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Council threatens judicial review over possible A&E closure

Exclusive Council leaders have threatened the health secretary with legal action if he goes through with proposals to close Lewisham A&E department in a dramatic intervention that could influence the outcome of a seminal test case for CCGs, Pulse has learned.

Jeremy Hunt is set to make a decision on 1 February about proposals made by the trust special administrator (TSA) to close Lewisham A&E. The administrator was appointed to look into the failing South London Healthcare NHS Trust under the unsustainable provider regime legislation.

The proposals for Lewisham have been opposed by all GPs in the borough and by Lewisham CCG, whose chair Dr Helen Tattersfield warned that the arrangements threaten the autonomy of CCGs.

A letter obtained by Pulse, dated 22 January, from Lewisham mayor Sir Steve Bullock to Mr Hunt, says: ‘I very much hope that you will not decide to implement the Lewisham proposals. If you do, I must put you on notice that the council may, if so advised, apply for judicial review of any part of your decision which seeks to implement them.’

Click here to read letter from Lewisham Council to Jeremy Hunt

The council contends that the administrator went outside its remit by proposing to reconfigure Lewisham hospital.

The letter states: ‘The council’s firm view, on legal advice, is that the TSA has no power, under the relevant statutory regime, to consider, or to make recommendations to you, about anything other than the affairs of the trust to which you appointed him.’

It points to the Department of Health’s ‘statutory advice for trust special administrators’, which stated: ‘The regime does not provide a back-door approach to reconfiguration.’

The mayor also quoted Prime Minister David Cameron who said there would be ‘no reorganisations unless they had support from the GP commissioners’.

Mr Hunt told Parliament on 8 January that he had taken legal advice on the TSA’s remit, which stated that the administrator could look at the broader area, but added he was taking fresh legal advice on the matter.

Shadow health secretary Andy Burnham told Pulse that the situation was a ‘nonsense’.

He added: ‘Powers are being used there for which they were not intended. I know that because I brought those powers on to the statute book.’

Dr Louise Irvine, a GP in Lewisham, said: ‘The reason that [the unsustainable provider regime legislation] was originally brought in by Labour in 2006 was so you could go in and troubleshoot a very small, narrow issue about one local trust that was in trouble.

‘It was never meant for reconfigurations. It is now being brought in not only for reconfigurations but to bypass all the checks and balances.’

Readers' comments (8)

  • Bravo Lewisham Council!

    we finally have elected politicians standing up for us.

    - anonymous salaried!

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  • Yet another election promise broken. This whole re organisation is nonsense - anyone one believed CCGs would be given autonomy are naïve. Just look at the bureaucracy in place now – heavens knows what will happen after April 2013

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  • Vinci Ho

    Whether you believe what politicians said is your own choice.
    But when it boils down to very big issue like this , people need to use their conscience to stand up against the tyranny . Right or wrong is up for a fight,
    Even Nick Clegg was saying the Coalition government was making a mistake in dealing with the economy today.
    Truth is out there mate.......

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  • In truth the proposed rearrangement of A&E reverts to the original proposal that SLHT included Lewisham Hospital. A judicial review sounds threatening but would it happen? When the Sidcup A&E was proposed for closure the council objected, the local MP objected as did most of the Bexley populace but it made no difference. The bottom line is that what we currently provide is unaffordable, and it is logical to examine all ways out of the mess. One could argue that asking King's College Hospital to take over the PRUH Farnborough is outside the remit, but to take such a narrow-minded approach is senseless.

    What would the Lewisham GPs like? For SLHT to close altogether? If the NHS was in the real financial world that's exactly what would happen. Then the manure would real hit the air-conditioning!

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  • I don't know the full ins and outs of this issue only having read a couple of articles but it seems to me that most are forgetting that CCGs are commissioners and this is a Provider issue. If it's not sustainable, economically, for the Provider then unless CCGs are willing to pay above tariff for this service then there's not a lot that can be done. If you want the service CCGs need to work in partnership with providers to get their costs down and/or pay more.

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  • But the point is that Lewisham CCG has been working with the provider (Lewisham Hospital) and has developed excellent collaborative arrangements that mean they had already started making the changes that could both provide excellent clinical care and be cost-effective. This included working with the local authority and social services as well as community services. This is what the government keeps saying is its vision and goal for the NHS - good collaborative working arrangements that transcend the primary/secondary/ community/social care boundaries. All of that achievement will be blown asunder if Lewisham Hospital closes as a DGH.

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  • In response to Andrew Bamji, if there are financial difficulties in one trust that cannot be resolved, why destroy a neighboring trust that is financially solvent and clinically well performing and needed by its population? The problems at SLHC are mainly due to PFI, and allegedly to "poor financial management". The government should take on and renegotiate the PFI debt, and the management should be replaced. There is no need to destroy a viable local hospital that is not even part of the problem. The aim there is that by denying people in Lewisham access to their local hospital that they will somehow decide to go to QEH, Woolwich, and as money follows the patient this will bring more income to QEH. QEH is not currently coping with patient demand both at A+E and Maternity so it is not going to be able to cope with the demand from Lewisham, a borough of over 270,000. But the most important point is that the patient flow assumptions are dangerously wrong. Most Lewisham people don't know where QEH is. In fact - and you may not believe it but its true - most Lewisham GPs don't even now where QEH is and how to get there. It can take nearly two hours to get there by public transport. Most Lewisham people will go to Kings College Hospital, or St Thoma's Hospital. Kings has already expressed concern about its ability to cope. The MPs in the Kings area have also expressed serious concern. The patient flow assumptions on which the financial case rests are seriously flawed. Closing Lewisham will not rescue QEH.

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  • Vinci Ho

    You cannot treat 15,000 people ,who were willing to come out to protest, like IDIOTs, Mr Hunt.....

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