Wednesday, 23 January 2013

Dear Mr Hunt...

Sooooo the consultation was an utter shambles! In addition to the protest on Saturday 26 Jan, everyone supporting the Save Lewisham Hospital campaign can write to Jeremy Hunt and share their views (probably best to keep it polite..!) Details can be found at: 

My letter is below (yes, I got caught up in a rant)


23 Jan 2013
Dear Mr Hunt,
I am writing to you with regard to the Trust Special Administrator report on the proposed reconfiguration of the South London Healthcare Trust, in particular reference to the proposals pertaining to Lewisham Hospital.
I’m well aware that most likely this letter will not be read by you but by a member of your staff (if that), and that, in response, I will most likely receive a standard statement stating merely that you’re considering the proposals. 
I am also aware that you will have heard many arguments – that the TSA far overstepped his remit, that Lewisham is a successful solvent hospital, and that the proposed changes will have potentially fatal consequences on the local population – before. As such, I would like to look at this issue from a different perspective and will do so briefly in the hope that, should this letter actually reach you, you will endeavour to read it in its entirety.
You have stressed on numerous occasions the important of the four tests. In the House of Commons on 8 January 2013, you said:
  • “[W]ere there to be any changes, we would need to be satisfied that they would have strong, local, clinical support”
  • “I will not accept any of the changes that the special administrator proposes unless I am satisfied that all four tests have been met.”
  • [We introduced the four tests as] “an additional safeguard to make sure that reconfigurations were not done without local clinical support”.

As I’m sure you are by now more than aware, the TSA’s report fails ALL four tests. But what is important is that you made these statements on the record, publicly and definitively. You will not be able to backtrack on these promises unnoticed.
We are one of the most deprived boroughs in London and yet the Save Lewisham Hospital campaign have secured consistent national coverage on our campaign ever since 10,000-15,000 people attended the demonstration on 24 November 2012, including:
Daily Mail
Daily Mirror
Regardless of political leaning, all coverage has been critical of the proposals. Look at the comments from Guardian readers, and then those from Daily Mail readers – they are equally opposed to the changes and equally critical of a Conservative government that would allow them to proceed.
The proposals were also a key topic of debate on a recent episode of Question Time broadcast on 10 January 2013 which was watched by three million people. The panel was unanimous in its opposition to the proposals, and NHS was a top UK trend on Twitter immediately following the show.
If you are even considering accepting the Lewisham Hospital proposals, you are heading for a PR nightmare. The country is watching your decision very closely at a time where confidence in the Conservative Party to stick to campaign promises is at an all-time low. This is the highest profile case of its kind in recent history. Should you approve these proposals, you are saying to every single voter in the country that, regardless of the four tests and your promises that NHS reconfigurations must have local support, if you deem it necessary, you can and will close down any NHS services you like. Is this the message you want to give to the electorate?
There seems to be a view that Lewisham residents are opposed to the proposals because they (a) are emotionally attached to their local hospital and don’t want to services removed; (b) don’t understand the urgent need for change given the SLHT’s dire financial situation; (c) aren’t willing to offer any alternatives. All the aforementioned points are completely inaccurate.
We are well aware that the SLHT’s financial situation is completely unsustainable and that something has to be done. We are also aware that sometimes difficult decisions have to be made to solve such large-scale problems. Local GP commissioners have been very clear that they understand the need for change and are more than willing to work with QEH to come up with a sustainable, workable solution that does not put the lives of patients at risk unnecessarily. We the public are also very clear that we oppose the proposals, not for reasons of sentimentality, but because they are dangerous proposals based on incomplete, inaccurate and flawed data. You said on the 8th January that the four tests were introduced because you “wanted to avoid what had happened so often, including in my own constituency—an alliance of Health Ministers and NHS managers riding roughshod over what local people wanted”. Should you approve these proposals, this is exactly what will be happening.
1) The most evident failure is that of the first test: support from GP commissioners. From your emphasis on local support during your speech on 8 January, I take this to mean “support from LOCAL GP commissioners”. As has been made very clear to you, local GP commissioners are unanimous in their opposition to the proposed closures at Lewisham A&E.
2) The proposals also fail the second test, strengthened public and patient engagement. The public were given little time to respond to the consultation. The proposals with regard to Lewisham Hospital were obfuscatory to the extreme – many (including myself) did not understand what was actually being proposed at first. A crucial piece of data on which the public consultation was based was also flawed - a fact only acknowledged after the public consultation period was closed. The final report states:
"Analysis included in the TSA’s draft report suggested around 77% of University Hospital Lewisham’s current A&E activity would remain at the hospital under this scenario. However, a number of responses to the consultation suggested that this estimate was too high. Therefore, further analysis was undertaken and, based on practice elsewhere in London, a revised figure of 50% has been used for the modelling that underpins the TSA’s recommendation."
There is a significant difference between 50% and 77%, I’m sure you will agree. Most local clinicians believe that the actual figure is yet lower than 50%, at around 30%. And if this figure was so substantially wrong, how can we trust any of the data in the report?
3) The recommendations are underpinned by a clear clinical evidence base
They are not in the slightest, as has already been outlined to you by local clinicians. More views can be found here:
4. The changes give patients a choice of good quality providers.
These changes do exactly the opposite. QEH is already severely over-stretched and simply cannot cope with the extra patients. Travel times for Lewisham residents to reach QEH have also been severely underestimated. The TSA has also significantly underestimated the flow of patients to Kings College Hospital in Camberwell, should the proposals be approved, as has been stated by Harriet Harman in her letter to you ( From a personal point of view, I can tell you that as a Sydenham resident, I would not consider travelling to QEH for emergency care.
I hope the issues outlined above, and the sheer size and high profile nature of the opposition to these proposals, in addition to the many other letters you will be receiving and meetings you will be having, are enough to convince that these proposals must be rejected.
I look forward to a prompt response, and eagerly await your decision on 1 February.
Kind regards,
Shannon Hawthorne, Lewisham resident.

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