Lewisham hospital will lose A&E and maternity units if SLHT is broken up due to accumulated debts and £1.3m weekly losses
Plans to “dissolve” an NHS hospital trust because of its large debts have caused an angry backlash from doctors and patients at a separate hospital nearby, which will lose its A&E and maternity units under the controversial overhaul of healthcare across a large swath of London.
Government-appointed special administrator Matthew Kershaw on Tuesday urged the health secretary, Jeremy Hunt, to approve the break-up of South London Healthcare NHS Trust (SLHT), which covers three hospitals, and let other healthcare providers take over its services. The trust is the first to be put into the NHS’s “unsustainable providers” regime – special measures, in effect – as a result of its accumulated debts and ongoing £1.3m weekly losses.
Hunt, who has until 1 February to endorse or reject the plans, now faces the first of many difficult decisions over how to deal with plans to reconfigure hospital services in England.
If implemented Kershaw’s proposals, which would cost £1.1bn to implement over the next 36 years, would lead to a major reorganisation of emergency care, childbirth and elective surgery in south-east London and Kent. The plans are painful and unpopular but Kershaw said they had to be introduced in full because SLHT in its current form was unsustainable and no “viable alternative solutions” existed to ensure patients received safe and high-quality care sustainably in the future.
But doctors and managers at Lewisham hospital, which is not part of SLHT, are furious that Kershaw’s plans will force it to lose its emergency department and obstetrician-led maternity unit, even though it is a financial success. Kershaw wants it to merge with Queen Elizabeth hospital in nearby Woolwich, one of the three hospitals in the SLHT.
Dr John O’Donoghue, a consultant physician at Lewisham hospital, said the plans would set “a disturbing precedent” for the rest of England if implemented. “If services at a successful and well-run hospital like Lewisham are closed due to problems at a neighbouring trust then no hospital in London, or the country, is safe. These plans are a travesty.”
The trust which runs Lewisham hospital said it was happy to merge with Queen Elizabeth but did not back what it called Kershaw’s “prescriptive approach to service change which would result in local emergency services being closed and maternity services being downgraded”. A petition against Lewisham’s projected loss of services organised by local Labour MP Heidi Alexander has attracted more than 40,000 signatures.
Hunt said: “I do understand the concerns of MPs and indeed the people living in the areas affected by these proposals, especially the people of Lewisham. They have the right to expect the highest quality of NHS care and I have a duty to ensure that they receive it.” He declined to comment in detail on Kershaw’s recommendations, except to say he would consider them with care before making a decision.
Part of Kershaw’s plan would see the Department of Health write off SLHT’s historic debt since 2009 (£207m), provide another £313m to implement his plan and cover the private finance initiative debts relating to the Queen Elizabeth hospital (£269.2m by the end of its contract in 2032-33) and Princess Royal University hospital (£304m by 2038-39) in Orpington, Kent, another of SLHT’s trio of hospitals.