Over the past few months, hospitals and A&E departments across London have been threatened with closures and downgrades. Lewisham is facing the closure of 60% of its site, following a flawed ‘special administration’ process. Ealing, Hammersmith and Central Middlesex are designated to lose their A&Es.Hammersmith & Fulham Council seems to have sold out Charing Cross Hospital behind the backs of local residents whilst pretending to save it. The Whittington Hospital is once again fighting for survival. The St Helier and Epsom hospitals are facing downgrading and the latest shock announcement shows that Croydon Mayday A&E and maternity is also threatened with administration.
Where will it all end?
This pattern is replicated across the country. The College of Emergency Medicine this week released data that shows our A&E’s are under ‘huge pressure’ and in need of their own emergency care. Reports of worsening conditions and seemingly premature deaths are emerging. Last week it emerged last week that the government’s new fragmented 111 service is being investigated in the case of at least three deaths.
Now faced with a near halving of London’s A&E services, patients and hospital workers are raising the alarm. At stake, is not just the survival of services, but also the survival of the patients who need them.
Hammersmith patient Desi Cranenburgh told me: ‘This should be about care not scare. Charing Cross hospital is a core part of our community. My mum has a breathing condition which we manage, but sometimes she needs to get to A&E quickly – and the same goes for me. Without our local hospital we will be at risk. I’m also on a low wage and the fares to visit her further away would be a real problem.’
The ambulance service is nearing breaking point, with patients waiting for up to 18 hours in ambulances before entering A&E. Some hospitals have even resorted to erecting makeshift shelters for patients waiting to be treated.
NHS Check data gathered by the opposition shadow team in February showed that the Coalition missed its own reduced waiting time targets throughout the winter, with an extra million patients waiting more than four hours. In some regions, fewer than seven in 10 ambulance calls reached the most serious cases within the eight minute target – and more than 11,138 ambulances are waiting over 30 minutes outside of A&E departments.
Far from protecting the NHS more than 5,000 nursing jobs have been lost since David Cameron became PM. One in six hospitals now have inadequate staffing levels in A&E.
The warnings were there last winter; in the personal evidence of both patients and doctors. Now with the publication of the College of Emergency Medicine report, asking for a complete re-vamp, we have another observation from our ‘NHS is coasting’ Secretary of State. Having tried to blame nurses as he did a few weeks back, Hunt now tells us that the problem apparently lies in the escalation of the numbers of old people turning up for treatment. But funnily enough the old and frail have been with us for quite a while now. They are hardly a sudden phenomenon and have a remarkable tendency to age with advanced notice.
In reality a significant part of the problem is cuts to front line staff. There is evidence of some A&E’s running at an almost skeleton crew. Meanwhile cuts in ambulance crews cause more emergency admissions due to time delays, as do insufficient out of hours services.
Whilst 30% of A&E attendees may well be in the wrong place, and better placed in an Urgent Care Centre, GPs are in no position to soak up the ‘slack’. They are under increasing pressure, dealing with endless restructuring, in some cases a new commissioning role, and significantly higher demand for appointments. It is GPs who are primarily dealing with the ill health caused by the additional stresses of living in an age of austerity. As Clare Gerada, Chair of the Royal College of GPs tweeted yesterday, ‘many GPs now having 60 contacts per day. Unsustainable.’
In addition, community nursing provision and community rehab have been similarly reduced. My own experience bears out the figures. After(superb) hospital care, I found that post-discharge physiotherapy down the phone doesn’t really cut it as a form of treatment!
Privatisation and market costs are compounding matters. On April 24th, a majority in the House of Lords opposed Lord Hunt’s appeal to safeguard services from rampant privatisation under the new Section 75 criteria. The Royal College of Physicians is now considering whether to eject government spokesperson Earl Howe for his part in dismantling the NHS. The current EU/US free-trade talks also hold serious implications for the health and well-being of whatever may remain of the NHS.
This weekend, to highlight the acute danger to the capital’s health, Saturday 18th May will find central London as the focal point for a protest march jointly organised by the key Save our NHS campaigns, working together to highlight the dangerous threat which comes with these ill thought-out plans.
Lewisham patient Carol Brown will be there with her carer and partner Barry Mills:
"I’m particularly worried about the reduction in ICU beds across the capital. I am only alive today because of Lewisham A&E and their fast action at getting me into their wonderful ICU unit – both of which are currently destined for dismantling. Nothing about this makes sense. It’s terrifying."
There is expected to be sizeable representation from hospital workers and key unions as well as patients and residents who are alarmed at proposals which are set to endanger lives.
The rally will assemble at Concert Hall Approach from 12.00pm before marching across Waterloo Bridge and proceeding up the Strand to Whitehall.
Speakers from across the capital’s NHS campaigns, politicians and union representatives will address the crowds from an open topped bus which will guide the marchers to no 10 Downing St – where a joint letter from all of the six Defend London’s NHS campaigns will be presented.
Join us there – and help us rescue the NHS from the biggest threat in a generation.
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