Lewisham Hospital A&E at risk – does Greenwich Council care?

Demonstrators are planning to picket Woolwich Town Hall on Thursday evening as the NHS administrator recommending downgrading Lewisham Hospital’s A&E arrives to takes questions from a panel of Greenwich councillors.

Trust Special Administrator Matthew Kershaw will talk to Greenwich’s eight-member healthier communities scrutiny panel about his plans to deal with the collapse of the South London Healthcare Trust, which runs Queen Elizabeth Hospital in Woolwich.

He recommends that QEH is taken over by Lewisham Healthcare Trust – but that Lewisham Hospital’s A&E is restricted to “urgent care for those who do not need to be admitted to hospital”.

Indeed, never mind consulting the public, the boss of Lewisham Healthcare has already been put in place to take over South London Healthcare.

Campaigners have already had the backing of Lewisham’s elected mayor Sir Steve Bullock, who has branded the proposals “staggering” and has pledged to throw the resources of Lewisham Council into fighting the report.

But what of Sir Steve’s Labour colleagues in Greenwich? Despite the obvious effects on the already-overloaded QEH of the plans for Lewisham, Greenwich Council has so far been coy about the plans. Health cabinet member John Fahy told a council meeting two weeks ago that the report was “better than expected but with serious negatives”, and the council has pressed for further public meetings (which, to its credit, it has got – see below).

But that’s been it. Two anodyne stories have appeared in its weekly newspaper Greenwich Time to promote the report and public meetings, but with no mention of what the council thinks, despite the paper existing to do just that. (Remember: “Greenwich Time represents the views that come from the decision makers at Greenwich Council,” according to its PR chief.)

There’s also a short summary on the council website, which doesn’t mention the Lewisham proposal, and a non-committal quote from leader Chris Roberts: “We will study its recommendations for healthcare in Greenwich before responding accordingly.”

Indeed, while John Fahy attended last week’s protest meeting in Lewisham, he rather enigmatically tweeted after that “changes need to happen”, without elaborating on what he meant.

Greenwich councillors won’t even be discussing the proposals at a full meeting before the consultation closes on 13 December; while Lewisham’s will be meeting on 28 November.

It’s a sharp contrast from Sir Steve Bullock’s damnation of the plan as “complete nonsense“, and Lewisham councillor Liam Curran declaring the government “must not be allowed to divide the people of Lewisham and Greenwich”. After all, Greenwich Council seems to be doing the job well enough on its own.

As for Thursday night’s meeting, the clash between a council uncomfortable with being scrutinised and a group of highly-motivated protesters looks set to be a troubled one.

But with campaigners feeling the closure proposals are a done deal, there may be clues towards whether Greenwich Council will line up alongside their Labour colleagues in Lewisham, or whether they’re content to join Bexley Council in siding with Conservative health secretary Jeremy Hunt.

A consultation’s under way on the proposals – read more on the Trust Special Administrator‘s website (and Save Lewisham Hospital) and there’s a series of public meetings too – most of which, however, have been scheduled for when most people are at work. The first one, on Tuesday at West Greenwich House, had only around 50 people there.

In fact, it’s worth questioning how seriously the TSA is taking the consultation, with two public meetings in Greenwich borough not listed on its website. While information about the proposals should be displayed in all surgeries and pharmacies in the area, the photo above shows all I could find at Sainsbury’s pharmacy counter in Greenwich on Wednesday evening, behind a sales display in a staff area.

Evening meetings include: Woolwich Town Hall on Monday 19 November (not listed on TSA website), St Mary’s Community Centre in Eltham on Monday 26 November (not listed on TSA website), Charlton Athletic FC on Monday 3 December and and the Calabash Day Centre in Lewisham on Tuesday 4 December (all 7pm).

Update 2.50pm Lewisham Council has now come out against the proposal on its website.


  1. The Draft Report continues to be the subject to scrutiny by those who are passionate about the health services they receive in South East London. It is important that the Administrator and his team are in a listening mode. A number of questions remain unanswered,particularly about capacity,staffing levels and access to services. Colleagues in Lewisham have a strong case about the A&E. it would be wrong to voice a view in the middle of a consultation process,however flawed it is perceived. I think the first public meeting at West Greenwich House was a good start with a number of key arguements being put forward by the public.

    It is clear that the finances of the Health Service need to be sorted,balanced against the backcloth of declining resources and increasing demand. The current government is determined to reduce funding although the NHS in London is in surplus. Promoting healthy living,developing a stronger community services through Clinical Commissiong is vital if the proposals are to work. The Council has a scrutiny role and this meeting will take place this evening. Councils in the area will work together in the interests of their residents .

  2. Why on earth would it be wrong to voice an opinion when the consultation is ongoing? It hasn’t stopped Steve Bullock from making his opinion abundantly clear. Closing Lewisham A&E isn’t just a Lewisham issue, it affects the whole area, including Greenwich. I get the impression Greenwich councillors are simply sitting back and letting change happen to them, all the while thinking, “phew, at least QEH is safe…” And the idea that “change needs to happen” is absolute tripe. For a start Lewisham NHS Trust isn’t in financial trouble, so why does change need to happen to it? On top of that, we know it’s basically PFI debt that’s caused this. By all means ditch the bad managers and bring in a new team, but this solution is throwing the baby out with the bath water. The government should step in, clear the PFI debt from the books and wipe the slate clean. If it can do it for the banks it can do it for the NHS. And Greenwich council are doing their residents a disservice by sitting back and keeping quiet on this issue. It makes me so angry.

  3. I think you should also point out that there is also a day time meeting (Wednesday 21 November, 10am to 12noon: Greenwich Forum) – why didn’t you list it?
    I note many of the contributors on the discussion on Run to the Beat make the assumption that everyone is fit enough to cycle or walk – and just as in the same way that some people have mobility problems so some people cannot get out in the evenings for a whole range of reasons. Come on Darryl!!

  4. I think the additional meetings are not on the TSA’s website because they haven’t been organised by them. I spoke to someome from the office a few weeks ago and asked why none of the meetings were being held in Woolwich, where the QE actually is, and their view was that the other locations were only a 10 minute bus ride away.

  5. “other locations were only a 10 minute bus ride away”? That infuriates me. Pretty typical of the stance taken in the ‘consultation’ too.

  6. Farhy says “it would be wrong to voice a view in the middle of a consultation process, however flawed it is perceived.” If a public consultation isn’t the time to voice a view then when would be? Perhaps the next election? By which time the current ideological government, more right wing than Thatcher, will have already signed the contracts for the ‘outsourcing’ of key sections of South East London’s healthcare and pushed through all the other recommendations from the flawed TSAs report. Now is absolutely the time to show that the impact of these recommendations will be catastrophic for the 1.6million people in the community. QE will remain open, but at what cost? They are already routinely closing their doors to A&E patients, through budget cuts, staff shortages and other circumstances that mean demand is greater than supply. Where do these patients get taken? The nearest alternative, Lewisham. I hope that after tonight the Royal Borough can offer a strong united opinion of the situation, one that sympathises with comrades in Lewisham and recognises that Greenwich doesn’t actually do alright out of this, quite the opposite.


  7. “The current government is determined to reduce funding ” Do you have any factual evidence to support this or are they just the ill informed rantings of someone with a very poor grasp of how the public finances work. Indeed it would appear you have no idea what your own party have proposed or implemented whilst in power. For any objective assesment of what the previous government’s fiscal plans would have meant for the NHS (and other public services) then read the various IFS Green Budgets from the last 5 or 6 years. Basically Labour like the Tories have reduced the assumed rate of growth of spending to the NHS, they have not cut anything. It would be nice if our elected representatives could propose actual policies that address our current economic plight as opposed to sniping, expressing opinion as fact and scaring their electorates. We have no money, our growth rates will be pitiful for YEARS its what happens when you delever after a MASSIVE boom. Of course we should debate why we are in the mess we are but lets be honest with ourselves, if you want more money spent on the NHS then that means less money spent elsewhere (either by reduced spenidng or increased taxes).

  8. To save anyone having to look, I’ve checked and Richard’s addressing John Fahy’s comment at the top of the thread.

  9. It is a myth that this problem is soley caused by the Private Finance Initiative. It just isn’t. About a third of the gap in resources in south-east London is caused by financial problems caused by the PFI. The view that it is all about PFI is being put forward by those who want to bash the last government and who don’t want any involvement in the private sector in the delivery of NHS services. Ranting in public meetings about PFI no doubt feels good, it just doesn’t bare relation to all of the full facts.

    The rest of the problems are caused by South London Healthcare NHS Trust being inefficient (spending far more money than it has to provide the same basic level of NHS care provided elsewhere) and with clinical commissioning groups (run by local GPs) finally wanting to spend more of the available money in services nearer to where people live and where they want more basic services delivered.

    Lewisham is also not financially sound, it is about to start losing money each year itself and will begin to sink into debt. Within a couple of years, it will be £3 million a year in debt, with no hope of becoming a foundation trust in its own right. The Trust Special Administrator wants to avoid that now by recognising the problem and making recommendations to fix it.

    Overall, the quality of clinical services need to improve in south east London. Women who are in established labour need to have a dedicated midwife stay with them up to delivery (which doesn’t happen now consistently at Lewisham or Greenwich), they need to know a senior doctor is on duty 24/7 (which doesn’t happen now consistently at Lewisham or Greenwich) and they need to know a consultant is on duty in their A&E for at least 18 hours of each day (which doesn’t happen now consistently at Lewisham or Greenwich).

    Regarding A&E at Lewisham, almost 80% of patients who currently use it now would use it even if these changes go through. Today, 99% of the population of Lewisham are within 30 minutes of a full Accident and Emergency department by a blue light ambulance. After these changes are implemented, 99% of the population of Lewisham will still be within 30 minutes of an A&E by blue light ambulance. And even after these changes, two-thirds of the population of Lewisham will be within 30 minutes by blue light ambulance of two or more full A&E departments.

    Keep banging on about PFI if you want, but it’s about clinical quality and saving patients’ lives by using resources wisely to create centres of excellence that save patients’ lives – not about politics or bashing PFI.

  10. Darryl – I am passionate about the NHS but do think that people need to read the report fully before putting some of the comments in their postings here. We are in difficult times, and need to ensure that the health economy in south east London actually is sustainable. I think that is the issue that the TSA is trying to sort. We also DO NOT need as many hospitals or A&E departments in London as we currently have. What we need is better community services, more accessible GP services, and people using them appropriately. Having sat in A&E observing on a number of occasions it is quite amazing the things people turn up with that they actually should go to their GP with or to an urgent doctor for (in Greenwich this is somewhere called Grabadoc). Frankly this is the real issue.

    So, if one needs less A&Es the issue then is about which you close. That is the harder call. If you read the report (which I actually have) you will see that each of the options are considered. It is also acknowledged that each of the alternatives that are looked at will not remain completely as they are – and it is really down to geography and population flow (including future growth such as Greenwich will have) that has determined it is Lewisham. However an urgent care centre is somewhere that will still do many of the things an A&E does, and around 80% of the current A&E attendances. So that means 20% going (largely by ambulance when called) to essentially King’s or QE. So not quite what the opposers of this suggest.

    Change is hard for people to contend with, and it is hard when this might mean major changes to your own local hospital. What we have to do now, however, is recognise that the most important contributor to health survival rates is not how local your hospital is but how good the services are. This was, after all, why (after a positive consultation) changes were implemented 2 years ago to stroke and trauma services. This has been very successful, and – for example – if someone has a major trauma in Woolwich they will be taken by ambulance to King’s not anywhere closer, and although the distance is more the clinical outcomes are significantly better than a non-specialist centre. As the public we need to think about the best services overall and stop obsessing about local hospitals. I would add, however, that the health outcomes for the QE in Woolwich and the quality of services (independently assessed) are very good. What we need to do is ensure that whatever changes are implemented the health outcomes and quality of service not only remain good, but improve further. I’d rather a good hospital with great outcomes than a local one with over-stretched resources: remember Mid Staffs!

  11. I went along last night and the questions were better than the answers, including from the councillors.

    More later, and if anyone can find somewhere to host two hours of audio from it, I’ll be grateful!

  12. Republican has made some very important points. Both the new structures in clinical commissioning and acute services need to be highlighted so everyone can see the whole picture. Sustainability is the key to all of these issues. Balancing budgets while maintaining quality services is tricky but achievable in my view. I cannot stress too often how important it is to attend he consultation meetings.

  13. Andrew:

    Sorry there’s so much of what you say that needs to be challenged. Given the lack of time I’ll highlight the most glaring bit of rubbish I’ve heard in many a year.

    Where exactly does the 1% of Lewisham residents who are currently over 30 minutes blue light travel away from an A&E department live?

    I mean you can get a significant distance on Blue lights in 30 minutes so I’m strggling to think of somewhere that would be that far away.

    Does Lewisham have a small outreach enclave in the Hebrides?

    I’m keen to know!


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