BMA questions Lewisham Hospital cuts

We're grateful to the Brockley Society, who circulated this email from the Lewisham branch of the British Medical Association, reflecting on the recommendations of the Trust Special Administrator, who proposes to cut front line services at Lewisham Hospital. The BMA says:

Unsurprisingly, he recommends that the hospitals be run more efficiently, cut staff (including 140 doctors) and put some services out to tender. More surprising is his recommendation that the accumulated debt be written off, and the DH make an annual contribution towards the excess cost of the PFI contracts...

His most detailed proposals are for Lewisham, a solvent and well run hospital not even in the SLHT. He recommends that the A&E be downgraded to an urgent care centre, that the site be developed for elective surgical care, and that all critical care activites should cease. This then brings into question the future of obstetrics on the site. He is silent on the subject of paediatrics. With the reduction in activity, he points out that part of the site could be sold off. 

The TSA recommends that Lewisham Hopsital should "join up" with QEH. There is a possibilty that Lewisham could impart good practice to QEH, but there is real risk that QEH could destroy the finances at Lewisham.

It is not clear if he expects all of the 70 patients currently admitted each day to go to QEH instead, and what would be the financial consequences if they did not. He presents no assessment of the capacity of QEH to cope with the extra work, nor of their capacity to cope with extra obstetrics, nor of the capacity at Kings, which is where I suspect many of the patients would end up.

This has many consequences for those of us who live or work in Lewisham. For hospital doctors and patients these are immedicately obvious, but for GPs too this is very problematic. The work of the CCG has been based on successful partnership working with the hospital, and mnore recently good partnerships have been developed with Lewisham Council. The abilty to plan services for the people of Lewisham is entirely undermined.

The full report, summary and online response froms are all available at

The TSA is organising consultation meetings in Lewisham:

16th November 10.00-12.00 Goldsmith's College SE14 6NW

26th November 14.00-16.00 St Andrew's centre SE4 2SA

4th Decemebr 19.00-21.00 Calabash Day Centre SE13 6HH


Anonymous said...

It's outrageous - they just want to bring Lewisham into the PFI trick and then bleed it dry - almost as outrageous as Lewisham Labour politicians thinking that they aren't indirectly and directly responsible for the PFI shambles - PFI is a core part of Lewisham Councils strategy and with A&E there never has there been a more compelling example that not only doesn't it work but it's corporate, and Labour, cynicism of the highest order.

Labour are even using their petition as a name gathering tool so they can build a database and contact you in the future. (read the small print at the bottom)

Tamsin said...

That last point is naughty... Once received something similar from one of the big age related charities - they did, at least, give you the option of signing the petition but opting out of going on their mailing list - which I made sure was absolutely high-lighted in the petition folder as we were gathering signature.

Whealie said...

There is a campaign meeting tonight at the hospital.

6-8pm in the Lessoff Auditorium

Whealie said...

Labour did indeed worship at the altar of PFI but it had been around a long time before they even had a chance of winning power.

It's an original Tory accounting trick by that other Chancellor turned PM, John Major (He was Chancellor to that hero of public services, to Margaret Thatcher).

At the time, of course, Labour denounced the policy.

It's only saddos like me who have long memories for these things.

Anonymous said...

Labour did indeed worship at the altar of PFI but it had been around a long time before they even had a chance of winning power.

True it was an original Tory idea, but the vast majority of PFI's were brought in the wonder years of New Labour as a way of getting debt off government balance sheets. We all know how that has ended!!

Tamsin said...

6-8pm in the Lessoff Auditorium

Which is in the Hospital. There will also be a simultaneous meeting in the Calabash Centre - five minutes walk away - with the same speakers at both (swapping venues half way through).

A general plea from the organisers to be civilised with each other, the hospital and the speakers - and get informed to respond fully and constructively to the consultations.

Anonymous said...

Where's Obama when you need him?

Whealie said...

Tasmin - is that because they are expecting large numbers?

I don't really need to listen to speeches from politicians to be convinced closing A&E is a silly idea. I was in A&E so often this year I actually became Mayor of the hospital on Four Square.

I am going along though as my daughter wants to go - it's her first protest meeting. It's a rights of passage isn't it?

Tamsin said...

You're probably on your way now - but yes, are expecting large numbers - as mentioned on the other thread. The hospital, anyway, were getting concerned - having agreed to host it and then worried about too many turning up than would fit in the proposed venue. So circus trick time - but please donate - we are having to pay for the hire of the second premises!

Whealie said...

Well overcrowded, everywhere. Such a level of support at this early stage is staggering.

I believe the revolution will be televised, which means you can watch it and edit out all the SWP speeches.

kolp said...

A packed meeting tonight- apparently over 500 people. Overflow room costing £195 was required. There was a collection bucket .

Was told the meeting will go online tomorrow. So hopefully someone will link it for those unable to attend.

Key points- ( I wasn't able to be there for the whole thing).

It was a call to arms to fight the proposals.

Sentiments expressed that -This isn't attack on Lewisham it's an attack on the NHS pitting hospital against hospital and unity is required.

It was stated that: A&E's are being threatened across all london, four north of the river, including Charing X, Ealing, Central Middlesex. This gives a lie to Cameron's expression that the NHS is safe in his hands.

TSA doesn't understand south London and the proposals such as the estimation of ambulance times from Lewisham to the Woolwich hospital were drawn from TFL journey planner.

The downgrading from an A&E to an enhanced urgent care centre means that patients will present and be told in effect that they are "too sick for this hospital"

There were also a good few personal reminisces about Lewisham hospital and how it's made an impact on lives.

Further resources:



max said...

I was at the Calabash Centre, also packed all the way out and into the street.

Anonymous said...

I'm beginning to think there may be some merit in these proposals. Reform is the only way ahead for the NHS and if the clinical and to some degree financial case stacks up, then I say lets go ahead. The onus is on the proposers to make the clinical case, as well as the financial one.
Kolp's recent posting has convinced me that the case against has not been made, and much of the opposition to these proposals seems to come from the self interested (BMA and other unions) and the usual knee jerks and loonies of the left.
Serious people know the NHS has to change radically to survive as a free at the point of treatment service.

max said...

The case was made over and over again actually.

The proposal is a seriously flawed idea - that you can remove A&E from Lewisham when all other A&E's around are already stretched to the limit without seriously impacting on the quality of care, not just here but also at all other neighbouring hospitals that do not have any extra capacity.
Anotehre part of the proposal is standing on the assumption that fewer bigger maternity units are better than more smaller ones is also complete rubbish.

We have a highly performing hospital that has been improving for years now and also balances the books.

The SLHT administrator hasn't managed to make a clinical case at all, it's only financial.
In fact in the report he says that South London Hospitals deliver care well but he has to make savings, the idea that he'd do that by closing down the best performing parts is just lazy.

He has not performed! This codswallop of a report has cost £2m and yet it failed to see that if would leave an enormous gap in provision because apart from removing services it doesn't add any, as if there weren't waiting lists, as if there was extra capacity. This report is dishonest.

Anonymous said...

Last year I had to wait over 6 hours with my wife in another A&E (not Lewisham). She was in great pain having broken her arm into a 'dinner fork' shape. And we had to pay for the carpark despite it being from 9pm Sunday to nearly 4am Monday. We don't want Lewisham closed or downgraded, I don't want to go to Woolwich or St Thomas' or the London. I want to go to my local excellent hospital. That's not a knee jerk reaction, or a leftie point of view, and I don't work for the NHS. Lewisham saved my wife's life 10 years ago. It is 'my' hospital.

Anonymous said...

I have visited A&E at Lewisham five times in the last six years. On only one occasion did I really need to go there, the other four times I was forced to go due to no out of hours doctor on call. I would say that a high percentage of the others waiting, were there for the same reason. This is a waste of resource

In my opinion we need an independent review of the NHS which is free from political influence. It is such a toxic issue for politicians, that's why we never get an objective view. There are no votes in closing hospitals, and indeed the opposite is usually the case.

Mezzer said...

I just read this article earlier today and if you take it in context with the Lewisham Hospital proposal, the future of the NHS looks bleak indeed if nothing is done to halt these things.

I am taking the unusual step as a GP to share the concerns I have around the current changes affecting general practice.

At present the BMA, our union, is trying to negotiate the terms of another new contract.

Despite months of work, the Government has decided to ignore these negotiations and impose the contract as it sees fit.

These changes do not just deal with how GPs are paid.

They concern the money used to fund all the services we provide – at the moment, about £70 per patient per year.

If imposed, it is likely that many GP practices will no longer be financially viable and will close.

This, I suspect, has been the goal of successive governments of all political persuasions.

The Government's goal is to out-source general practice services to private companies, such as Sir Richard Branson's Virgin Healthcare.

It would not really affect people too much if they planned to carry on things in a similar way to now.

However, these companies will, quite reasonably, be out to make a profit. In order to do so I suspect that most of the following changes would need to happen:

Centralise GP practices into large "super" health centres. Locally to me, this is likely to be at Loughborough.

Most care will be provided by nurses, with a few salaried doctors to care for more complex cases.

The doctors, as employees, will have little or no say in how the service will be run.

Home visiting will end, or be done by a central visiting service, similar to the situation now at nights and weekends.

Patients would be encouraged to get their prescriptions from a chemist in the health centre, rather than using their chemist as now.

Obviously, patients will still be able to see a more traditional GP privately.

I have worked for the NHS since I left medical school 23 years ago and have been a GP for 12 years.

I have never been so worried about the future of NHS general practice. I know many of my fellow GPs feel the same way.

I am writing now as this is the time to act if you feel that such changes would be bad. The Government has yet to make a final decision public and, of course, once they do it will be difficult, if not impossible, to get it to change its mind.

We have few options when opposing such political decisions outside of election time, but we can at least write to our local MP, or the Health Secretary.

Dr Stephen Shepherd, North St Surgery, Ashby de la Zouch.

Anonymous said...

thanks for sharing..

Vicar's Hill said...

If you look at the whole picture then it is difficult to come to a different conclusion from the administrator. Labour left this country in an almighty mess, that they continue to deny. This is just the beginning of some serious cuts to public services which cannot be avoided. All the talk of so called austerity is disingenuous. If you want  to see real austerity then look at Greece, Spain, Portugal or even Ireland. 
As far as the NHS is concerned there are three questions that need to be answered.
Who is it going to treat?
What it is going to treat?
Where is it going to treat?
It is obvious to anyone who has ever run a business that things cannot continue.

Kettles and Pots said...

A bit of context here.  Was it not the case the BMA hired professional negotiators that ran rings around the Department of Health officials and got an exceptionally good deal for GPs who benefited from a substantial pay rise?

GPs are not in a union, they are all independent professional practitioners and the BMA is their professional association.  It represents their professional interests and any bearing on the Health Service is secondary.  They have been a thorn in the side of NHS reform since its inception. What did Bevan say about doctors when trying to get the NHS started in the face of their vehement opposition?

'I had to stuff their pockets full of gold'

It is high time this historical anomaly was put right and they became employees of the National Health Service and so too, that other self interested professional pressure group: the Consultants.

I really do not understand how these groups who operate their own private practices within the National Service can say anything about the threat of privatisation and not appear to be completely hypocritical.

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