Defend London’s NHS: MPs, Doctors and Activists Describe An Unprecedented Threat to the NHS

Defend London’s NHS: A Week of Action, a set on Flickr.

Last week, from February 9 to 16, campaigners across London — in Lewisham, in Hammersmith, in Ealing, in Archway and in Kingston — who are fighting to save essential frontline services from the government (which is committed to the destruction of the NHS), and from senior NHS management (who have forgotten what the NHS is for), came together as ”Defend London’s NHS,” an unprecedented coalition of MPs, unions, campaigners, patients, doctors and other health workers.

In the inaugural week of action, there were events on Saturday February 9 outside Ealing Hospital and Central Middlesex Hospital (between Brent and Ealing), which are two of the four A&E Departments (out of nine in total) that face the axe in north west London, along with the two hospitals in Hammersmith — Charing Cross and Hammersmith itself, and there were also protests and events throughout the week, culminating in a rally in Lewisham on Friday (see my photos here), and rallies in Hammersmith and Kingston on Saturday.

The Parliamentary launch of “Defend London’s NHS”

However, the week of action’s central event took place on Monday February 11, when “Defend London’s NHS” was launched in the House of Commons. At this event, the speakers, who included the doctors Louise Irvine, the chair of the Save Lewisham Hospital campaign, and Onkar Sahota, the chair of the Ealing Save Our Hospitals campaign, and two MPs, Andy Slaughter and Heidi Alexander, were united in their recognition that the NHS currently faces an unparalleled threat, greater than at any other time in its 65-year history.

Different themes are at play in the various parts of London affected by the proposed cuts, but what was clear from the meeting was the fact that, across the board, senior management in the NHS — the medical directors, primarily — have bought into proposals to inflict savage cuts on the NHS, while claiming that they are committed only to improving clinical standards.

In contrast, those of us fighting to save services recognise that lives will be endangered and people will die as a result of the proposed cuts, and also that, whether deliberately or not, those defending the cuts from within the NHS are spinning a web of lies and deceit — including false figures about the numbers of patients who will have to travel much further than previously to A&E Departments, the knock-on effect of this on the ability of hospitals without emergency admissions to provide anything approaching a comprehensive service of clinical care, and the knock-on effect of this on neighbouring hospitals, who simply do not have any spare capacity. In addition, every cut is defended with a hollow mantra about providing community-based care, rather than needing hospitals and hospital beds, which, though worthy as an ideal, is not grounded even remotely in reality, and can only, at present, be regarded as an aspiration.

At the meeting last Monday, a powerful panel of speakers laid out the pressing case for a London-wide campaign, building up to a national campaign.

I unfortunately missed the speech by Dr. John Lister, an authoritative campaigner for the NHS, but I urge you to check out his excellent Health Emergency website, and I only caught the end of the speech by Dr. Sahota. The Morning Star, however reported that Dr. Lister said that creating a national campaign for the NHS “has been problematic historically,” adding, “It’s difficult because what matters most to the general public is the hospital down the road from them, their local hospital. This means it has always been hard to co-ordinate campaigners in the north to join up with events that only affect those in the south. Even in London where the boundaries are more blurred, it has proved to be a challenge that hasn’t been achieved for many years, so this is an encouraging development. I’m sure a national NHS campaign can be done.”

Dr. Louise Irvine of Save Lewisham Hospital

Fortunately, I was in time for all the other speakers, beginning with Dr. Louise Irvine, the chair of the Save Lewisham Hospital campaign, of which I have been a part for the last four months, since Matthew Kershaw, an NHS Special Administrator appointed last summer (by former health secretary Andrew Lansley) to deal with the financial problems of the neighbouring South London Healthcare Trust (in Greenwich, Bexley and Bromley) proposed that rationalising services across south east London — and disembowelling Lewisham as part of that process, cutting A&E, downgrading a range of other services, and selling off 60 percent of the site — was the best way forward.

We believe the plans to close Lewisham’s A&E Department and other acute services, which will mean journeys to neighbouring boroughs for tens of thousands of emergency cases a year (up to 1,500 every week), and will mean that only 10 percent of Lewisham’s mothers (currently 4,400 a year) will be able to give birth in the borough in which they live, are wrong, reckless and illegal. We believe that Kershaw did not have a mandate to include Lewisham in the solutions to the problems of the SLHT, under the “unsustainable providers” legislation that was used for his appointment, and we will continue to fight against health secretary Jeremy Hunt’s approval of the plans on January 31, through the campaign that has galvanised the people of Lewisham — with 15,000 marching in November, and 25,000 the weekend before Hunt made his announcement (see my photos here, here and here).

Louise Irvine made all these points and more, telling the crowd of journalists and activists that Lewisham was a test case for the “unsustainable provider regime.” With 60 trusts nationally in financial trouble, she painted a bleak picture of a situation in which, if the axe falls on Lewisham as planned, financially viable hospitals will also find themselves being sacrificed for their neighbours — often, as with the South London Healthcare Trust, when a large part of those financial problems only came about because of ruinously expensive PFI deals — in the SLHT’s case, two hospitals for £210 million, which will eventually cost £2.5 billion.  As Louise Irvine so memorably described it, “neighbours will be cannibalised to pay the beast.”

She also spoke about the terrible impact of the plans on maternity services in Lewisham, noting that, although she had every respect for a midwife-led service, that alone, without the ability to deal with emergencies provided by an obstetric-led service, is unacceptable. As she noted, it rules out almost all first births, and the many births these days involving women in their late 30s and 40s. She also noted that, although Jeremy Hunt stated that just 10 percent of Lewisham babies would be born in lewisham as a result, “we think it will diminish further.”

Shirley Franklin of Defend the Whittington Hospital Coalition

Next up was Shirley Franklin of Defend the Whittington Hospital Coalition. The Whittington, in Archway, was under threat three years ago, but that threat was seen off by campaigners, Now, however, as the campaign explains, “The Board of the Whittington Hospital has agreed to sell off £17million of buildings, leading to ward closures, massive reduction of maternity provision, loss of wards for the elderly, total loss of staff accommodation. They also plan huge cuts of up to 570 hospital staff.”

The day after the Parliamentary meeting, DWHC held a meeting with four MPs — Jeremy Corbyn, David Lammy, Frank Dobson and Emily Thornberry — and the author and journalist Owen Jones, attended by 600 protestors. the hospital’s chairman, Joe Liddane, was also present, and he stated that the board “has no intention of changing tack or slowing down, despite the pleas,” as the Islington Gazette described it. Instead, he “promised more meetings to explain the move” and stated, “They are complex ideas but we think when people understand why we are doing it, they will be more amenable.” Crucially, the Islington Gazette noted that hospital bosses “are championing ‘care in the community’ because beds will be lost through the plans” — a theme that emerges everywhere in the proposed cuts, as senior officials argue for the significance of a community-based care system that doesn’t even exist.

Shirley Franklin, who chaired the proceedings, ended the meeting by saying to Joe Liddane, “You stuck your two fingers up at us. We are your Whittington community and you gave us absolutely zilch information and zilch respect and that’s why we’re angry. Don’t give us, ‘we don’t need hospital beds.’ It’s disgusting, it’s insulting and we’re not stupid.” Those were powerful words, similar to the message she delivered on Monday in the House of Commons, when she said that board members had been saying that it was “old-fashioned to be treated in hospital.” As she asked, incredulously, “How dare they?”

Andy Slaughter, MP for Hammersmith

Next up was Andy Slaughter, the Labour MP for Hammersmith, and the secretary of Save Our Hospitals Hammersmith and Fulham, who spoke about the plans to close four of the nine A&E Departments in north west London. As with Lewisham, he noted that all acute, ICU (intensive care) and specialist departments would be closed at the hospitals affected, leaving them as shadows of their former selves, eventually to be closed or privatised.

As ITV News noted on Saturday, “The NHS’s North West London trust has recommended that four of its A&E units will be closed and Charing Cross Hospital will no longer remain a ‘major hospital.’” ITV News also noted that “the key decisions expected to be pushed through by the NHS” on February 19 were that “Charing Cross will be a ‘local hospital’ with no A&E, surgery, Intensive Care or Stroke Unit,” that “the majority of the Charing Cross site will be sold off at a profit for development,” and that “Hammersmith, Central Middlesex and Ealing Hospitals will lose their A&Es.”

This was no surprise to the campaigners, although it remains a bitter blow — one made all the more unpalatable by the fact that, as Andy Slaughter told the crowd on Monday, although the Ealing campaign had the full backing of the council, in Hammersmith and Fulham the council did not help at all — and in fact actively opposed the “Save Our Hospitals” campaign. Alarmingly, the Tory spin machine is so brazen in Hammersmith that last week the council had the nerve to claim that it had “saved” Charing Cross A&E from closure, echoing what happened in Lewisham when, at the last minute, feeble concessions were promised that enabled the spinners to claim that A&E had been saved, when that is not the case at all.

As Andy Slaughter explained last Monday, “This is a particularly cynical move from the council. To get everyone’s hopes up by saying that their A&E has been saved and then including what they’re really doing in the small print.”

Andy Slaughter also explained that the cuts currently taking place are “the biggest threat there has ever been to the NHS in London and across the country,” which he described as “creating a second-tier service” for the majority of people.

Heidi Alexander, MP for Lewisham East

He was followed by Heidi Alexander, the MP for Lewisham East, who has been working diligently on the Lewisham campaign. She stated that “hospitals in London as we know them will disappear,” and described the role of the Matthew Kershaw, regarding the South London Healthcare Trust and Lewisham, as “deceitful and opaque,” as well as one that cost £5.2 million, at a time when money is supposed to be being saved. Pointing out the injustice of “services axed to pay for financial problems elsewhere,” she stated that “the NHS should be for patients and not accountants,” a key theme in my dealings with the NHS, which, over the last 13 years, has saved my life and that of my wife and son, and has always done so on the basis that it provides a service that needs money to run it, not as a business first and foremost.

In conclusion, Heidi Alexander exclaimed, “Jeremy Hunt says that his proudest moment was saving the A&E Department at the Royal Free in Surrey. My proudest political achievement will be to expose what this government is doing to the NHS in London.”

The pernicious role of the NHS medical directors

Afterwards, there was a lively Q&A session, to which my contribution was to point out that, as campaigners, we need to focus not only on the government’s role, but also on that of the senior NHS officials who are destroying the health service they claim to love, while providing false evidence about the cuts being in the interest of improving clinical standards — that plus all the nonsense about a community-based care system that doesn’t exist.

It struck me in particular, at a meeting in Lewisham with the Special Administrator and his team on December 3, that the great betrayers of the NHS are the medical directors, three of whom were at that meeting. One was Dr. Jane Fryer, the medical director of NHS South East London, who closely advised Matthew Kershaw, and who admitted — and must be held accountable for the admission — that the proposals for the SLHT provided an excuse for a long-cherished reorganisation of hospitals across south east London, in which Lewisham was always a target. The others, who spouted nonsense about presiding over widespread cuts to improve clinical standards, were Dr. Mike Marriman, the medical director of King’s, and Dr. Andy Mitchell, the medical director of NHS London. When Jeremy Hunt approved the plans for Lewisham on January 31, he drew on advice given to him by Sir Bruce Keogh, the medical director of the whole of the NHS.

I asked the panel what they thought about the role of the medical directors, and how we might be able to target them in campaigns to urge them not to betray the NHS — or be held accountable for deaths that would otherwise have been  avoidable, when journey times and waiting times increase massively, as they undoubtedly will if all the planned cuts take place.

Onkar Sahota picked up on the medical directors’ fantasies about community-based care as a justification for cutting departments, wards and beds, stating that they were “painting a picture of aspiration, not reality.” Louise Irvine went further, noting that they were appointees, who were “naive” and “being used politically, just as GPs were used to sell the Health and Social Care Act.” She also recognised, as I was suggesting, that some of these people might be vulnerable to criticism, especially if they recognise that failures — deaths and chronic overcrowding, for example — will be laid at their door, and indicated that it was time to say to the medical directors, “Either you are doctors whose job is to hand out sound medical advice, or you are stooges of the government.”

Andy Slaughter added that the medical directors — who have also, of course, played a key role in the plans for north west London — “should be ashamed,” and Heidi Alexander highlighted “the need for a high-level debate within the medical profession.” In conclusion, Onkar Sahota pointed out another group of people within the NHS who might find themselves taking the blame for political failures in the not too distant future — namely, the GPs, who, as Clinical Commissioning Groups, are going to be responsible for most of the NHS’s budget. He noted that “cuts are being forced through already on behalf of CCGs, before they even exist,” which is surely an intolerable position for any GP to find themselves in.

The photos at the top of this article come from the press launch of “Defend London’s NHS” in the House of Commons last Monday, and the rally in Hammersmith on Saturday, which I attended, along with Louise irvine and the Strawberry Thieves Choir from Lewisham. It was quite a long journey to show solidarity, but it is of inestimable importance that we make the campaign to save the NHS London-wide and then national.

Help the campaign!

If you have time to volunteer, to join a small team to play a part in this campaign, particularly if you have any particular expertise in establishing and running websites, dealing with social media via Facebook and Twitter, coming up with ways to attract media attention, and mobilising and organising supporters, then please get in touch with me. This is my country, and my NHS, and I will not stand by and watch it gutted by yet more pigs hungry for the trough of privatisation.

Note: For the threats to A&E, maternity and children’s services at two out of five hospitals in south west London — St. Helier (Sutton), Kingston, Croydon, St. George’s (Tooting) and Epsom — please see the Kingston Save Our Hospitals website. Several hundred people turned up for their rally on Saturday, and, as they note, “recommendations about which hospitals will lose their key A&E, maternity and children’s services are due to be made on Thursday 25th February.” A video from Saturday is here, and photos are here.

Andy Worthington is the author of The Guantánamo Files: The Stories of the 774 Detainees in America’s Illegal Prison (published by Pluto Press, distributed by Macmillan in the US, and available from Amazon — click on the following for the US and the UK) and of two other books: Stonehenge: Celebration and Subversion and The Battle of the Beanfield. To receive new articles in your inbox, please subscribe to my RSS feed — and I can also be found on Facebook, Twitter, Digg, Flickr (my photos) and YouTube. Also see my definitive Guantánamo prisoner list, updated in April 2012, “The Complete Guantánamo Files,” a 70-part, million-word series drawing on files released by WikiLeaks in April 2011, and details about the documentary film, “Outside the Law: Stories from Guantánamo” (co-directed by Polly Nash and Andy Worthington, and available on DVD here — or here for the US). Also see my definitive Guantánamo habeas list and the chronological list of all my articles, and please also consider joining the new “Close Guantánamo campaign,” and, if you appreciate my work, feel free to make a donation.