Embattled Lewisham A&E gets a stay of execution as Jeremy Hunt shies away from closure

 

Jeremy Hunt fudged a key decision on the future of a London hospital accident and emergency department today - but signalled a potential revolution in the provision of accident and emergency services across England.

The health secretary wrong footed critics when he announced the partial downgrading of the A&E unit at Lewisham hospital, south London, to help rescue a neighbouring trust from bankruptcy. He had been expected either to save the unit or close it.

Lewisham would become a second rank A&E department, treating up to three quarters of the cases currently seen, with more serious cases sent to first rank A&E departments at Kings College, St Thomas’s, Queen Elizabeth, Woolwich and Princess Royal, Bromley, Mr Hunt said.

The decision followed advice from NHS medical director Sir Bruce Keogh, who is heading a review into A&E units nationally which is considering a health department proposal for a two tier emergency service. Details of the plan for Lewisham and neighbouring trusts have yet to be spelt out but appear to represent the first moves to implement a two tier arrangement.

The announcement, which included the downgrading of the maternity department at the hospital to be midwife-led, provoked anger from unions and opposition MPs who accused Mr Hunt of putting cost savings before clinical care. Ed Miliband said it was driven by the “wrong priorities.”

“We think it’s the wrong thing to do because it is not driven by clinical needs, it is driven by cost pressures.  Any changes in hospitals must be justified on medical grounds - not simply on the basis of  cost saving as we are seeing at Lewisham,”  the Labour leader said.

But it was a partial reprieve for the hospital, after the special administrator appointed to sort out the neighbouring South London NHS Trust, which is running up debts at a rate of £1.3 million a week, proposed that the A&E department at Lewisham should be closed and replaced with an “urgent care unit”.

That proposal was seen as deeply unfair to Lewisham, a successful trust, and triggered a grassroots backlash with 15,000 local residents marching in support of the hospital last weekend.

Acknowledging the protests in the Commons today, Mr Hunt said to ensure NHS reconfiguration decisions improved safety, he had asked Sir Bruce Keogh to examine the clinical implications of closing Lewisham’s A&E.

Sir Bruce warned it would disadvantage local residents, especially the frail and elderly, and recommended a smaller A&E unit, open 24 hours a day and with senior consultant cover, should be retained at Lewisham.

Accepting the recommendation, Mr Hunt said the  slimmed down A&E would see “up to 75 per cent” of the patients currently treated compared with the 50 per cent the special administrator calculated would attend an urgent care unit.

The decision was condemned as a fudge after the health secretary said his compromise solution would increase costs but would only “marginally” increase the financial risk. The health department put the extra cost at £2 million a year.

 Julia Manning, chief executive of the think tank 2020 Health, said: “Mr Hunt is delaying the inevitable and costing the taxpayer more. Sentimentality and politics have left us with a solution that is unsustainable and will have to be revisited yet again in the future”.

Sir Steve Bullock, Mayor of Lewisham, said the council was taking legal advice on applying for judicial review. “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.  This is not the end of the matter,” he said.

Chris Ham, chief executive of the Kings Fund said “‘South London Healthcare NHS Trust has longstanding and serious financial problems so no change is not an option. With a number of other trusts also facing serious financial challenges, it is vital that these problems are resolved before it becomes necessary to invoke the failure process. This will require stronger political leadership than we have seen in the past.”

Suggested Topics
Start your day with The Independent, sign up for daily news emails
PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
ebooks
ebooksA special investigation by Andy McSmith
2015 General Election
May2015

Poll of Polls

Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Tradewind Recruitment: English Teacher

Negotiable: Tradewind Recruitment: My client is an excellent, large partially ...

Tradewind Recruitment: Science Teacher

£90 - £140 per day: Tradewind Recruitment: I am currently working in partnersh...

Tradewind Recruitment: Year 3 Primary Teacher

£100 - £150 per day: Tradewind Recruitment: Year 3 Teacher Birmingham Jan 2015...

Ashdown Group: Lead Web Developer (ASP.NET, C#) - City of London

£45000 - £50000 per annum + Excellent benefits: Ashdown Group: Lead Web Develo...

Day In a Page

Isis hostage crisis: The prisoner swap has only one purpose for the militants - recognition its Islamic State exists and that foreign nations acknowledge its power

Isis hostage crisis

The prisoner swap has only one purpose for the militants - recognition its Islamic State exists and that foreign nations acknowledge its power, says Robert Fisk
Missing salvage expert who found $50m of sunken treasure before disappearing, tracked down at last

The runaway buccaneers and the ship full of gold

Salvage expert Tommy Thompson found sunken treasure worth millions. Then he vanished... until now
Homeless Veterans appeal: ‘If you’re hard on the world you are hard on yourself’

Homeless Veterans appeal: ‘If you’re hard on the world you are hard on yourself’

Maverick artist Grayson Perry backs our campaign
Assisted Dying Bill: I want to be able to decide about my own death - I want to have control of my life

Assisted Dying Bill: 'I want control of my life'

This week the Assisted Dying Bill is debated in the Lords. Virginia Ironside, who has already made plans for her own self-deliverance, argues that it's time we allowed people a humane, compassionate death
Move over, kale - cabbage is the new rising star

Cabbage is king again

Sophie Morris banishes thoughts of soggy school dinners and turns over a new leaf
11 best winter skin treats

Give your moisturiser a helping hand: 11 best winter skin treats

Get an extra boost of nourishment from one of these hard-working products
Paul Scholes column: The more Jose Mourinho attempts to influence match officials, the more they are likely to ignore him

Paul Scholes column

The more Jose Mourinho attempts to influence match officials, the more they are likely to ignore him
Frank Warren column: No cigar, but pots of money: here come the Cubans

Frank Warren's Ringside

No cigar, but pots of money: here come the Cubans
Isis hostage crisis: Militant group stands strong as its numerous enemies fail to find a common plan to defeat it

Isis stands strong as its numerous enemies fail to find a common plan to defeat it

The jihadis are being squeezed militarily and economically, but there is no sign of an implosion, says Patrick Cockburn
Virtual reality thrusts viewers into the frontline of global events - and puts film-goers at the heart of the action

Virtual reality: Seeing is believing

Virtual reality thrusts viewers into the frontline of global events - and puts film-goers at the heart of the action
Homeless Veterans appeal: MP says Coalition ‘not doing enough’

Homeless Veterans appeal

MP says Coalition ‘not doing enough’ to help
Larry David, Steve Coogan and other comedians share stories of depression in new documentary

Comedians share stories of depression

The director of the new documentary, Kevin Pollak, tells Jessica Barrett how he got them to talk
Has The Archers lost the plot with it's spicy storylines?

Has The Archers lost the plot?

A growing number of listeners are voicing their discontent over the rural soap's spicy storylines; so loudly that even the BBC's director-general seems worried, says Simon Kelner
English Heritage adds 14 post-war office buildings to its protected lists

14 office buildings added to protected lists

Christopher Beanland explores the underrated appeal of these palaces of pen-pushing
Human skull discovery in Israel proves humans lived side-by-side with Neanderthals

Human skull discovery in Israel proves humans lived side-by-side with Neanderthals

Scientists unearthed the cranial fragments from Manot Cave in West Galilee