Lewisham hospital will stay open - but only the lawyers have true cause to celebrate

The NHS's survival depends on the closure of services and even whole hospitals


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There may be egg on Jeremy Hunt's face, after today's High Court decision to reprieve Lewisham hospital, but it is the lawyers who are riding the gravy train.

Once again efforts to reorganise the NHS to make it more efficient and affordable have been derailed by the legal process, sackloads of cash have been diverted from patient care to lawyers pockets and the urgent task of healthcare reform has taken another step backwards.

Last month Mr Hunt suspended necessary but controversial plans to reform the provision of children's heart surgery, reducing the number of hospitals providing it from 10 to seven, after "flaws" were identified in the process. Now the urgent need to address longstanding problems with the health service in south London, which is effectively bust, have also been put on ice.

Lewisham's supporters are rightly celebrating. The proposal to downgrade the  A&E and maternity departments at the borough's popular and successful hospital  were seen as deeply unfair, and triggered a grassroots backlash with 15,000 local residents marching in protest. Their anger was fuelled by the fact that it was the neighbouring South London NHS Trust that was in difficulty, racking up debts at the rate of £1.3 million a week, but it was Lewisham that was being made to pay for it.

The Special Administrator called in to sort out the South London Trust had concluded that the only way to save it from bankruptcy was to curb services at its neighbour (Lewisham) and drive more patients in its direction. But the High Court ruled that the administrator had exceeded his powers by making recommendations about a separate trust, which would require a separate process of consultation, and Mr Hunt had compounded the error by following them. Back to square one.

Among the many responses welcoming Lewisham's reprieve today, the one from the NHS Confederation, representing managers, is the most instructive.

Mike Farrar, its experienced chief executive, said: "We should remember that the original intention shared by all organisations was to find a way to create sustainable high quality care that was affordable. This remains the underlying issue that has to be solved and one which cannot be ignored.".

Only last month NHS managers and medical Royal Colleges joined forces to demand a radical re-think of the way the NHS approaches the reconfiguration of services in order to overcome its “paralysis in relation to change”.

Today that paralysis continues. The closure of services, units and in some cases whole hospitals is essential to concentrate expertise, raise standards and achieve economies of scale in those that remain. The survival of the NHS depends upon it.