Lewisham hospital wins partial victory over A&E plans

http://www.guardian.co.uk/society/2013/jan/31/lewisham-hospital-partial-victory-a-and-e

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Lewisham hospital in London will retain most of its A&E service but its maternity unit will be downgraded – a partial victory for a hospital whose uncertain future has sparked large protests.

The south-east London hospital will continue to have an accident and emergency unit, rather than see it disappear, as was proposed by a government-appointed troubleshooter earlier this month, the health secretary, Jeremy Hunt, announced on Thursday. But it will lose about 25% of the unit's caseload as more seriously ill patients will in future go to one of a number of other hospitals in the area.

Hunt said Lewisham will still be able to admit patients with less serious conditions and will continue to have 24/7 senior medical emergency cover, in a compromise that will allow it to keep functioning as an A&E department treating "up to 75% of the patients who currently use it".

He told MPs that while there was a financial case for closing the department, there was not a clinical case.

Doctors, MPs and thousands of residents in Lewisham regard the hospital as the innocent victim of the huge financial problems affecting the separate, neighbouring South London Healthcare Trust (SLHT). An estimated 25,000 people took part in a protest march there last weekend and Hunt has come under heavy pressure from Lewisham's MPs to save the hospital's services.

The trust special administrator (TSA) appointed to sort out SLHT's problems, Matthew Kershaw, had proposed that Lewisham should lose its A&E service to other hospitals and have its maternity unit downgraded as part of a radical restructuring of NHS care in south-east London to make services financially and clinically sustainable.

But Lewisham council warned that it may take legal action to thwart Hunt's plan. Sir Steve Bullock, Lewisham's mayor, said: "The secretary of state is riding roughshod over the people of Lewisham. These plans have been roundly rejected by local people, by the staff who work in the hospital and by local GPs. The secretary of state has pressed ahead regardless by downgrading maternity services and emergency services at Lewisham hospital. But let him be clear, this is not the end of the matter.

"I do not believe that the TSA had the statutory power to make recommendations about Lewisham hospital and the secretary of state therefore has no power to implement them. I will be talking to our lawyers this afternoon and we will be considering our options. We will not give up," Bullock said.

In a statement to MPs, Hunt said he accepted in full the rest of Kershaw's recommendations, which will see SLHT's three hospitals taken over by other healthcare providers and the Department of Health spend around £1.1bn over the next 40 years covering payments due under its private finance initiative contracts, debts and expected future losses before the restructuring takes place in 2015.