Editorial: Local A&Es are a national issue, too

Share
Related Topics

Thousands took to the streets of Lewisham in south-east London on Saturday to protest against the proposed closure of the local hospital's A&E department and the downgrading of its maternity services. Their grievance was more complicated than just the protection of a local hospital. As they see it – and it is hard to disagree – "their" hospital is being punished for the sins of the adjacent South London Healthcare Trust, which is in administration. A wholesale reorganisation across the region is seen as the only solution and Lewisham, by all accounts well run and solvent, must help to meet the bill.

If this case were a one-off, a single point might be made about the injustice of "robbing Peter to pay Paul" and the mixed message it sends about good stewardship in the NHS. What incentive, it might be asked, is there for managers to run a tight ship, if their reward is to be called upon to bail out the profligate.

That point stands. But this case highlights an issue that goes far beyond one London hospital. Some 20 NHS trusts across the country have declared themselves financially unsustainable. And clinicians are agreed that health services generally have to be restructured – not just for financial reasons, but because medical advances and demographic trends, including the rise in the elderly population, mean that demands on the health system are changing.

The Government's plan is for fewer, but better, state-of-the-art hospitals and more local clinics providing some of the services currently found only in hospitals. This must be the shape of the future. But it comes up against two problems. One is the real affection in which many local hospitals are held – something that, as Sir Bruce Keogh, the medical director of the NHS, complained last week, encourages local MPs to thwart justified closures. The second is the fear that closures are all to do with "cuts" and will not be offset by new provision.

Given the deterioration in emergency provision that many have experienced since GPs were allowed to opt out of out-of-hours services (while also receiving a generous pay rise), people's distrust is not without foundation. The best way for the Government and the NHS to foster confidence would be to fund a few pilot projects first. If the new system is an improvement, patients will vote with their feet.

React Now

Latest stories from i100
iJobs Job Widget
iJobs General

Austen Lloyd: Private Client Solicitor - Oxford

Excellent Salary : Austen Lloyd: OXFORD - REGIONAL FIRM - An excellent opportu...

Austen Lloyd: Clinical Negligence Associate / Partner - Bristol

Super Package: Austen Lloyd: BRISTOL - SENIOR CLINICAL NEGLIGENCE - An outstan...

Recruitment Genius: Sales Consultant - Solar Energy - OTE £50,000

£15000 - £50000 per annum: Recruitment Genius: Fantastic opportunities are ava...

Recruitment Genius: Compute Engineer

Negotiable: Recruitment Genius: A Compute Engineer is required to join a globa...

Day In a Page

Read Next
SEEN graffiti Wonder Woman  

Warner Bros’ bold stance on Wonder Woman opens the door for Hollywood evolution

Matthew James
 

Errors & Omissions: moderate, iconic royals are a shoe-in for a pedantic kicking

Guy Keleny
Iraq invasion 2003: The bloody warnings six wise men gave to Tony Blair as he prepared to launch poorly planned campaign

What the six wise men told Tony Blair

Months before the invasion of Iraq in 2003, experts sought to warn the PM about his plans. Here, four of them recall that day
25 years of The Independent on Sunday: The stories, the writers and the changes over the last quarter of a century

25 years of The Independent on Sunday

The stories, the writers and the changes over the last quarter of a century
Homeless Veterans appeal: 'Really caring is a dangerous emotion in this kind of work'

Homeless Veterans appeal

As head of The Soldiers' Charity, Martin Rutledge has to temper compassion with realism. He tells Chris Green how his Army career prepared him
Wu-Tang Clan and The Sexual Objects offer fans a chance to own the only copies of their latest albums

Smash hit go under the hammer

It's nice to pick up a new record once in a while, but the purchasers of two latest releases can go a step further - by buying the only copy
Geeks who rocked the world: Documentary looks back at origins of the computer-games industry

The geeks who rocked the world

A new documentary looks back at origins of the computer-games industry
Belle & Sebastian interview: Stuart Murdoch reveals how the band is taking a new direction

Belle & Sebastian is taking a new direction

Twenty years ago, Belle & Sebastian was a fey indie band from Glasgow. It still is – except today, as prime mover Stuart Murdoch admits, it has a global cult following, from Hollywood to South Korea
America: Land of the free, home of the political dynasty

America: Land of the free, home of the political dynasty

These days in the US things are pretty much stuck where they are, both in politics and society at large, says Rupert Cornwell
A graphic history of US civil rights – in comic book form

A graphic history of US civil rights – in comic book form

A veteran of the Fifties campaigns is inspiring a new generation of activists
Winston Churchill: the enigma of a British hero

Winston Churchill: the enigma of a British hero

A C Benson called him 'a horrid little fellow', George Orwell would have shot him, but what a giant he seems now, says DJ Taylor
Growing mussels: Precious freshwater shellfish are thriving in a unique green project

Growing mussels

Precious freshwater shellfish are thriving in a unique green project
Diana Krall: The jazz singer on being friends with Elton John, outer space and skiing in Dubai

Diana Krall interview

The jazz singer on being friends with Elton John, outer space and skiing in Dubai
Pinstriped for action: A glimpse of what the very rich man will be wearing this winter

Pinstriped for action

A glimpse of what the very rich man will be wearing this winter
Russell T Davies & Ben Cook: 'Our friendship flourished online. You can share some very revelatory moments at four in the morning…'

Russell T Davies & Ben Cook: How we met

'Our friendship flourished online. You can share some very revelatory moments at four in the morning…'
Bill Granger recipes: Our chef serves up his favourite Japanese dishes

Bill Granger's Japanese recipes

Stock up on mirin, soy and miso and you have the makings of everyday Japanese cuisine
Michael Calvin: How we need more Eric Cantonas to knock some sense into us

Michael Calvin's Last Word

How we need more Eric Cantonas to knock some sense into us