and (less honestly) to save current political face.

King Canute said...

Trust me, I'm a Doctor?

Doctors are rather more concerned about preserving their own professional privileges than providing an efficient health service to the public.  This has been the case since the start of the NHS.  They are just another unelected political group exploiting the Health Service for their own interests.

There seems to a profound public ignorance of how services are provided at the moment and how they will be in the future.  Maybe these things are not explained lest they incite a tinderbox of concern by groups fearful of change.

I guess this campaign has been successful in the simple emotional terms in which it was expressed. There will be no closures.   PFI debts will be dealt with centrally. 

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