Matthew Kershaw, the Special Administrator brought in to reorganise NHS services after South London Healthcare Trust went bust, has made his final recommendations.
There are no surprises. He recommends SLHT be dissolved, with services being taken over by other Trusts, and that Lewisham Hospital’s A & E and maternity units be axed.
He offers no answers on how 125,000 annual patient visits to Lewisham A&E will be accommodated or how the 4,365 births in Lewisham maternity unit will be adequately supported. Three quarters of million people will be left with one A & E. Kershaw’s cuts will cost lives.
The report estimates 140 jobs will be cut but others estimate this figure to be much greater.
Kershaw’s accountants estimate the changes will cost a staggering £1.093 billion to implement. It will cost £195 million over a two-three year period (up to 2015-16) to close down services at Lewisham. And Kershaw’s report has just cost taxpayers £5 million to produce, most of which went to line the already well-lined pockets of management consultants.
Less than two years ago £12 million was spent the A & E at Lewisham. Kershaw also recommends that £207 million of debt accumulated since SLHT was established in 2009 should be written off. The DoH will fork out an extra £25 million a year to help continue to pay for PFI deals. Naturally, nowhere does Kershaw recommend PFI debts be cancelled. Jeremy Hunt (Secretary of State for Health) will make the final decision on the proposals on 1 February (though he is not required to make his decision public).
Despite a groundswell of angry opposition from tens of thousands of people in Lewisham and the fury many clinicians and hospital workers; despite Jeremy Hunt saying “[hospital] reorganisations are not always the panacea they are made out to be” while claiming that saving his local hospital from closure as his proudest political achievement, it’s hard to see how Hunt will not implement Kershaw’s recommendations.
Many people, including health experts, see Kershaw’s proposals for SLHT and Lewisham Hospital as being a testing ground for the government for changes in healthcare across England.
It’s one thing fighting to save your local hospital as an opposition Tory MP under a Labour government; it’s quite another to backdown over ideological attacks on the NHS when you are Tory Secretary of State for Health and charged with the job of abolishing the NHS.
In 2005 Hunt and Gove, among others co-authored Direct Democracy in which they state “Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of healthcare in Britain”.
The proposals for south London hospitals are as irrational for taking care of the sick and vulnerable as capitalism itself. They reflect the ideology of a government who want to break up the NHS, sell it off, or give it away to private profiteers. Reducing the NHS to little more than a logo, the service is being parceled up and privatised to move towards a US-style healthcare system.
The NHS is perhaps one of the last two strands of the post-war welfare state, the other being education, that can mobilise people to defend it. All over the country “Save our Hospital” campaigns are springing up. We urgently need to find ways of co-ordinating these local campaigns in a nationwide movement.
The Save Lewisham Hospital campaign is an energetic and vigorous community campaign with collective experience, determination and resolve to carry on fighting no matter how long it takes (and it may take years).
Health workers within the hospital campus need to take confidence from the campaign.
Hampered by a local Unison bureaucracy concerned with little more than defending its own position, union membership in the hospital is low. Workers on the hospital campus need to get organised to control over their union, pursuing a vigorous membership drive recruiting porters, cleaners, nurses and admin staff and running an open and democratic campaign to defend the hospital.
Discussing with and educating members on ways to fight the cuts and closures must be a priority. Preparing for a work-in to keep services going, arguing for and convincing other workers of the need for solidarity action, building up rank and file support to defend the NHS are all necessary if we want to win this fight.
If Hunt does back Kershaw’s recommendations then we have to match his commitment to wreck the NHS with our need and desire to maintain, build on and improve it.
Any victory along the way would rebuild confidence in the labour movement that has the potential to go beyond defending the NHS.