Image: Martin Rowson. All rights reserved.
Whilst the country has been battled by the elements, the battle for public services continues.
Lewisham Campaigners were in usual dogged but polite mode when they dropped in to see Jeremy Hunt. He can’t say he wasn’t warned. A year ago he had hidden from a Valentine’s Day buggy army of 120 mums, dads and children serenading him outside his office in protest at plans to close more than half a local hospital with barely any consultation.
Twelve months and two legal victories against Hunt later, the Lewisham campaigners were back, waiting for his arrival to speak at a central London conference ‘Implementing the recommendations to The Francis Inquiry: A Year On’.
The landmark Francis Report is about healing and helping. Brought in to look at the mid Staffs crisis, Sir Robert Francis initially recommended an increase in nursing figures. Since his report he’s gone even further, recommending legal targets on nurse ratios. The Francis Report recommends not hospital closures but hospital improvements. High profile mortality statistic researcher Professor Brian Jarman, who also wrote on Mid Staffs, agrees it is better to mend hospitals than to close them.
But campaigners think hospitals are being set up to fail – and that even those that are successful are under attack from the Hospital Closure Clause.
Awaiting Jeremy Hunt inside the building campaigers observed many empty seats, presumably due to the £400 per head ticket price. They were then told in good humoured fashion that even remaining half an inch inside the ‘international territory building’ could induce a diplomatic police incident. So they waited for Jeremy by handing leaflets out to passers by, some of whom opted to join in. With the rainy afternoon turned to evening, and some 50 minutes late, suddenly from one of several circling darkened window vehicles sprang the startled Secretary of State.
Unfortunately for Mr Hunt, most of the conference delegates had given up and gone home while the huddle of Lewisham campaigners surrounded him on the pavement politely asking him to drop Clause 118.
His only words ‘this is about failing hospitals’.
There was an easy answer to that: ‘But Mr Hunt – you are making hospitals fail.’
To which Hunt had no reply. He promised to return to speak to campaigners - but fled out of the back door instead.
Clause 118 has been renumbered Clause 119 but remains the ‘Hospital Closure Clause’, the cuckoo in the nest of the Care Bill.
Mr Hunt knows full well its purpose. It is one which he really does not wish to discuss with Lewisham campaigners. The intent is to make lawful what he tried failed to do in Lewisham – asset strip hospitals down to the bone, sell off land to property developers and create an unsustainable rump of an elective surgical centre in attractive new buildings ripe for the privateers.
If the hospital closure clause goes through, no hospital in England will be safe from such greedy land grabbing - as already advocated by both McKinsey and Monitor.
But we can’t afford to lose more capacity. A&Es have just had their worst week in missing 4 hour waiting times since April ’13, with some patients having to wait more than 12 hours. Channel 4 Dispatches reveals the scandal of hospitals being fined £1billion for “failing” when “too many” patients turn up at A&E or need re-admission. This “marginal tariff” system disadvantages poorer communities with poor health.
The £1 billion of fines has disappeared without trace from the NHS coffers.
Even the Dept of Health’s own Professor Keith Willett admits:
“I don’t think anyone can track that money and see how it was spent…”
The usually quiescent Foundation Trust Network observed:
“It’s very clear that this results in worse care and just shows how big the pressure is on hospitals.”
It seems Sir Bruce Keogh is not a fan of the failing term, nor of using generic national data to cover for local situations. He has previously written to Jeremy Hunt outlining concerns where rushed re-configurations put intolerable pressures on neighbouring hospitals. Just as seen in Barnet, where it was reported this week that they had declared an “internal emergency” and were turning away ambulances following the closure of neighbouring Chase Farm A&E.
Yet the downgrades continue. This week Northallerton’s Friarage Hospital is told that its maternity services are to be downgraded. West to East transport routes across North Yorkshire are notoriously tricky, which means more pressure on York District Hospital - already beleaguered with the financial and capacity difficulties featured in Channel 4’s Dispatches.
Back in London, on Saturday the local comedy club was packed out with residents from Chiswick and environs – not a community which has a tendency to angry meetings, but come they did. Even the Tories were there.
Central Middlesex and Hammersmith A&Es are to close with almost immediate effect. Ealing and Charing Cross are to be downgraded. They’ll lose 500 acute beds in the demolition works and their A&Es will become Hunt’s pretend variety.
Andy Slaughter MP captured the concerns about capacity, saying:
“this chaotic hospital reconfiguration at a time when services are already seriously overstretched and with a winter A&E crisis upon us, will result not in lives being saved, but in many people being put in needless danger.”
Supporting the downgrades, Cllr Marcus Ginn of Tory-led Hammersmith & Fulham Council, maintained that the changes would save lives because “centralisation had worked for stroke patients”.
Mary McLeod, Conservative MP for Brentford & Isleworth, said that whilst she was not medically trained, she thought the reconfiguration would be “want her family would want”.
Both denied any moves towards privatisation. Cllr Gregory Stafford from Ealing borough was quoted as saying that senior medics will be on 24/7 A&E duty - but attendees pointed out his comments were disengenous - these units will be staffed by GPs.
The meeting noted that aside from stroke, many other conditions need faster access to a local blue light A&E in order to save lives.
Charing Cross Hospital is renowned for having the best stroke unit in the country. But - extraordinarily - the unit is to be closed if these plans go ahead, said Community Matron Anne Drinkell. She also highlighted the plight of the very community provision which is supposed provide the care when hospital beds close.
“The scale and timing of these service cuts impacts when there are redundancies and cuts across primary and community care…in 2011 only 5 district nurses qualified in London…when Clare Gerada spoke of the strain on GP practices, [these cuts are] utterly irresponsible… Finance is the major driver. Age adjusted spending will fall by 9% per person.”
Transport and travel routes emerged as major concerns, along with access difficulties for the sick and disabled in crossing London.
Dr Mark Spencer, NW London Medical Director, shocked the audience when he told them that ‘anyone going to A&E by bus should instead attend a pharmacy’. He was reminded that residents of Acton have amongst the lowest car ownership in the capital.
Cuts in the London Ambulance Service have collided with increased need, noted London Assembly member Murad Qereshi. Ambulances are now being used as holding bays in queues for patients waiting to get into overcrowded A&Es.
The hospital buildings which are tagged for demolition occupy land which will afterwards be offered to property developers.
Immediately the meeting ended, Cllr Ginn vacated the building in Hunt fashion.
Mary McLeod remained to have a high decibel argument with concerned resident.
Clare Gerada, whilst Chair of the Royal College of GPs said
“It is clear the provision of emergency care is in crisis across the whole of the NHS. Before any further closures are contemplated, there must be a full, independent assessment of their impact on patients and on the system as a whole.”
Both Sir Keith Willett and Prof Bruce Keogh have said that patients should be treated as close to home as possible.
Perhaps their definition of “possible” is rather different from what most patients and relatives would wish for. Clause 119 seems aimed to facilitate inadequately prepared land-grabs and asset-stripping re-configurations without only the barest token gesture of local consultation, easily overridden by NHS England.
There will be a day of protest against the Hospital Closure Clause (Clause 119) on Thursday 27th February.
Join us in Whitehall at 10.30 am when our petition is presented at No10 Downing St, then take part in a rally at the war memorial opposite the Houses of Parliament. Afterwards there will be a meeting in Committee Room 3a where Andy Burnham MP, Michael Mansfield QC, Louise Irvine from Save Lewisham Hospital, Kailash Chand of the British Medical Association and Caroline Molloy of OurNHS will be speaking.