Lewisham Hospital gets its case argued

[fl0wer]

Anyone who enjoys reading Polly Toynbee - fresh column inches here http://www.guardian.co.uk/commentisfree/2013/jan/25/lewisham-start-hospital-protests-to-come

Sorry - can't say whether its newspaper comment thread is worth joining - see for yourselves.

[klove]

And don't forget the march tomorrow!

http://www.savelewishamhospital.com/demonstration-26th-january/

[Marmora Man]

You could also read this which suggests opposing the closures is ill advised if we want to get the best out of the NHS. Rather better point of view than Polly T's instinctive opposition.

http://www.guardian.co.uk/society/2013/jan/24/urgent-access-accident-and-emergency

[Otta]

Rather better because it matches your's MM?

I'm sure there are some very good business reasons why the proposals may be a good idea, but everything just can not come down to finances.

[malumbu]

It's shite. There is my business reason against the closure.

[malumbu]

As in the argument is shite, rather than the hospital I hasten to add.

[Annette Curtain]

Lewisham essentially saved my youngest child and my partners lives.

I can't thank them enough, they treated us with admirable professionalism and genuine care.

To close a hospital like this would be a massive loss.

Please attend the march if you can

Netts

[Huguenot]

I don't think that's reasonable Nette.

Here's that notorious right wing hate rag : http://www.guardian.co.uk/society/2013/jan/24/nhs-politics-closures

Your youngest child and partner would have been treated somewhere else with equal professionalism and genuine care.

The NHS should not be run by tub thumpers.

[Top Banana]

South London Healthcare's problems have been complex and longstanding but can be entirely nailed down to PFI. PFI was an utterly insane idea by both Conservative and Labour.

[Marmora Man]

Top Banana Wrote:

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> South London Healthcare's problems have been

> complex and longstanding but can be entirely

> nailed down to PFI. PFI was an utterly insane idea

> by both Conservative and Labour.

Not quite - how can something be complex longstanding AND entirely the fault of PFI?

For most of the life of the NHS - managers / administrators spent their budgets unwisely - and the fabric of the hospitals suffered because only the minimum was ever spent on upkeep and maintenance. Hospitals relied on large dollops of capital injected every 20 / 25 years to make up for this failing and build a new hospital. One of the effects of PFI was to build into the running costs the proper and sensible cost of routine maintenance - which had a twofold effect.

1. PFI hospitals will still be safe, effective buildings in 25 years time - not crumbling and leaking edifices requiring major injections of capital.

2. NHS management had to fund this cost of proper maintenance - which reduced the amount of P&L expenditure available for the clinical side of the business. Most found this very difficult to do - but it was every sensible operator of services & buildings would do elsewhere.

As a city London has too many hospitals too close to each other. Rationalisation and co-location of critical services will allow for improved services and more effective use of a, necessarily, curtailed budget.

[Marmora Man]

Otta Wrote:

-------------------------------------------------------

> Rather better because it matches your's MM?

> I'm sure there are some very good business reasons

> why the proposals may be a good idea, but

> everything just can not come down to finances.

Rather better yes because it reflects my views. However, my views are shaped by over 20 years working in the healthcare sector - in the NHS, contracting with the NHS, in independent hospitals and in delivering large projects for the NHS. I consider therefore that I bring real knowledge and objective understanding to this topic, rather than Polly T's instinctive opposition to coalition policies and other's more sentimental / emotional arguments.

[LondonMix]

If you actually read the report (how many intending to march have actually bothered?) you'll understand the issues at hand much better. Make up your own minds but the decision has sensible, well reasoned arguments behind it.

[Annette Curtain]

Mine's an emotive & personal view. Plus, I like tub thumping as H puts it.

[Carrie]

This is a response from someone who has read the report (sorry can't see how to make it a link)

www.goonerjanet.blogspot.co.uk

[Otta]

I've read the report, but I get a bit fed up with the patronizing tone of people saying "here are all the good reason, if you disagree it must just be because you're an emotional weakling". Sometimes emotive arguments are valid, particularly when a community is trying to save a valuable resourse.

I have a pretty good understanding of budgets within local authorities and PCTs, and as I said before, I wouldn't say that none of the arguments for these changes are valid. However, I believe that there are valid arguments on both sides, and I personally think the services at Lewisham Hospital need saving.

[LondonMix]

I hasten to add the the idea is not to close Lewisham Hospital. Lewisham's A&E will be turned into a 24/7 Urgent Care facility with the ability to deal with the vast majority (70%) of the cases that currently come through its A&E. The hospital will also be expanded to create a new specialist non-complex surgery unit (which is missing from SE London) to deal with non-emergency surgeries. Currently, wait times for these are unacceptable because when these types of surgeries (hip-replacement / knee surgery etc) are done at hospitals with A&E units, they often have to be cancelled or postponed as the surgeons are called to deal with major traumas.

The decision to create this new surgery unit and urgent care centre at Lewisham was based on the specialist emergency care units (and their geographical spread) available at other SE London hospitals-- major trauma, stroke, heart attack etc. Lewisham has a specialist emergency paediatric unit but there are 2 others at other South London hospitals (totally 3). When deciding which A&E to transform into an Urgent Care Centre, the travel times by car and blue light ambulance, the specialist units the hospitals have within their A&Es, as well as the types of cases the A&E is currently dealing with were all considered.

[Otta]

Is 70% a "vast majority"? That still leaves 30% (a pretty big number) that they'll have to send elsewhere.

[LondonMix]

Yes, but less critical cases should be directed to the UCC from other hospitals. Waiting times are better for those with non-critical injuries at urgent care centres than attending A+E (since critical cases are not constantly being prioritized over non-critical injuries).

The only real arguments against the propsals I can see are if there is an argument that 5 full blown A+Es are objectively needed vs 4 + a UCC (in terms of health outcomes / travel times and waiting times). Or if the emergency travel times in the report based on the proposed reconfiguration are wrong- while travel times for Lewisham residents to an A+E would be longer, the report analyis says they will still be within national guidelines.

[Otta]

Another view, which no doubt wilk be dismissed.

labourlist.org/2013/01/the-arguments-for-cuts-at-lewisham-hospital-dont-stack-up/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+LabourListLatestPosts+(LabourList)

[Saffron]

LondonMix Wrote:

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> If you actually read the report (how many

> intending to march have actually bothered?) you'll

> understand the issues at hand much better. Make

> up your own minds but the decision has sensible,

> well reasoned arguments behind it.

I'm aware, and I do understand that, BUT...

There are also sensible and well-reasoned arguments not to impose these cuts to services at Lewisham.

Personally, I don't like the precedent it sets if Lewisham hospital services get deconstructed over these current issues. So, then, anytime a couple of hospitals aren't doing great, instead of actually doing what's morally and financially necessary to improve them, we'll just look to the nearest well-functioning hospital and carve it up instead? These aren't good long term solutions, IMHO.

[StraferJack]

Reasons schmeasons

I don't hold any truck with most class based waffle on here but I would stake my life on the following

If this hospital was in well heeled Tory heartland it would not be closed

Even if all same logic and reasons applied

It just wouldn't be

I can hear some people splutter already. Save it. THAT hospital wouldn't be closed

No

It

Wouldn't

But you know... What's the worst that can happen to the people closing this hospital

[Saffron]

yes, that too

[Otta]

StraferJack Wrote:

-------------------------------------------------------

> Reasons schmeasons

>

> I don't hold any truck with most class based

> waffle on here but I would stake my life on the

> following

>

> If this hospital was in well heeled Tory heartland

> it would not be closed

>

> Even if all same logic and reasons applied

>

> It just wouldn't be

>

> I can hear some people splutter already. Save it.

> THAT hospital wouldn't be closed

>

> No

>

> It

>

> Wouldn't

>

> But you know... What's the worst that can happen

> to the people closing this hospital

What he said! x 10

[sillywoman]

and another 10.

[Marmora Man]

Saffron Wrote:

-------------------------------------------------------

> LondonMix Wrote:

> --------------------------------------------------

> -----

> > If you actually read the report (how many

> > intending to march have actually bothered?)

> you'll

> > understand the issues at hand much better.

> Make

> > up your own minds but the decision has

> sensible,

> > well reasoned arguments behind it.

>

> I'm aware, and I do understand that, BUT...

>

> There are also sensible and well-reasoned

> arguments not to impose these cuts to services at

> Lewisham.

>

> Personally, I don't like the precedent it sets if

> Lewisham hospital services get deconstructed over

> these current issues. So, then, anytime a couple

> of hospitals aren't doing great, instead of

> actually doing what's morally and financially

> necessary to improve them, we'll just look to the

> nearest well-functioning hospital and carve it up

> instead? These aren't good long term solutions,

> IMHO.

"instead of actually doing what's morally and financially necessary" - when there are constraints on what is financially possible this absolutist position cannot be sustained. The report proposes a sensible and rational compromise. Sir Bruce Keogh has deplored politicians that oppose sensible rationalisation, as did Lord Darzi on the Today programme his morning, as actually damaging the NHS and affecting its ability to deliver optimum healthcare to the greatest number of people. Selfish might be another description.