LondonMix

Yes, much more. Derivatives desks are dominated by the French. There are many more French, especially in the heavily mathematical areas of finance, than any other single European country in my experience too.

I agree with you H on all points. I only included commuting times etc to show the "indirect economic" factors that are considered to provide some greater detail. In one of the documents I read, it appears the regeneration of New Cross or Catford (including greater residential development to deal with population growth) is trying to be included in the business case for the reasons you've stated. Extending the tube into the suburbs cannot otherwise be justified even according to Lewisham Councils own analysis.

It isn't. Within the cost benefit analysis, shorter commuting times, relieving pressure on London Bridge services etc are all given a value. Regeneration and job creation though is important.

Agree, this is beyond petty. Homes with off-street parking cost more so clearly its considered desirable and hardly shocking someone took advantage of local policy. If you think people shouldn't be able to get dropped curbs in the local area due to parking pressure issues, then take it up with the council.

Oh, wow. Did they ever find out what happened? I found the old threat. At least it doesn't appear anyone was hurt.

This reminds me of that story a while back in which Pringles was arguing for tax purposes that they weren't a potato chip because there was hardly any potato in them!

Rice cakes are NOT cakes! No one on earth would consider a rice cake an actual form of cake...

No, not at all. I really don't know very much as I don't know much about healthcare or the NHS. I have read the report in detail is all and tried to follow the protests in the press. The report itself is very detailed (it took me 3 hours to get through). Because Kings is involved in the reorganisation (its absorbing one of the hospitals), I wanted to understand what was happening to the greatest degree possible.

Where in ED do you live? If its convenient for you, the surgery on Forest Hill Road has always been fairly good when I've needed them.

There was a drive-by shooting or is that a joke!

Ah, I see. Looking at the list I don't see any relationship at all regarding taste etc. Some of my favourite places scored pretty low and some scored pretty high. I think all the rating means is that the kitchen is dirty or clean-- simples!

That list of 5-star rated places seems to have ommited all the non-chain restaurants that contradict your point like: Franklins Indian Mischief Le Chandelier Scoop The SeaCow The Actress The Great Exhibition There are quite a few more in the 4 category as well (The Palmerston, Bluebrick Cafe). Good food does not necessitate a filty kitchen. StraferJack Wrote: ------------------------------------------------------- > let's look at some of those 5 star-rated places > > Adventure Bar > Barcelona Tapas > Cafe Nero > Dominos > GBK > Clockhouse > > non-existant food, bland pap or just plain ropey

The explanations int his thread are all partially right I think. Burbage?s comment while perhaps too nihilistic touches upon some research that has been done regarding food choices in sub-Saharan Africa. People who are chronically malnourished, when they get extra money, are much more likely to spend it on something that brings them pleasure (like a TV) than extra food at first. Life is a fine balance between pleasure and taking care of yourself. If the only luxury you can afford is what you believe is tasty high fat treats, then it makes sense. However, I don?t think anyone making poor food choices is intentionally attempting to shorten to kill themselves or shorten their lives. The other extreme argument that poor people are fat because they are undisciplined and lazy again slightly touches on some truth while again being too extreme. Long-term thinking and impulse control are associated with being wealthier and healthier later in life. There was a study on this as well looking at children who could resist eating a cookie for 15 minutes for the reward of getting 2 cookies instead when the time was up. The kids who lacked will power, when followed up later in life, were fatter and did worse in school and were more likely to have had run-ins with the law. Cultural and eating habits of those who traditionally may have done manual labor have also probably been slower to change to reflect more sedentary lifestyles now. Ignorance about nutritional issues does play its part?I?ve seen how information from doctors has transformed some of the eating habits in my own extended family despite cultural norms about eating very starchy, heavily fried foods in West Indian culture.

To those of you like SJ who believe this was just some Whitehall type proposal totally divorced from medical / clinical considerations please note that clinicians were very involved with coming up with the Kershaw's recommendations: 24. A clinical advisory group ? composed of clinicians from all NHS organisations in south east London, and a patient and public advisory group ? formed of representatives of Local Involvement Networks and patient councils ? have fed directly into a TSA advisory group. 25. An external clinical panel has provided additional scrutiny to the development of the draft recommendations. The panel was assembled to act as a ?critical friend?: an independent group that fully understands the context of the work and can provide constructive criticism and ask provocative questions. In carrying out its function, the panel has provided the programme with valuable insights, based on independent clinical expertise. It has played a key role in challenging the development of draft recommendations, for example, to emergency and maternity services and is supportive of the proposals and options in this report.

AlexK, the proposal was actually put together with the endorsement and input from various clinicians and the issue you raise is why the maternity services would have to change with the change of the A&E to a UCC. There have been a few options on the table including only a mid-wife led unit dealing with low risk births which is considered clinically safe without full emergency capabilities at the hospital. However, continuing to deal with complex, high-risk births without full emergency capabilities was deemed too risky by the independent clinical panel. Please see extract from the report where this is discussed in detail: 158. There are two options under consideration for draft recommendations relating to maternity services. In both options ante-natal and post-natal care would be provided, as now, at all hospital sites and in the community. The option of a home birth would remain open to women. The two options relate to women who need to be admitted to hospital during their pregnancy and those women who need, or wish, to have an obstetric-led delivery. The two options are whether south east London has four or five hospital sites providing obstetric-led services: ? The option of 4 hospital sites: King?s College Hospital, Princess Royal University Hospital, Queen Elizabeth Hospital and St Thomas? Hospital would all provide obstetric-led births, meaning these services are co-located with full emergency critical care. This co-location was the initial proposal developed by clinicians and endorsed by the external clinical panel. However, this option would mean the 4 sites would need to increase capacity which would require some investment. ? The option of 5 hospital sites: King?s College Hospital, Princess Royal University Hospital, Queen Elizabeth Hospital, St Thomas? Hospital and University Hospital Lewisham would all provide obstetric-led births. In this option University Hospital Lewisham would not have full emergency critical care co-located with its maternity unit; instead it would have a surgical high dependency unit (HDU) with obstetric anaesthetists present. This means the service would only take lower risk obstetric-led births. This option would provide better access to obstetric-led services in south east London. It would also provide more resilience to the needs of a growing population. However, the external clinical panel has expressed some reservations about the clinical sustainability of this model. 159.There are benefits and risks associated with each of these options (see figure 25). Therefore, the external clinical panel has recommended that further work is undertaken to examine each option. There are also different views on the expected population growth and birth forecasts within south east London over the next 3 ? 10 years. Broader engagement in exploring these options will be sought through the consultation process. Agreement will be sought on the number of births forecast so that correct capacity requirements can inform the work. The outputs of this will be scrutinised by the external clinical panel and a recommendation will be made by the TSA in the final report in January 2013.

It wasn't about Lewisham, it was about the South London Healthcare Trust. Lewisham delivers a good service but due to its small size is very vulnerable to cost swings as it doesn't have economies of scale. Lewisham's Trust will take over one of the hospitals in the South London Healthcare Trust. Anyway, the proposal is absolutely not for the hospital to close as you rightly say! Certain services will be reduced and new services will also be added...

It concerns me a great deal which is why I spent 3 hours reading the full report. The decision, before looking into it, struck me as very odd, which is why I decided to try to learn more. Bad decisions are made by people even with good intentions all the time. All of us, including Kershaw et al, are only human and are entirely fallible. That's why I would like to try to critically assess all of the assumptions. I've tried to find out what I can regarding waiting times at UCCs etc and it appears to hold up but there might be a million and one things I as a non-expert might be overlooking. I would urge everyone to read the report and engage with it. I want what's best for SE London healthcare, whatever that might be.

Also, the idea would be to create a specialist elective surgery (like hip replacement and knee surgeries) unit at Lewisham as part of the changes. Waiting times for these surgeries are currently too high in SE London because when they are housed in a hospital with an A&E the surgeries too often have to be postponed at the last minute due to demands on staff to deal with urgent life-threatening surgeries that arise. By creating a specialist centre at Lewisham (where there will be a UCC but no A&E) serving all of SE London, scheduled surgeries of this type won't be cancelled at the last minute thus reducing waiting times for these procedures across this entire part of London.

The hospital is not closing. The A&E will become and urgent care centre which can treat all non critical (so broken bones but not strokes) issues. 70% of Lewisham's cases are already issues that the proposed 24/7 UCC will be able to deal with. Waiting times at UCCs are shorter than at A&E's for people with non-life threatening issues for the reasons I explained in an earlier post.

No, SJ I'm just saying the report isn't the first time those involved with the NHS (as reporters or staff) seem to have been aware that perhaps there are too many A&Es to be viable in the area. You seemed to suggest that no one new this was a concern before the report in your previous post unless I misunderstood you. I'm not saying that's true- others closer to the NHS on the EDF have. If this isn't true, the argument against changing Lewisham falls apart. That's why I have repeatedly asked about this as this is really the crux of the entire proposal. If it is true that there are too many A&E's then how you decide which to close has to be done by geography and services-- you can't close a hospital if it meant that a portion of the population would have greater travel times via blue light ambulance than minimum safety guidelines allow. Also, you need to have an appropriate spread of hospitals with certain specialisations like stroke, major trauma. Anyway, here is the report for anyone who hasn't been able to find it but would like to read it. http://www.tsa.nhs.uk/sites/default/files/TSA-DRAFT-REPORT-WEB.pdf

There already was the realisation that there were too many A&E's I think based on what some who work for the NHS in South London have already said on another thread about this issue (I don't know myself). Nick Triggle, BBC's Health Care correspondent well before this report was published argued the same so it appears to be a well understood problem for some time. I do know that the people waiting 3 hours at an A&E (usually for urgent but non-critical injuries) are in part waiting that long because they are at an A&E vs and urgent care centre. At urgent care centres (like the one being proposed) people in need of stitches and with broken bones are not constantly being pushed down the queue by more serious emergencies like heart attacks, reducing waiting times for those who aren't critically ill. This isn't to say that the decision to make the changes at Lewisham is the right one. However, I do think it's important to engage with the actual proposal if you are going to argue against it. Some issues are complex and the right decision isn't always obvious to everyone unfamiliar with all the details and I don't think saying that is condescending. I don't think there is anything insulting or bad about acknowledging that. I actually think its condescending to assume the general public can only understand fire in the belly rhetoric.

So the viable alternative is something those who oppose the changes at Lewisham understand but refuse to articulate! I have been trying to find a credible argument against the closure (that the analysis in the report is wrong on any front / that there is a better alternative etc). If someone who is passionate about this actually has any information like this from a credible source, I'd like to read it. Just because the report reaches certain conclusions doesn't mean that should be the end of the discussion but I do want to engage with actual facts and analysis... Saffron Wrote: ------------------------------------------------------- > Use your noodle.

The common would be smaller (potentially not too much smaller) for an entrance to a subway station to be built on it. I have no idea how much of the common would need to be used for this (or if the entrance would be the grassy park across from the common). I just want more details regarding the plans and how they will affect existing amenities like this.

What are the other viable options that work as well?

GEEK, it's not really responsible to suggest citizens support projects without any information or understanding of the options and trade-offs. I support the extension but I want to understand if (and how much) of Peckham Rye Common would be destroyed in the process. ED History's question regarding the geological survey gets to the heart of the feasibility of the current proposal. If this hasn't been taken into account, then the analysis carried out regarding costs and the cost benefit analysis won't hold up which means it would be less likely to go forward. I hope the extension happens and that we can secure the funding (I would personally benefit enormously) but supporting something with absolutely no facts is ridiculous.