Could it happen again? Lewisham Hospital campaigners on alert over new south east London health shake-up

An NHS document called Our Healthier South East London was published this month, outlining general aims to "improve" healthcare in Bexley, Bromley, Greenwich, Lewisham, Lambeth and Southwark - including integrating services and providing more care outside of hospital.

But the news has set alarm bells ringing in south-east London where the government's attempted closure of Lewisham's A&E and the demise of Bexley's emergency department - recommended by the Picture of Health programme - are still fresh in the memory.

Dr Louise Irvine, who chaired the successful Lewisham campaign, said: "The strategy does not explicitly talk of hospital closures but, worryingly, uses language and ideas very similar to the ones that were used by the Trust Special Administrator (TSA) and before that the Picture of Health reconfiguration.

"It talks of the need to provide more care in the community instead of in hospital, for example. 
While better community care would, of course, be a good thing, it's important to recognise that there is no evidence that community based care can replace hospital services to any significant degree."

She added: "London health chiefs have regularly referred to the failure to close Lewisham as 'unfinished business'. 

"Both previous attempts were defeated by strong local campaigns - the most spectacular being the one against the TSA proposals which saw 25,000 people marching through Lewisham and a double win in the courts. 

"The Save Lewisham Hospital Campaign is ready to fight again to defend our hospital and maternity services because, despite our victory, we have always been aware that further closure threats are a real possibility."

The issues paper has been drawn up by the area's clinical commissioning groups, who will work with councils, hospitals and patients over the next five years.

But, while Greenwich Council's cabinet member for health Councillor David Gardner said he thought the debate over closing A&Es was won, saying he was more concerned over government cuts to social care budgets, Lewisham's Councillor Alan Hall told News Shopper he was worried the document mentioned potential "major service change".

And Lewisham East MP Heidi Alexander, a leading voice in the battle to save Lewisham last time around said: "I must admit I am feeling slightly uneasy about where all of this might be heading. 

"It's not entirely clear to me what exact service changes might be proposed as part of this process and whilst it is entirely right that local clinicians and NHS managers are thinking about the future, the memories of the Lewisham Hospital fiasco are still very real for many of us. 

"There is no doubt that the NHS is under enormous pressure - even the big teaching hospitals in London are now forecasting deficits for the first time in recent history. I think we need to keep a very close eye on all of this."

Chief Officer at NHS Lewisham Clinical Commissioning Group Martin Wilkinson said: "There are no site-specific proposals at this stage, but we are engaged in a wide discussion with lots of different groups, including clinicians, healthcare providers, the public and others about the challenges in the NHS and what we can do to address them.

“We're working with the five other CCGs in south east London and with NHS England on a shared five year plan and have collectively published an Issues Paper to explain the major challenges and some of the ideas we have to improve the NHS for everyone.

“We think that we should do more to help people stay well, make services more joined up and deliver more care in community settings. This is likely to mean that we begin to spend money differently, with more money spent on community-based services while hospitals provide specialist care for those who need it, but we’d like to know more about what residents think.

“We’re committed to commissioning the very best health services for people in Lewisham and would encourage local residents to read the Issues Paper and tell us what they think of the questions we set out. Feedback from local people is vitally important in helping us develop ideas for improving the NHS.

“You can read the Issues Paper and feedback your comments at www.ourhealthiersel.nhs.uk.

“If, at any point, we think that significant service changes are needed, formal consultation with the public would be required before deciding whether to proceed.”