Lewisham Hospital Closure Quashed at High Court – August 2013


Lewisham Hospital Closure Quashed at High Court

On 31 July 2013 Justice Silber found that Secretary of State Jeremy Hunt M.P. had acted unlawfully when he ordered the ‘downgrading’ of  the A&E and Maternity Departments at Lewisham Hospital. The judge quoted the National Health Services Act 2006 as the legislation that made Mr Hunt’s actions illegal.  The idea of one trust bailing out another seems to have been Mr Hunt’s undoing.


BBC TV and national newspaper coverage of the story was almost non-existent.  Apparently the Zimbabwe election and a Top Shop T-shirt showing an illegal image of Rihanna was judged as more important by national news media than the lives potentially saved by keeping Lewisham Hospital’s A&E open.


Mental Health Primary Care Plans for Ealing Cause Uproar

At a poorly publicised and poorly attended West London Mental Health Trust (WLMHT) meeting in Ealing Town Hall on 23 July 2013 mental health primary care plans for Ealing were revealed.


Ealing GP practices are to be financially ‘incentivised’ to offer mental health primary care services.  If they decline this offer, mentally ill patients at those practices will be deprived of primary care services.  WLMHT says that GPs will be given training in mental health primary care ‘this summer’. WLMHT admitted that this training had not yet started.  Only passing reference was made to resourcing challenges. Estimates of cuts to the NHS NW London mental health services are £43 to £54 million by 2015.


The few mental health service users and carers who attended the meeting expressed their disapproval.  Members of the Ealing Clinical Commissioning Group (ECCG) were on hand and they attempted to placate users and carers, but to no avail.  One service user savagely bemoaned the annihilation of the John Connelly Ward secure and successful mental health services at St Bernard’s Hospital.  She clearly had little or no confidence in moving the ‘setting of care’ from a secure, dedicated mental health hospital to GPs’ surgeries and her own front room.  No engagement has been attempted with service users, and the John Connelly Ward users wanted the ward to be re-opened.


This whole farrago exposes one of the flaws in the setting up of the NHS in 1948.  GPs should have been engaged as NHS employees way back then. The spectre in Ealing of GPs  – independent traders – electing not to provide mental health primary care is outrageous and very dangerous.  However, the NHS has no statutory requirements to insist that GPs should provide these services.


What a very worrying shambles.  Why is the NHS so unwilling to engage with its local communities during the formative stages of plan making?


My own experience of GPs and mental health issues is that the majority of GPs are not interested in dealing with mental illness.


Dedicated Government Press Campaign to Destroy our Public NHS?

Never in my lifetime can I remember such a relentless ‘headline’ campaign attacking a public service as the one now taking place on the NHS.  Every day newspapers, radio and TV are dominated by lead stories which expose, embarrass, denigrate or ridicule NHS staff, organisations, performance, outcomes, deaths, care standards, statistics, etc, etc.


No doubt there are regular failures in other public services, such as law and order, public housing, child protection, health and safety, not to mention private health care.  However, those involved in other public service failures must be delighted that they are not being pursued by a dedicated press campaign to expose their failings. When are we going to be asked if we would recommend Ealing Police Station to a friend?


‘Death Rates’ Explained


To quote ‘Private Eye’:

‘The Hospital Standardised Mortality Ratio (HSMR) represents the number by which the deaths in a particular hospital exceed the number that would have occurred if the hospital had had the national death rate for each age, sex and diagnostic group etc. for which adjustments are made.’


HSMR cannot be used to determine precise numbers of deaths.  However, the HSMR can alert managers and regulators to a potential problem or problems.


Sir Bruce Keogh’s review of 14 NHS Trusts with high HSMR rates is seen by many informed observers as being of value.  For the Coalition Government to use the review as a weapon to attack the Labour Party is pathetic. Keogh’s plea for NHS inspections to be carried out by doctors somehow got lost in the political crossfire.

NHS Good News Gets Little or No Coverage and NHS Media Failures Past and Present

Maybe in some ways the crisis is in the media coverage of the NHS and the Government’s public press relations policy to rubbish the public sector NHS services at every opportunity. However:


+ ‘The Guardian’ 20 July 2013 Letters page contains glowing personal experiences at NHS treatment centres including those in Freeman Hospital Newcastle, Barts, Homerton, a Drop In Centre in Sheffield and Kings College Hospital London.


+ As I queued for my appointment this month with the so called Independent Reconfiguration Panel I spoke with a local Paediatrician who was queuing to go in before me. He said Paediatric services at Ealing Hospital had never been better than they are now and it was clear that service needs are growing. The NHS/Government plans to close Paediatrics at Ealing Hospital will have disastrous consequences he said.


+ I’m reading the fascinating but shocking book ‘NHS SOS’. In it are chronicled failure after failure by the BBC and national broadsheet newspapers. These organs failed to report the various moves in the Bill and in Parliament to privatise the NHS and remove the statutory right for the Government to provide a universal health service. These news organisations bought all the garbage about ‘GP led’ Clinical Commissioning Groups and more or less completely missed the looming prospect (now a reality) that 49% of NHS ‘work’ could be private/paid for.



I make no excuse for devoting much of this newsletter issue to the works of the excellent Keep Our NHS Public (KONP) campaign group. KONP was formed in 2005 by the NHS Consultants Association, NHS Support Federation, and Health Emergency.


Keep Our NHS Public (KONP) – www.keepournhspublic.com

I attended the KONP AGM in Central London on Saturday 13 July 2013. It was impressive in every way. 100 people attended from all over England. KONP now has 36 groups established throughout England. Its HQ has paid staff and in 2012 its operations showed a healthy surplus.


Guardian columnist and number one broadsheet newspaper NHS campaigner Polly Toynbee delivered the Keynote Speech. It was packed with useful facts and insightful views. You might hate the Labour Party for kicking off the current Coalition NHS privatisation – she boomed – but surely they could not do a worse job than the Coalition. UKIP won’t make any Parliamentary inroads in 2015 so your least worst option is to support the Labour Party! Single issue save the NHS Parliamentary candidates are unlikely to succeed she says.


Just what are the Department of Health and Jeremy Hunt actually for asked Wendy Savage. Hunt no longer has a statutory duty to provide a universal healthcare service. Is he just there to whinge about how bad the NHS is so that his private healthcare chums can come in and take it over? Polly was positively apoplectic about the failure of the BBC to accurately report what is happening to the NHS and the laziness of BBC journalists to supinely be spoon fed Government propaganda. If you don’t like BBC coverage on NHS matters phone the BBC and complain on 03700 100222.


It was clear from the meeting Q and A that more good work could be carried out by KONP in soliciting and receiving Union grant funding nationally, regionally and locally.


KONP felt it had failed somehow by not being able to kill off Section 75 of the Health and Social Care Act 2012. However successful concerted efforts by many had watered it down so that potential delays and ‘wiggle room’ have been introduced into this open sesame for private healthcare providers.


We have all failed to prevent the damaging and at times absurd introduction of European competition law into NHS processes. Possibly sensible  hospital/service mergers are now being halted/delayed while competition lawyers earn huge fees arguing the case for the glories of competition. Polly Toynbee quoted chapter and verse of the merger of Bournemouth and Poole hospitals now subject to an OFT competition review. Earnings by competition lawyers is £1.67 million so far on this case!


Many fears were expressed about the impending US/EU free trade agreement. If the Transatlantic Trade and Investment Partnership (TTIP) agreement, when signed, includes healthcare services, it will grant transnational corporations rights to access public procurement in England. KONP will lobby heavily to try and gain an exemption for the NHS in the TTIP. It will also lobby for exemption from ‘investor protection’ which allows corporations to sue governments for loss of future profits. TTIP is expected to be signed in November 2014. More information at:



However KONP did highlight some successes.


The 2013 book ‘NHS SOS’ edited by Jacky Davis and Raymond Tallis was rightly praised. I bought a copy. (ISBN: 978-1-78074-328-8. Publishers Oneworld – www.oneworld-publications.com). The book is both brilliant and disturbing.


The demo about BBC failures and inaccuracies in reporting on the destruction of our NHS outside the BBC in Portland Place caused quite a stir.


Many delegates wanted KONP to remain apolitical.


We all agreed that healthcare and social care must be integrated together.


One Manchester delegate suggested – quite correctly in my view – that KONP should reach out to synergistic campaigning groups like Shelter, Amnesty International, student unions and medical students’ networks.


The Lewisham Hospital campaign had shown us all the power of NHS Staff and residents working together. The 25,000 on the Lewisham march was awesome. However 6,000 nurses have lost their jobs in recent years and many of those remaining in the NHS are nervous or afraid of demonstrating.


Local democracy is under attack. All CCGs have just 5 elected local GPs and 25 paid officials. National democracy is under attack. CCGs report to the new NHS Commissioning Board now renamed NHS England which is directly accountable to no-one in Government.


There was universal agreement on the fact that the vast proportion of the population and huge numbers of NHS staff have little idea of what was actually happening to the NHS.


Jeremy Hunt Says NHS is Failing: If So Then He Must Take the Blame and Be Fired

Thousands have died needlessly apparently at 14 NHS hospitals in 2010 to 2012. Casualty and maternity units at the poorly performing hospitals may close.


All this data appears in a research report from NHS Medical Director Bruce Keogh and was broadcast in Parliament by Health Secretary Jeremy Hunt MP on 17 July. Clearly these NHS failings are happening on his watch and clearly he must be fired.


No doubt we are all assumed to deduce that the key to failing hospitals is to close them down, demolish them and sell the land for residential development (like Ealing Hospital). No doubt altruistic global healthcare companies will step in and offer new casualty services (such as at the BMI Clementine Churchill Private Hospital in Harrow) and new maternity services (such as at the HCA Portland Private Maternity Hospital in Great Portland Street, W1).


The ‘NHS SOS’ book tells us that 70 MPs and 142 Peers in the House of Lords ‘…have a vested interest in the promotion of private healthcare’. So the Right Wing press rubbishing the NHS may be the softening up process before we are all bludgeoned into ‘believing’ that the public sector can’t hack it and it’s time to bring in those wonderfully efficient private healthcare companies…..


Urgent Care Centres are Nothing of the Sort: 44 Medical Conditions Are Excluded

Care UK ( ‘Fulfilling Lives’ is their catchphrase ) advises us that its UCCs (like the one at Ealing Hospital) do not treat:


‘ACS/MI, acute anaphylaxis, actively suicidal/deliberate self harm (not suicidal ideation), acute confusion, alcohol or drug intoxication (likely to need obs), alleged rape (with major injury), children with complex fracture of upper or lower limb likely to require manipulation, complex fractures/pelvic fractures/hip or long bone fractures, colles fracture, collapse state, currently having seizure, CVA/TIA (separate pathway), dental injury (Northwick Park maxfax), Dvt or suspected Dvt, extensive burns, fever with oncology, hematuria post abdominal injury, inhalation of smoke or fumes, mandible dislocation, major head injury, meningitis or suspected meningitis, needle stick injury, overdose, penetrating eye injury, poisoning, pregnancy with persistent vomiting, psychosis, PV bleeding (heavy) ( pregnancy less than 20 weeks to ED and more than 20 weeks to obstetrics), pregnant with abdominal trauma, paediatric white card holders (will go directly to paediatrics), patients with GP referral letter go to speciality direct, renal colon (blood positive on urine dipstick), severe pain (requiring parental analgesia), severe breathing difficulties, shoulder dislocation, Sickle Cell crisis, significant epistaxis, significant haemoptysis/haematemisis, gunshot injury, significant stab wound, unconscious, uncontrollable haemorrhage and unresponsive floppy child’.


So – after Ealing Hospital A&E closes you’ll need to check through this list before rushing yourself or your loved ones for ‘urgent care’ to Ealing Hospital or Northwick Park Hospital or  West Middlesex Hospital or Hillingdon Hospital or where ever else.


Whittington Hospital Plans Ripped Up!

People power appears to have forced the cuts and sell off plans for Whittington Hospital in Camden to be withdrawn and the Board to apologise for coming up with cuts without a clinical plan in place. However local activists say the Board still wants to become a Foundation Trust and ‘transfer hospital services into the community’. Whittington Hospital is also the place that Ealing CCG supremo Rob Larkman disappeared from ‘overnight’ in 2011 when his NHS plans to close A&E and Maternity were rubbished – again by people power.


Camden Council Agree Public Inquiry into Harmoni

Camden Council Health Scrutiny Committee has agreed to set up an inquiry into Care UK’s Harmoni running of North Central London’s Out of Hours GP service. Keep Our NHS Public in Camden proposed the inquiry on the basis of Harmoni failing its CQC inspection and the contract being awarded on price not quality.


Privatising Our Blood

An American private equity firm – Bain Capital – has agreed to pay £200 million for 80% ownership of state-owned Plasma Resources UK, the main blood plasma supplier to the NHS. The deal was roundly condemned by cross-bench peer Lord David Owen who described the deal as ‘the worst possible outcome’. Professor Allyson Pollock, a prominent public health researcher, warned against Bain asset stripping and subjecting our blood supplies to open market economics.


Would You Recommend Your Local Hospital to a Friend?

This is the latest nonsense in ‘consumer tests’ on hospitals.  We don’t have such tests on Police Staions, state schools, Job Centres or Magistrates Courts.  Why is that? Well, it’s probably because it’s political dogma that is driving the Coalition Government to denigrate state healthcare so that it can be wheel in private providers.


Ambulance Chasers are Alive and Well

I visited West Middlesex University Hospital on 23 July 2013. Whilst waiting I glanced at an NHS leaflet on ‘Knee Injury’. Quite useful information. However filling the back page was an advertisement by a firm of solicitors – ‘Had an Injury?….let our super lawyers help you with your claim…’


Words fail me.