It was a night when the questions were better than the answers. About 30 demonstrators gathered to greet NHS administrator Matthew Kershaw when he arrived at Woolwich Town Hall on Thursday to take questions from a group of Greenwich councillors about his plans to revamp south-east London’s NHS, including the downgrading of Lewisham Hospital’s A&E to an “urgent care centre”. He turned up late – stuck in traffic crossing Blackheath – and may have missed them.
I had hoped to be able to give you audio from the meeting, but unfortunately, the notorious acoustics in committee room 4/5 has defeated me – people rarely speak into microphone properly and the speakers in the public area are set at a whisper level. (Update: There is now audio, see the foot of this post.) But I can show you the video shown to the healthcare scrutiny panel before the meeting. Get ready to tick off the cliches.
There was half an hour given over to public questions – some were pertinent, some were time-wasting, like the woman from an organisation called Greenwich Link who rambled on about bringing back women-only hospitals. Well, thanks for that. Others voiced dissatisfaction with publicity and the consultation process – it appears the TSA website has had 12,500 unique visitors since it launched last month, which Kershaw’s team seemed pleased with, yet seems rather low to me (it’s probably about as much as this site gets).
Chair Janet Gillman, who happens to be one of my local councillors, asked if there was any chance the consultation would be extended – a call echoed by Bromley Council – but Kershaw indicated there wasn’t.
There were also concerns that the administrator hadn’t taken into account the rise in population in Greenwich borough, which weren’t fully allayed, while Kershaw claimed that local council leaders “fully understood the aspirations” of his report, which may be news to Lewisham mayor Sir Steve Bullock.
When it was the councillors’ turn to ask questions, plenty did themselves proud. That said, Conservative Mandy Brinkhurst earned her additional cash for sitting on a scrutiny panel by asking no questions at all.
By contrast, Labour’s Danny Thorpe, Barbara Barwick and Clare Morris all expressed concern about the effects of the downgrading of Lewisham A&E on the already-overstretched Queen Elizabeth Hospital. Barbara Barwick was to the point, but Danny Thorpe put it best: “I’m amazed nobody’s mentioned transport – it’s appropriate you were late,” he told Kershaw. “It’s very difficult to believe your distance figures are true.”
But whatever the truth of the figures, Kershaw said everybody within south-east London would be within 30 minutes by blue-light of an accident and emergency department – which, apparently, is the London standard. “Care starts the minute an ambulance driver arrives,” he said, noting the improvements in the care paramedics can offer.
Thorpe also brought up the appointment of Lewisham Healthcare’s chief executive to work on a merger with QEH – before the consultation has even finished. Kershaw denied it was a “pre-emptive decision”. “We need to do planning now on the work done so far, and Tim Higginson has been asked to provide a work plan for the future.”
It was Barbara Barwick that started to really home in on the point. If someone turned up at Lewisham after suffering a heart attack, she said, what would happen to them?
Already, Kershaw said, people with heart attacks would be taken to King’s College Hospital in Camberwell or Princess Royal Hospital in Farnborough – Lewisham had stopped specialising in heart attacks and strokes some time ago.
“The way emergency care is delivered in London now,” he continued, “people aren’t taken to the nearest hospital to get the best services.” He cited the case of Fabrice Muamba, the Bolton footballer who collapsed at Tottenham earlier this year but was taken to the London Chest Hospital at Bethnal Green, bypassing two closer hospitals (although I always thought that was at the behest of the doctor who happened to be watching the match and dashed onto the pitch at White Hart Lane.)
“It does mean some people will be carried further, but on balance we think that’s the right thing to do.”
Charlton councillor Allan MacCarthy reminded Kershaw of how slow the bus network is in south London. “I had a constituent who took a bus to an appointment at Lewisham Hospital, but never made it because the bus was stuck in traffic.” Kershaw waffled his way through a response.
It’s clear he has a job to do, within limited, politically-defined boundaries – one questioner asked why south-east London was suffering when the NHS in London as a whole enjoys a £250 million surplus.
But the reality of life as we know it in south-east London, with clogged up streets and slow journey times; together with how many people find Queen Elizabeth Hospital; overcrowded, understaffed, and in a mess, does not tally with the shiny promises in his report. There were pledges to reorganise the way QEH’s A&E is run, but they were short on detail.
It was suggested that when the A&E at Guy’s Hospital in Southwark closed in 1999, it only took a couple of months for people to adjust to using St Thomas’s in Lambeth. Yet the two hospitals are barely a couple of miles apart – nothing like the lengthy, bus-changing terrain that separates Lewisham and QEH (or King’s).
Indeed, even those who seem to be agreeing with the general thrust of his comments think that Kershaw isn’t arguing his case properly. Greenwich’s cabinet member for health, John Fahy, observed that few people seemed to know the difference between an “urgent care centre” and accident and emergency; indeed, it’s possible to argue that things won’t change a great deal for users of Lewisham Hospital.
But the focus on finance (which is what Kershaw is paid to do), together with the rushed consultation, means that the real experience of hospital users is neglected – and sparks suspicions about there being a more sinister endgame for users of Lewisham Hospital.
Backbench Labour councillors in Greenwich may be be sceptical about the plans, but regular readers of this site will know that nobody even breaks wind in the “royal” borough without the say-so of leader Chris Roberts. And it turns out we’ve been here before.
Roberts ally Mick Hayes referred to Greenwich’s support for the little-publicised A Picture of Health review from 2009, which was never fully implemented, but led to the closure of A&E at Queen Mary’s in Sidcup – leaving Bexley borough residents to have to go to QEH or distant Darenth Valley Hospital in Kent. Will Greenwich’s Labour leadership listen to its backbenchers’ concerns this time, or will it back the downgrading of a second neighbouring borough’s hospital? We’ll have to wait and see.
There’s a different viewpoint from the meeting at Clare’s diary, and different sides to the argument at the TSA website and Save Lewisham Hospital. There are also public meetings, including tonight (organised by Greenwich Council) at Woolwich Town Hall.
(Tuesday 1am update: Brockley councillor Vicky Foxcroft reports the Labour group on Lewisham Council has donated £500 to the Save Lewisham Hospital campaign. Will there be an equivalent donation from their comrades in Greenwich?)
Friday, 10pm update: Thanks to Clare, here’s the (very quiet) audio from last Thursday’s meeting.
Dulwich and South London Press have had good coverage of what is being proposed. For cardiac arrest the imperative is quick treatment – without easy access to A&E chances of survival is very slim – and goodness knows what injured and ill residents can expect as ambulances and paramedical services are outsourced to AQP (any qualified commerical company). This and the threat to fire stations have little to do with restructuring or saving money – this is to do with cutting public services and hang the consequences especially in poor boroughs.
I watched that presentation all the way through. I get enough corporate wank-babble at work.
How depressing. Poor old Nye, spinning in his grave he is.
Heart Attack patients have been triaged to specialist centres by Ambulance staff for a number of years and this is what happened with Fabrice. That said there has never been a Heart Attack centre at the PRU so it looks like Mr Kershaw might need to check his figures.
Equally until this report I’d never heard of this supposed 30 minute standard travel time on blue lights which seems ludicrous to me, as a rough guage It’d probably take about 30 minutes to travel on blue lights from Bluewater to Kings College Hospital. Its a bit like imposing a standard for electoral turnout and saying that 5% is the target for a sucessful election!
I’ve come out out of hospital this year after a serious and near-fatal illness. I can’t thank Lewisham, my local hospital, enough. I’m pretty sure that Matthew Kershaw will recommend improved public transport to QEH for patients and their visitors. Dream on! Unless, as one of my friends joked, such transport involves a helicopter it isn’t going to work.
Ambulance operatives told us they reckon under this proposed system, they’ll lose about 10% of severely ill patients. Lewisham to QEH even under blue lights in heavy traffic will be about 20 minutes (5 in the middle of the night). TSA will not be drawn on how many extra critical care beds he plans at QEH, nor how much longer waiting times will be.
Please come to the demonstration on Saturday if you can. It’s at 2 p.m. from Loampit Vale.
Sorry! My memory is still not what it should be. He also reckons, (from the ‘consultation’ at Goldsmiths, that no stroke patients are admitted to Lewisham. This is plain wrong. They can go to Kings if they need specialist scanning equipment, otherwise they’re admitted to Lewisham and stay in Lewisham.
Carol: In practice any stroke patient taken by ambulance will be taken to the nearest available HASU (stroke unit) this would probably be Kings or Princess Royal.
25 November 2012
I thank you for your blog which highlights major concerns about London’s healthcare system – not just one or two hospitals – but the entire system including PCTs, the GP surgeries, the Commissioning Groups, the Hospitals Trusts and the local councils of London.
As I understand it, there will be winners, but also losers.
How can we ensure that everyone will be winners?
“There is no wealth but health”.
supporter of keeping South London Healthcare NHS Trust and Lewisham Hospital and increasing the financial support for these Trusts so as to ensure the good services and enhance them for everyone using them
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