I’ve just be on Radio 5 Live talking about the decision by a High Court Judge to quash the government’s decision to reduce services at Lewisham Hospital on the grounds that it is unlawful. By all accounts the government had acted outside its powers as they had applied failure regime criteria to a Hospital that wasn’t failing.
I’m no legal expert, but it sounds like the Department of Health lawyers need replacing and that the only winners here are the legal profession. Lewisham residents might think they have ‘won’, but the reality is that their hospital is part of the wider health economy and if the South London Cluster is losing £1m a week, then that is a total waste of tax-payers money, leaves unsustainable rising debt and means people will be denied care on the basis of their not being enough money. This is the problem with any ‘Save the Hospital’ campaign. The NHS is a system and there is a finite budget for all expenditure, be it a consultant-led maternity unit, expensive medicines for a rare condition or support for the elderly at home. The last point is particularly pertinent – hospital is the last place that older people should be cared for – and if money is being spent on shoring up bricks and mortar then there simply isn’t the money for providing care in the home.
If there is to be no change in the way services are reconfigured in Lewisham then clearly some other services will have to be changed or reconfigured close by. The alternative is that the South London Cluster is allowed to overspend at the current rate, and if South London can then why not others? We cannot afford to open the door to massive overspends and create an environment where managers and clinicians are no longer accountable for the money they spend. For far too long we have avoided addressing the hard issues in our healthcare system. It is time we made sure that the public understands that hard choices are necessary and that they will lead to necessary and desirable changes, not only for financial reasons but for clinical reasons too. Our love affair with hospitals must come to an end. It is time to embrace a new dawn.