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
News
Pro-Russia rebels guard a train containing the bodies of victims of the Malaysia Airlines flight MH 17 crash in Torez, Ukraine
i100
Life and Style
Child's play: letting young people roam outdoors directly contradicts the current climate
lifeHow much independence should children have?
Arts and Entertainment
Tycoons' text: Warren Buffett and Bill Gates both cite John Brookes' 'Business Adventures' as their favourite book
booksFind out why America's richest men are reading John Brookes
Arts and Entertainment
<p><strong>2008</strong></p>
<p>Troubled actor Robert Downey Jr cements his comeback from drug problems by bagging the lead role in Iron Man. Two further films follow</p>
filmRobert Downey Jr named Hollywood's highest paid actor for second year running
PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
News
ebookA unique anthology of reporting and analysis of a crucial period of history
Property
Sign here, please: Magna Carta Island
propertyYours for a cool £4m
News
people
News
The Commonwealth flag flies outside Westminster Abbey in central London
news
Arts and Entertainment
Struggling actors who scrape a living working in repertory theatres should get paid a 'living wage', Sir Ian McKellen has claimed
theatre
News
Skye McCole Bartusiak's mother said she didn't use drink or drugs
peopleActress was known for role in Mel Gibson film The Patriot
Arts and Entertainment
tvWebsite will allow you to watch all 522 shows on-demand
Arts and Entertainment
filmThe Rock to play DC character in superhero film
News
i100
Arts and Entertainment
Damon Albarn is starting work on a new West End musical
artsStar's 'leftfield experimental opera' is turning mainstream
Life and Style
Paul and his father
artsPaul Carter wants to play his own father in the film of his memoirs
Sport
Ben Stokes trudges off after his latest batting failure for England as Ishant Sharma celebrates one of his seven wickets
cricket
Arts and Entertainment
Members of the public are invited to submit their 'sexcapades' to Russell T Davies' new series Tofu
tv
News
Sky's Colin Brazier rummages through an MH17 victim's belongings live on air
i100
Arts and Entertainment
Keira Knightley and Benedict Cumberbatch star in the Alan Turing biopic The Imitation Game
arts + ents'The Imitation Game' stars Benedict Cumberbatch and Keira Knightley
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
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

History Teacher

£110 - £120 per day: Randstad Education Chelmsford: We are seeking a teacher o...

IT Teacher

£110 - £120 per day: Randstad Education Chelmsford: We are seeking a suitably ...

Legal Cashier - Oxford

Very Competitive: Austen Lloyd: Legal Cashier - Oxford We have an excellent ...

Legal Cashier - Oxford

Very Competitive: Austen Lloyd: Legal Cashier - Oxford We have an excellent ...

Day In a Page

Some are reformed drug addicts. Some are single mums. All are on benefits. But now these so-called 'scroungers’ are fighting back

The 'scroungers’ fight back

The welfare claimants battling to alter stereotypes
Amazing video shows Nasa 'flame extinguishment experiment' in action

Fireballs in space

Amazing video shows Nasa's 'flame extinguishment experiment' in action
A Bible for billionaires

A Bible for billionaires

Find out why America's richest men are reading John Brookes
Paranoid parenting is on the rise - and our children are suffering because of it

Paranoid parenting is on the rise

And our children are suffering because of it
For sale: Island where the Magna Carta was sealed

Magna Carta Island goes on sale

Yours for a cool £4m
Phone hacking scandal special report: The slide into crime at the 'News of the World'

The hacker's tale: the slide into crime at the 'News of the World'

Glenn Mulcaire was jailed for six months for intercepting phone messages. James Hanning tells his story in a new book. This is an extract
We flinch, but there are degrees of paedophilia

We flinch, but there are degrees of paedophilia

Child abusers are not all the same, yet the idea of treating them differently in relation to the severity of their crimes has somehow become controversial
The truth about conspiracy theories is that some require considering

The truth about conspiracy theories is that some require considering

For instance, did Isis kill the Israeli teenagers to trigger a war, asks Patrick Cockburn
Alistair Carmichael: 'The UK as a whole is greater than the sum of its parts'

Alistair Carmichael: 'The UK as a whole is greater than the sum of its parts'

Meet the man who doesn't want to go down in history as the country's last Scottish Secretary
Legoland Windsor's master model-makers reveal the tricks of their trade (including how to stop the kids wrecking your Eiffel Tower)

Meet the people who play with Lego for a living

They are the master builders: Lego's crack team of model-makers, who have just glued down the last of 650,000 bricks as they recreate Paris in Windsor. Susie Mesure goes behind the scenes
The 20 best days out for the summer holidays: From Spitfires to summer ferry sailings

20 best days out for the summer holidays

From summer ferry sailings in Tyne and Wear and adventure days at Bear Grylls Survival Academy to Spitfires at the Imperial War Museum Duxford and bog-snorkelling at the World Alternative Games...
Open-air theatres: If all the world is a stage, then everyone gets in on the act

All the wood’s a stage

Open-air productions are the cue for better box-office receipts, new audiences, more interesting artistic challenges – and a picnic
Rand Paul is a Republican with an eye on the world

Rupert Cornwell: A Republican with an eye on the world

Rand Paul is laying out his presidential stall by taking on his party's disastrous record on foreign policy
Self-preservation society: Pickles are moving from the side of your plate to become the star dish

Self-preservation society

Pickles are moving from the side of your plate to become the star dish
Generation gap opens a career sinkhole

Britons live ever longer, but still society persists in glorifying youth

We are living longer but considered 'past it' younger, the reshuffle suggests. There may be trouble ahead, says DJ Taylor