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
Arts and Entertainment
Joe Cocker performing on the Stravinski hall stage during the Montreux Jazz Festival, in Montreux, Switzerland in 2002
musicHe 'turned my song into an anthem', says former Beatle
News
Clarke Carlisle
sport
Sport
footballStoke City vs Chelsea match report
Arts and Entertainment
theatreThe US stars who've taken to UK panto, from Hasselhoff to Hall
PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
ebooks
ebooksA year of political gossip, levity and intrigue from the sharpest pen in Westminster
Life and Style
Approaching sale shopping in a smart way means that you’ll get the most out of your money
life + styleSales shopping tips and tricks from the experts
News
newsIt was due to be auctioned off for charity
News
Coca-Cola has become one of the largest companies in the world to push staff towards switching off their voicemails, in a move intended to streamline operations and boost productivity
peopleCoca-Cola staff urged to switch it off to boost productivity
Environment
Sir David Attenborough
environment... as well as a plant and a spider
Voices
'That's the legal bit done. Now on to the ceremony!'
voicesThe fight for marriage equality isn't over yet, says Siobhan Fenton
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

Austen Lloyd: Regulatory / Compliance / Exeter

Excellent Salary: Austen Lloyd: Exeter - An excellent opportunity for a Solici...

Ashdown Group: IT Support Technician - 12 Month Fixed Term - Shrewsbury

£17000 - £20000 per annum: Ashdown Group: IT Helpdesk Support Technician - 12 ...

The Jenrick Group: Maintenance Planner

£28000 - £32000 per annum + pension + holidays: The Jenrick Group: Maintenance...

The Jenrick Group: World Wide PLC Service Engineer

£30000 - £38000 per annum + pesion + holidays: The Jenrick Group: World Wide S...

Day In a Page

Surrounded by high-rise flats is a little house filled with Lebanon’s history - clocks, rifles, frogmen’s uniforms and colonial helmets

Clocks, rifles, swords, frogmen’s uniforms

Surrounded by high-rise flats is a little house filled with Lebanon’s history
Return to Gaza: Four months on, the wounds left by Israel's bombardment have not yet healed

Four months after the bombardment, Gaza’s wounds are yet to heal

Kim Sengupta is reunited with a man whose plight mirrors the suffering of the Palestinian people
Gastric surgery: Is it really the answer to the UK's obesity epidemic?

Is gastric surgery really the answer to the UK's obesity epidemic?

Critics argue that it’s crazy to operate on healthy people just to stop them eating
Homeless Veterans appeal: Christmas charity auction Part 2 - now LIVE

Homeless Veterans appeal: Christmas charity auction

Bid on original art, or trips of a lifetime to Africa or the 'Corrie' set, and help Homeless Veterans
Pantomime rings the changes to welcome autistic theatre-goers

Autism-friendly theatre

Pantomime leads the pack in quest to welcome all
The week Hollywood got scared and had to grow up a bit

The week Hollywood got scared and had to grow up a bit

Sony suffered a chorus of disapproval after it withdrew 'The Interview', but it's not too late for it to take a stand, says Joan Smith
From Widow Twankey to Mother Goose, how do the men who play panto dames get themselves ready for the performance of a lifetime?

Panto dames: before and after

From Widow Twankey to Mother Goose, how do the men who play panto dames get themselves ready for the performance of a lifetime?
Thirties murder mystery novel is surprise runaway Christmas hit

Thirties murder mystery novel is surprise runaway Christmas hit

Booksellers say readers are turning away from dark modern thrillers and back to the golden age of crime writing
Anne-Marie Huby: 'Charities deserve the best,' says founder of JustGiving

Anne-Marie Huby: 'Charities deserve the best'

Ten million of us have used the JustGiving website to donate to good causes. Its co-founder says that being dynamic is as important as being kind
The botanist who hunts for giant trees at Kew Gardens

The man who hunts giants

A Kew Gardens botanist has found 25 new large tree species - and he's sure there are more out there
The 12 ways of Christmas: Spare a thought for those who will be working to keep others safe during the festive season

The 12 ways of Christmas

We speak to a dozen people who will be working to keep others safe, happy and healthy over the holidays
Birdwatching men have a lot in common with their feathered friends, new study shows

The male exhibits strange behaviour

A new study shows that birdwatching men have a lot in common with their feathered friends...
Diaries of Evelyn Waugh, Virginia Woolf and Noël Coward reveal how they coped with the December blues

Famous diaries: Christmas week in history

Noël Coward parties into the night, Alan Clark bemoans the cost of servants, Evelyn Waugh ponders his drinking…
From noble to narky, the fall of the open letter

From noble to narky, the fall of the open letter

The great tradition of St Paul and Zola reached its nadir with a hungry worker's rant to Russell Brand, says DJ Taylor
A Christmas ghost story by Alison Moore: A prodigal daughter has a breakthrough

A Christmas ghost story by Alison Moore

The story was published earlier this month in 'Poor Souls' Light: Seven Curious Tales'