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Moratorium on A&E closures urged

There should be a moratorium on closures of hospital emergency departments until a full national review has been carried out, ministers were told.

Labour MP Virendra Sharma said a review of A&E units which had already been announced was being conducted in an “obscene rush” and would not provide the necessary evidence.

The Commons debate led by Ealing Southall MP Mr Sharma follows last week’s announcement that Lewisham Hospital in south-east London would see its A&E unit downgraded because of the financial collapse of a neighbouring NHS trust.

Last month it was announced that NHS Commissioning Board (NHSCB) medical director Sir Bruce Keogh would review the way A&E services were run.

Mr Sharma said: “I’m pleased that the government has belatedly announced a national review of A&E services.

“But I’m horrified to note that it is planning to report by March this year.

“This is being done in an obscene rush and cannot be the considered review that we need.”

Mr Sharma is fighting to save Ealing Hospitals A&E unit which faces closure under a review of services in north-west London.

He said: “There should be a moratorium on all A&E closures until a proper, considered and full review of A&E services is carried out, not the current rushed review.”

But Tory David Morris (Morecambe and Lunesdale) hit out at Labour for scaremongering about A&E closures.

He said: “This debate is part of a national campaign to scare people into believing that their NHS will be deconstructed.”

A “disingenuous story” about hospital closures was used by Labour in the Corby by-election campaign to “great effect”.

He added: “This is now the scare story in Lewisham and now, surprise, surprise, is the scare story in the Morecambe area at Lancaster University trust.

“These A&Es are not under threat, they are not closing down and the public will see through this Labour campaign to start a fire and claim to put it out, saving us all.”

Tory Patrick Mercer, MP for Newark, urged the government to be flexible in its approach to A&E services for different communities.

He said: “Could we please take a flexible view of these things, could there be clinical cases assisted and made in places like Newark so that minor injury units can indeed provide other critical services than those that they do at the moment.”

Labour’s Dame Joan Ruddock, MP for Lewisham Deptford, spoke out on the controversial issue of the proposed changes to Lewisham hospital’s services.

She said: “Reconfigurations ought to be on the basis of clinical grounds and patient safety, not so in Lewisham.”

She added: “Lewisham now faces a reconfiguration that is not said to be a reconfiguration.

“It now faces having an A&E that isn’t a proper A&E, a maternity service that no woman giving birth to her first child will be able to go to.

“Will the minister explain to me today how is this improved clinical care, how is this is improved patient choice.

“This is an absolute disgrace, completely unjustified and we will all fight it to the very last.”

Lib Dem Stephen Lloyd, MP for Eastbourne, also queried the current reconfigurations process.

He said: “I really am far from confident of the process to determine whether or not reconfigurations of health services or A&E are being done in the best interests of local people and that it’s working.”

He added: “This must be addressed and it needs to be done quickly because if we get it wrong then quite literally lives could be lost unnecessarily.”

He said the Coalition had protected NHS funding at a far higher level than any other government department, but he added he feared “we may be getting the reconfiguration elements wrong”.

Labour MP Jim Dowd, MP for Lewisham West and Penge West, said there was a “sense of seething injustice in Lewisham” at the decision to downgrade its hospital’s accident and emergency department because of failures to manage budgets elsewhere in the NHS.

He said: “I would say to anybody here that if you are in a trust that is performing badly, fear not because you will be rewarded.

“What you really need to be careful of is being anywhere near a trust that is doing badly.

“Although your local trust may be doing well, the secretary of state will appoint his henchmen, and women for that matter, to go in there, jackboot their way around the place, spend millions of pounds of public money, and then come up with a scheme that doesn’t actually do much for the purpose for which they have been appointed, but actually deals with others who have played by the game and played by the rules.”

Tory Gavin Barwell, MP for Croydon Central, said constituents wanted to be able to access facilities at a local hospital, but there was a balance between that convenience and quality of treatment.

On Lewisham, he said: “We do have a national health service and the consequence of that is that when things go wrong in a neighbouring area it does have a knock-on impact into other areas.”

He added: “There is a balance between convenience for the locality and making sure that we have sufficient acute cover.”

Labour former health minister David Lammy, MP for Tottenham, spoke of the “deep concerns” voiced by some MPs about the changes proposed in “every single area of our capital city”.

London’s population was forecast to grow to 9.5 million by 2031, he said.

He listed hospitals which he said were failing to meet certain targets, adding: “And yet it is proposed that we can lose so many of our A&E departments, eight across London at this time, it does not make sense.

“This is a health service in the London economy that we look to when a helicopter falls out the sky, it’s a health service that we look to whether it’s bombs that go off in Canary Wharf or go off as we saw on London Underground.

“This is an A&E service that we look to following riots.”

Labour’s Jeremy Corbyn, MP for Islington North, said: “One of the problems is that in London the population is rising, health inequalities are rising, health demands are rising amongst poorer people.

“Whilst I can understand all the arguments about putting stuff in the community, the reality is if you close hospitals there are many desperately poor and ill people who simply will not be properly served.”

Shadow health minister Jamie Reed said financial considerations were now overruling clinical needs.

He said: “We must return to the first principles of healthcare provision. The patient comes first. Their healthcare and well-being is paramount and the needs of the patient must always take priority over the needs of any other interest within the system.

“Services should reflect this and so should their design and delivery.”

Health Minister Anna Soubry said lifestyle and society continued to change so the NHS had to change too. Any changes to services had to be “locally led and clinically driven”.

She said the decision to downgrade services at Lewisham Hospital was “very difficult” but was “absolutely right”.

She went on: “As has been alluded to by some, these things are not easy. I want to set the record straight and make it absolutely clear and say that the reconfiguration of local services is essentially a matter for the local NHS, which must in its considerations put patients at the heart of any changes.

“The NHS… has always had to respond to patients’ changing needs and advances medical technology. As lifestyles, society and medicine continue to change, the NHS needs to change too.”

Readers' comments (2)

  • I worry that any temporary halts to closures doesn't mean that the government is just biding its time to allow the dust to settle + people start forgetting or lose impetus in campaigning.
    It also feels like time in which regional trauma centres are being further developed + for local ambulance services to reduce patients flow to district general A&E departments, in preparation for turning A&Es into Urgent Care Centres on a purely financial basis.

    Unsuitable or offensive?

  • Many of our A&E units are, in fact dangerous. Impossible to adequatly staff these departments stagger from crisis to crisis ! Medical staffing is achieved more often than not by the employment of locuns of dubious quality.

    To offer a full service an A&E depatment must have access to a 24 hour on site imaging service (x-ray ant CT), medical lab sevice and blood bank. Consultant led teams providing for general surgury, gynae, paediatrics , general medicine, aneasthetics and intensive care! Tauma care demands that a "trauma team" of senoir doctors and nurses can be assembled quickly.

    Consideration must be given as to how specialst servces are accesed with minimal delay- ie cardiac revascularisation , stroke service, plastic, neuro, cardio-thoracic and vascular surgery etc.

    In my view many A&E departments only function at the level of an urgent treatment centre it is wrong to pretend otherwise !

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