LondonMix

Great, thanks

And my questions?

Cried with laughter! Help-Ma-Boab Wrote: ------------------------------------------------------- > Was it ever open? > > macrobana Wrote: > -------------------------------------------------- > ----- > > Why did Jacks close?

I was recently burgled (its terrible). However, the forensic team told me that East Dulwich's burglaries are way down since 2010 and very low compared to most of South London (Lewisham and Lambeth got name checked as particularly bad). Don't know if he was just trying to make me feel better.

Thanks for the update Renata. So are all three schools previously discuss- Dulwich Hamlet, Bessemer and Langbourne- definitely going to be expanded. If not, which ones? Has the funding for all of these expansions been secured? How much of the funding is from the Department of Education and where is the balance coming from?

That's for the great link at Sense about Science.

So where do things stand? The total number of new primary school places needed for the area is 260 from what I understand. The Harris Primary school (being a 2 form entry) would deal with 60 of this 260 place shortfall. That would still necessitate 7 bulge classes a year throughout this part of South London. Renata, are you still exploring alternatives to such a high number of bulge classes? If all 3 schools you are in discussion with expanded, that would reduce the shortfall from 200 to 110? Can you please also respond to my earlier questions regarding timing and funding? Thanks, LM

Sorry to hear about your loss ZT. I have to say, H can be too aggressive when making his points but in this thread I do think its tit-for-tat. M&M fairy has said some pretty unpleasant things so in my view if you can dish it, you should be able to take it.

People are starting to confuse two different yet important issues. Post cultivation waste is bad and ways to reduce this should be explored. Resource intensive cultivation is also problematic. Addressing one issue doesn't justify allowing the other to persist. The average difference in yield across all organic products is circa 30percent which is signifant. For certain specific items its much less and for others its much more. Yield / resource intensive production is an issue that needs to be addressed.

You mean this forum :)? I live in ED but I think Peckham Rye and ED are close enough together to think of the amenities of each being available to all residents hence why I commented. It's silly acting like people in ED don't go to Beggin' Bowl or that Peckham Rye residents don't come to Lordship Lane. I occasionally go to the Horniman Museum too in Forest Hill when I really feel like an adventure away!

Are you saying you believe the distance children will have to travel to A&E and the quality of care they will receive in the other hospitals is life threatening? I find that hard to believe. If a child is suffering from a major trauma any responsible parent would call an ambulance or drive if they thought that would be quicker and had a car (and ambulance times to A&E, if the stats are correct, would remain well within clinical guidelines even if Lewisham's A&E closes). If its not clear to the parents that a child's injury is quite that serious, I imagine they would go to Lewisham's Urgent Care Centre where they would be assessed quickly (because as you say children have priority) and then transferred via ambulance to another hospital if necessary. Other SE London hospitals have Paediatric A&E departments (Kings and Queen Elizabeth I believe). Do you have any specific cases where the time delay (essentially the time for the ambulance transfer between Lewisham and its closest A&E) would have grave consequences beyond what is considered acceptable?

There are many factors on which you can assess farm management. Health and welfare of the animals, safety of the cultivated products, and resource consumption among them. There are ways to increase yields and thus reduce resource consumption that don't necessarily conflict with organic farming methods. My point is, resource consumption per unit of output should be a greater focus within the broader discussion of food and farming and it is often forgotten outside of academic circles (where it is a huge focus). Most organic produce require significantly more energy for their cultivation because yields are so low. This is something that can and should be addressed through better farm management practices as it doesn't have to be this way.

Yield has more implications than just the quantity of food produced. If one farm uses the same resources as another farm but can only produce half the amount of crops, that farm is wasting limited resources (energy, water, land). Yield is linked with conservation of resources not just increasing the food supply.

Yes, yield is extremely important and often ignored. Farm management that increases yield is key to many food and energy issues. Huguenot Wrote: ------------------------------------------------------- > Surely the fairly obvious point is that you can't > feed a conurbation of 25m people from a pocket > farm on the Surrey borders delivering boxes of > endives. > > New agrarianism is a middle class conceit. > > I don't know about nuance, but any conversation > about agriculture needs to start with bulk!

Ah, I see. So your concerned Kings in particular will be the favoured choice of Lewisham residents so the other A&E's will be underused while Kings is overused. I suppose policy and coordination will be necessary to tackle that and the draft recommendation doesn't really address this.

So you think the travel times are unrealistic and that closing Lewisham admissions will lead to a shortage in hospital beds?

It would be great if someone could comment on the below: ? Closing Lewisham?s A&E wouldn?t drop travel time standards below national guidelines. It isn?t made clear if closing any of the other A&E?s would result in similar, better or worse changes relative to the Lewisham option. ? Lewisham (unlike most of the other hospitals with A&E?s) doesn?t appear to have any of these specialist care divisions: stroke, vascular, heart attack, major trauma. Can someone confirm this is true? You couldn?t close the other hospitals? A&Es that have these specialist units with without also shutting down the specialist care units which would have serious health implications for SE London ? Probably because Lewisham doesn?t have a specialist care division like Princess / Kings et al, the most serious cases are already diverted via the ambulance service to the neighboring hospitals. Therefore, 77% of cases coming through Lewisham?s A&E currently don?t require admission (fractures/ stiches/ burns/ etc) and could be dealt with by the proposed Urgent Care Centre that will be open 24/7. Urgent care centres have shorter waiting times for people suffering from the types of injuries they deal with as more serious cases aren?t constantly being prioritized. ? The 23% of cases currently treated at Lewisham that would now be redirected to other hospitals amounts to 70 patients a day. It?s not clear in the report whether or not it?s assumed that surrounding hospitals can easily absorb this or if its assumed that patients with less serious injuries will be redirected to Lewisham?s Urgent Care Centre so the system balances out. ? The report suggests SE London is lacking a centre specializing in non-complex elective procedures (hip and knee replacements) and that a new centre serving all of SE London should be developed at Lewisham. Placing the Elective Procedure centre at a non-A&E hospital should reduce waiting times across SE London since currently, appointments often have to be postponed / cancelled due to the need for staff to deal with emergencies. More complex / riskier procedures will still need to be performed at hospitals with full emergency capabilities.

Exactly. This whole area is much more suburban and family oriented than Brixton which is still cooler / edgier with better ammenities (art-house cinema / tube / clubs etc). Its all about your stage of life. If you are still partying every weekend with your single mates, you might find the area a bit too quiet. With that said, there are lots of good restaurants / cafes / green open spaces etc and Peckham, more so that Dulwich, is has an increasing amount of interesting things going on (from what I've been told)

Simonthebeaver, you are right. It is an average deterioration across SE London. The impact on the Lewisham population is much worse but still remains within guidelines for blue-light ambulance journeys which are 30 min for strokes and 45 min for major trauma. Following the implementation of the proposal, the journey times via blue light ambulance (both on average for Lewisham and for 95% of the people in Lewisham ) would remain well within these guidelines. Even by private car, the travel times appear okay for time sensitive cases (assuming of course that the guidelines are correct and the travel analysis has been done properly). All of this is on page 69 of the report.

Yes, I agree. There are many other factors that for many would justify the consumption of locally produced food-- food security (as highlighted in flower's link) being one of them. My posts really weren?t trying to say don?t eat organic or don?t eat local. Just that if you are doing so because of concerns about energy consumption, then you are mistaken. Really, I would like to conversation to be more nuanced. Most academics studying these issues recognize that the best farm management practices (from an energy perspective when yield is taken into account, how the animals are treated and biodiversity supported on the farms) aren?t captured fully by either concept and often the very opposite of what the average man on the street might expect is the case.

Peckhamnearbe I've read the comments at the links you provided and I (genuinely) don't understand the arguments being made. Someone alleges the data in the studies is incorrect. Do you know which facts are seen as contentious? Also, do those who want to save Lewisham's A&E believe that SE London needs 5 A&Es or do they agree that 4 A&E's and a 24/7 urgent care centre would be better but think that one of the other hospitals should lose their A&E instead? If it?s the latter, which of the other hospitals and why (geographical spread / population density / relative quality of the A&Es, statistics regarding how many people need to be admitted in the various A&E departments)? If it?s the former (5 A&Es being best) what?s the basis for this argument? The draft report concludes that travel times to an A&E in SE London following the implementation of its recommendations would increase by 1, 2,and 3 min via ambulance, private car and public transport respectively. Do those who oppose the proposals disagree with this analysis or do they believe that the increased travel time is unacceptable from a health perspective? The specific analysis on the impact just on the population of Lewisham (pg 69) shows that journey times would still be within recommended guidelines (>95% of the population within 30 min of an A&E when travelling via blue light ambulance). Is this analysis being questioned? Medley, besides calling the proposals insane, can you be more specific regarding your opposition?

Not sure how it will work but transfer if it turns out admission is necessary seems likely. The report says Guys has a well established urgent care services (pg 61 paragraph 157) but that might not be accurate, I have no idea! Edited to add: Guy's describes the emergency service it offers as a UCC but unlike the one in Lewisham it doesn't appear it opens 24/7. Perhaps because of the close relationship and proximity with St Thomas? http://www.guysandstthomas.nhs.uk/our-services/emergency-care/urgent-care-centre.aspx buggie Wrote: ------------------------------------------------------- > > LM: Guys doesn't have an UCC, it has a minor > injuries unit which I believe has had it's opening > hours cut in recent years.

Yes, having read through the document more carefully it appears that the 4 hospitals that are to remain A+E's with full admission capabilities have specific specialist treatment units within their A+Es that will continue to serve all of South East London (major trauma, hyper acute stroke, emergency vascular and heart attack all of which already exist as specialist care units in 3 of the hospitals). The urgent care unit that will replace the A+E at Lewisham will be open 24/7 and will be able to deal with the vast majority of the types of emergencies (77%) Lewisham hospital currently manages via its A+E unit. Additionally, the plan is to create a new unique treatment facility at Lewisham. It would be an Elective Care centre serving all South East London for non complex procedures such has hip and knee replacements.

My point is that very simple and thus appealing idea that buying local in and of itself will result in a lower carbon footprint for your food is not correct. Its too simplistic a way to analyse food options. Under certain circumstances that might be the case and under others it won't be the case. Often, the true complexity behind the carbon footprint of imported vs. locally produced food is too much for us to understand without a host of other facts of which we are usually ignorant. I have nothing against locally grown food (I think it tastes better if nothing else) and there are other factors that might make it an appropriate choice for each of us. Your other points don't have any specific bearing on the local vs. imported choice. Cultivating meat and diary produce more emissions than vegetables and grain. That is well proven and giving up meat even one day a week will do more for greenhouse emissions and water use than most other dietary changes one can make. Promoting less polluting transport systems is certainly a good thing as well. I am in no way against trying to make things better. However, I just think its important that people understand the real facts behind the positions they are taking, particularly on complex issues. Local does not equal less carbon emissions.

I don't necessarily disagree. I just don't assume that those making the decision didn't take this into account. The upgraded facilities will probably still be used for the 24/7 urgent care facility that will operate in place of the A+E and is basically an A+E without admissions. Given 77 percent of Lewisham's A+E cases fall into that category hopefully it won't be wasted. Moreover, if there is a need to reduce A+E's and an opportunity to make sure each of the remaining A+E's have a unique specialization within SE London, this rationalisation might be of greater value on balance. There are rarely decisions that don't have trade-offs.