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
Have you tried new the Independent Digital Edition apps?
ebooks
ebooksAn introduction to the ground rules of British democracy
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
SPONSORED FEATURES
Independent Dating
and  

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

iJobs Job Widget
iJobs General

Recruitment Genius: Sales Executive or Senior Sales Executive - B2B Exhibitions

£18000 - £30000 per annum: Recruitment Genius: A Sales Executive or Senior Sal...

Recruitment Genius: Head of Support Services

£40000 - £55000 per annum: Recruitment Genius: This is an exciting opportunity...

Recruitment Genius: Warehouse Team Leader

£22000 per annum: Recruitment Genius: This industry leading company produces h...

Recruitment Genius: Business Development Manager / Sales - OTE £40,000

£20000 - £40000 per annum: Recruitment Genius: This IT provider for the educat...

Day In a Page

A nap a day could save your life - and here's why

A nap a day could save your life

A midday nap is 'associated with reduced blood pressure'
If men are so obsessed by sex, why do they clam up when confronted with the grisly realities?

If men are so obsessed by sex...

...why do they clam up when confronted with the grisly realities?
The comedy titans of Avalon on their attempt to save BBC3

Jon Thoday and Richard Allen-Turner

The comedy titans of Avalon on their attempt to save BBC3
The bathing machine is back... but with a difference

Rolling in the deep

The bathing machine is back but with a difference
Part-privatised tests, new age limits, driverless cars: Tories plot motoring revolution

Conservatives plot a motoring revolution

Draft report reveals biggest reform to regulations since driving test introduced in 1935
The Silk Roads that trace civilisation: Long before the West rose to power, Asian pathways were connecting peoples and places

The Silk Roads that trace civilisation

Long before the West rose to power, Asian pathways were connecting peoples and places
House of Lords: Outcry as donors, fixers and MPs caught up in expenses scandal are ennobled

The honours that shame Britain

Outcry as donors, fixers and MPs caught up in expenses scandal are ennobled
When it comes to street harassment, we need to talk about race

'When it comes to street harassment, we need to talk about race'

Why are black men living the stereotypes and why are we letting them get away with it?
International Tap Festival: Forget Fred Astaire and Ginger Rogers - this dancing is improvised, spontaneous and rhythmic

International Tap Festival comes to the UK

Forget Fred Astaire and Ginger Rogers - this dancing is improvised, spontaneous and rhythmic
War with Isis: Is Turkey's buffer zone in Syria a matter of self-defence – or just anti-Kurd?

Turkey's buffer zone in Syria: self-defence – or just anti-Kurd?

Ankara accused of exacerbating racial division by allowing Turkmen minority to cross the border
Doris Lessing: Acclaimed novelist was kept under MI5 observation for 18 years, newly released papers show

'A subversive brothel keeper and Communist'

Acclaimed novelist Doris Lessing was kept under MI5 observation for 18 years, newly released papers show
Big Blue Live: BBC's Springwatch offshoot swaps back gardens for California's Monterey Bay

BBC heads to the Californian coast

The Big Blue Live crew is preparing for the first of three episodes on Sunday night, filming from boats, planes and an aquarium studio
Austin Bidwell: The Victorian fraudster who shook the Bank of England with the most daring forgery the world had known

Victorian fraudster who shook the Bank of England

Conman Austin Bidwell. was a heartless cad who carried out the most daring forgery the world had known
Car hacking scandal: Security designed to stop thieves hot-wiring almost every modern motor has been cracked

Car hacking scandal

Security designed to stop thieves hot-wiring almost every modern motor has been cracked
10 best placemats

Take your seat: 10 best placemats

Protect your table and dine in style with a bold new accessory