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We have met ‘no centrally dictated closures’ pledge, claims Government



The coalition Government has claimed it is meeting its pledge to stop ‘centrally dictated closures’ of A&E and maternity wards despite the likely closure of Lewisham A&E in the face of opposition from the local CCG and the local population.

In a detailed appendix to the coalition’s mid-term review published yesterday, it claimed that it achieved this through measures outlined in the Operating Framework for 2010/11.

The framework stated that future reconfiguration proposals had to demonstrate: support from GP commissioners; strengthened public and patient engagement; clarity on the clinical evidence base; and consistency with current and prospective patient choice.

But this week a trust special administrator appointed to oversee the reconfiguration of the failing South London NHS Healthcare Trust his recommended the closure of Lewisham A&E despite fierce opposition from the local CCG.

Meanwhile, a public petition against the changes has reached over 25,000 signatures. Health secretary Jeremy Hunt will make the final decision about the trust on 1 February.

The Government’s pledge to ‘stop the centrally dictated closure of A&E and maternity wards, so that people have better access to local services’ was made in the coalition agreement published in May 2010.

Dr Louise Irvine, a GP in Lewisham, east London, and a BMA Council member, said it was ‘absolutely’ a centrally-dictated closure for Lewisham A&E and maternity services.

She said: ‘There is no demonstration of support from the CCG. There is no public or patient support, and the clinical basis is very weak. You taking away a service which is used and valued by the local population. Well of course you are reducing choice.’

Other pledges discussed in the document included: ‘stopping the top-down reorganisations of the NHS that have got in the way of patient care’, which the Government claims is being met ‘through measures contained within the Health and Social Care Act’; and a pledge to renegotiate the GP contract ‘and incentivise ways of improving access to primary care in disadvantaged areas’.

Other election pledges for which progress was outlined included the rollout of NHS 111, clinical commissioning, the founding of the NHS Commissioning Board, rolling out the friends and family test, online access to health records by patients and stopping foreign healthcare professionals from working in the NHS unless they speak English ‘properly’.

It revises a statement made in the Mid-Term Review on Monday that practice boundaries have been abolished in six pilot areas, admitting that a boycott of the programme by GP practices in NHS City and Hackney and Tower Hamlets meant it had failed to get off the ground in those areas.

A Cabinet Office spokesperson said: ‘The Programme for Government Update Document published yesterday provides a summary – or snapshot – on the progress that has been made so far in implementing the commitments in the Programme for Government.’

‘In response to whether or not pledges have been “met, failed or ousted,” this is not a score card – it sets out progress against each pledge.’