All District General Hospitals in the South East London area are to be ‘radically overhauled’ with their Accident & Emergency facilities closed, according to a consultation document ‘A Picture of Health’, circulated by joint Primary Care Trust bosses.
The document claims great benefits and a modern health service will emerge from the ashes of all the area’s District General Hospitals (DGHs), which will lose their A&E facilities and be reduced to ‘Urgent Care Centres’ under the scheme.
Hospitals affected are Bromley Hospitals (including the Princess Royal University Hospital and Orpington Hospital), Queen Elizabeth Hospital in Greenwich, Queen Mary’s Sidcup, and University Hospital Lewisham.
The scheme will also affect the major teaching hospitals in the area, St Thomas’ & Guy’s, and King’s College, which will be asked to take up the slack, and whose managers already have drawn up plans to absorb the blood laboratory work done at all four DGHs.
Professor George Alberti, the National Clinical Director for Service Design and chair of the National Clinical Advisory Team, said in the document: ‘Health services in Bexley, Bromley, Greenwich and Lewisham need a radical overhaul if they are to meet patients’ demands for modern 21st century healthcare and offer the public value for money . . . no change is not an option.’
When patients need specialist care, perhaps to treat a premature baby or for an emergency, (such as a fall resulting in a broken hip or a knee replacement), they need to be treated by specialist staff.
However, Alberti continues: ‘For our areas the teams in each individual hospital are too small to provide the level of consultant and specialist cover required to provide high quality care.
‘Simply increasing the numbers of doctors, even if they were available and this was affordable, would not solve the problem’.
He doesn’t say why increasing staff ‘will not solve the problem’ but ‘value for money’ and ‘financial savings’ statements permeate the document.
The 50 page, pleasantly worded, consultation document is loaded with ‘management-speak’ and speculative promises to bolster the alleged ‘benefits’ of closing A&Es with unsubstantiated research – and only alludes to the private interests operating behind the scenes.
Hospital workers well know that when A&Es go, so do all the departments required to support major surgery, like blood transfusion and labs, cardiac teams, and intensive care facilities.
And when these facilities go, then so do maternity and major surgery, and all the skilled medical practitioners required to provide these services.
So what are the claims of ‘Picture of Health’?
Following, are excerpts from the document which reveal the real intent behind the justifications.
The entire document can be found on the PCT website if readers would like to sift through it.
‘A Picture of Health’ says: ‘Far too many people are attending Accident & Emergency (A&E) because there are not good alternatives.
‘We want to provide a much better service by setting up new Urgent Care Centres, and assessment centres for older people and children, at each of the four main hospital sites.
‘Our three options propose changes to all of the hospitals – but the same changes to services in the community and at Bromley Hospitals, Queen Elizabeth Hospital and Queen Mary’s Sidcup. Each option proposes a different mix of services at University Hospital Lewisham.’
Without any supporting evidence, the document claims: ‘For the few people with a life-threatening illness (for instance internal bleeding), evidence suggests that a slightly longer ambulance journey to a hospital that has specialist staff and equipment is much better for patients than a shorter journey to a hospital that doesn’t have the right facilities or experienced staff.’
Well, let us just hope that there is no rush hour traffic when the patient starts to internally bleed.
Instead, the document claims we will have a modern service based on ‘new ways of working’, and then goes on to propose ‘moto para docs’, in fast cars, treating patients at the roadside.
It says: ‘New ways of working at the London Ambulance Service mean that fast response cars can get paramedics to an emergency to start treatment quicker than ever before.
‘This service and the improved skills of staff in ambulances means that they can start emergency treatment on the way to hospital, just like a “mobile A&E service”.’
The shear arrogance and unscientific nature of the document make it and the people who wrote it a danger to public health.
A Picture for Health goes on to claim: ‘The majority of people who attend A&E services have an illness or injury that could be treated in an Urgent Care Centre, or by a family doctor or a pharmacist.
‘Urgent Care Centres are staffed by GPs, specialist nurses and other healthcare professionals. These staff provide assessment, advice and treatment for patients who are not seriously sick or injured but have problems such as broken bones, pains and existing conditions getting worse.’
Elsewhere it says: ‘We also think that older people who currently come to A&E could be much better cared for by a special team dedicated to supporting them, such as a Medical Assessment Service’.
So, no in-patient beds for admission into District General Hospitals for ‘older people’ (who are the majority of patients in hospital) but an ‘Assessment Service’, or maybe ‘treatment’ in the community, isolated in their own homes and paying for untrained care workers to see them through.
For maternity and seriously ill children the document says it will ‘stop providing both maternity (except ante and post natal care) and newborn services at Queen Mary’s Sidcup’ . . . and under Options 1 and 3 these services will not be provided at University Hospital Lewisham.’
The document concludes: ‘We need to make these changes urgently in our area because relying solely on making efficiencies, and on changes that may follow the London-wide plans for healthcare (called “Healthcare for London”), will not have enough of an impact, or happen fast enough, to deliver the changes that we need to make now.’
Why the urgency? The document says: ‘Currently the hospitals are spending £400,000 a week more than they have, and they are spending £5.4m a year just paying the interest on the £218 million debt.
‘Efficiency savings, planned to deliver £10–£15million per year are insufficient to solve the depths of the financial problem.
‘Every day this overspend is increasing. First we need to get to a position where, every year, we spend as much as we receive so that our debt doesn’t get any bigger.
‘The quicker we can start reducing our financial problems, the more will be available to spend on health services.’
‘A Picture of Health’ has four options, which News line will expose in further articles.
What these planners fail to understand, is that the NHS was the ‘jewel in the crown’ of the Welfare State won by workers returning from the war having defeated Hitler in 1945.
The working class will defend its gains, but it will have to defeat the trade union leaders, who have no intention of defending the NHS.
This means a general strike to drive out the privateers and the Brown government which is driving the cuts, and go forward to a workers government and socialism.
