MAJORITY OF RESIDENTS REJECT DOWNGRADING QUEEN MARY'S

THE majority of residents who responded to a consultation have rejected options to change A&E services in the area.At least a third of south east Londoners who responded to the A Picture of Health (APoH) consultation into downgrading health services in the area said that none of the proposed options were suitable.Some 2,469 residents rejected any option to close the A&E at Queen Mary Hospital, Sidcup, while only 1,949 elected to chose the most popular closure option out of the total three.

Director of the Centre for Health Management at the Imperial College London, Professor Rifat Atun, who presented the consultation results at the Old Royal Naval College in Greenwich last Friday, said most of the 8,374 replies were from Bromley and Bexley residents, whom he said had responded "passionately". Pointing to a slide which showed that the majority of respondents did not want any of the options, he said: "The results are quite clear for the decision makers to see and they must take the views of the public very seriously."

All options in the consultation proposed to close the A&E at Queen Mary's Hospital, Sidcup.

Option one - to keep an A&E department in Lewisham but to stop emergency surgery or paediatric services - was chosen by 23.3 per cent respondents.

Option two - to keep A&E as it is in Lewisham but take away children's assessment and treatment services - was chosen by 17.8 per cent.

Option three, closing the A&E at Lewisham, was chosen by 16.3 per cent. From Bexley Times 26.6.08

Response to Helen Cameron, Programme Director - APoH

In her letter (News Shopper 11th June) Helen Cameron, Programme Director for A Picture of Health unintentionally confirms our suspicion that the NHS bureaucrats are now seeking to give the impression that Queen Mary's Hospital's A&E admissions are now minimal, and those that there are are so low as to make keeping the A&E open unwarranted. In stating that of the 41 patients on average per day over the past year having been taken by ambulance to Queen Mary's only 2 to 3 were "blue light", i.e. requiring A&E services, she contradicts the statistics in the APoH consultation document which states that approximately 50% of A&E patients require A&E services.

This leaves a difference per day of 18 blue light patients. Where are they going? Is the APoH report wrong or is what is in fact happening is that the London Ambulance Service has been instructed to take blue light emergencies to one of the PFI hospitals first even if they're further away?

Even with an Urgent Care Centre, there will still be 30% of existing A&E activity that will be classed as a "very major health emergency" and will need to go to a fully admitting hospital. With Queen Mary's A&E attendances last year reaching 88,190, this means that over 26,000 very major health emergencies will have to go elsewhere. Anyone living in the Bexley, Sidcup or Chislehurst area, instead of having to travel a mile or so, would have to go an average 6 1/4 miles further to Princess Royal. It's one thing for the London Ambulance Service to claim its ability to get patients to hospital within target times, it's quite another for a bed to be available at a hospital that is 99.5% full.

If Ms Cameron feels her proposals foresee a bright future then she's looking through a very cloudy crystal ball indeed.

Letter to Bromley Times, published 17th April

It is unfortunate that Bromley Hospital's NHS Trust should be supporting all three of the A Picture of Health options but nothing short of an obscenity that the Trust directors and chief executive are backing option 3. This is the option that would see both Queen Mary's and Lewisham lose their A & Es. The tragic plane crash at Farnborough recently shows the need to have several A & E's locally and not just two with one under the flight path. Furthermore, Queen Mary's and Lewisham's loss is the Princess Royal's gain as under the controversial payment by results plan the more A & E patients that the PRUH can treat the more they get paid. When one also factors in the aim to reduce the average length of stay within the PRUH by 34% then one gets the distinct feeling that the Trust is putting saving money first and clinical need last.

PRUH's future "very healthy"!

Letter to News Shopper 28th March.
Bromley Hospitals' NHS Trust chief executive Ian Wilson, in his interview with Thom Kennedy, makes the assertion that as the Princess Royal University Hospital (PRUH) is to remain a major admitting hospital, under the A Picture of Health (APoH) consultation, then the future for the people of Bromley "is very rosy". That is, until Queen Mary's Hospital starts sending its patients over to him. In stating that "some work is moving out and some is moving in" he is implying quite unjustifiably that the net effect will be nil. In reality, whilst the PRUH will only lose planned inpatients, day and orthopaedic surgery, and children's assessment and treatment services it will have to accommodate a new urgent care centre and a new midwife led birthing unit. It will also have to take over some of Queen Mary's A&E, non-surgical emergency, emergency and complex surgery, trauma surgery, children's services-inpatients, assessment and treatment, and doctor-led maternity unit with intensive care for babies. It will also have to cope with a forecast rise in the local population over the next 10 years by over 90,000!

These new and diverted patients will not all be able to be accommodated by the PRUH and no attempt has been made whatsoever in the APoH consultation to try to address this future needs situation, choosing instead to concentrate on a clinical version of musical chairs.

Urgent Care Centres...look and smell...

Letter to Bromley / Bexley Extra, published 4th April.If Ms Liz Butler, chair of Bromley PCT, believes (report 28th March) that urgent care centres, as is proposed for Queen Mary's Hospital, "look and smell" like A&E departments then she is living in cloud cuckoo land. Let me help her out. Around 1/3rd of existing A&E patients - i.e. the ones requiring the most urgent care - would NOT be catered for by an urgent care centre. They would have to travel further for their A&E care with all the inherent risks that that poses. A&E departments are staffed by senior clinicians with intensive care back-up. Urgent care centres on the other hand would be nothing more than glorified GPs, staffed by family doctors, with outpatients and diagnostic facilities but with no emergency back-up.

The picture is beginning to not look very healthy at all.

Princess Royal University Hospital (PRUH) Maternity Unit closed.

Following an investigation by Independents to save Queen Mary's Hospital it was discovered that the Maternity Unit at the PRUH, Farnborough was closed for the whole of Wednesday (day and night) and the following Thursday [12th and 13th March]. This was due to what the hospital called "high activity".

Expectant mothers due to give birth at the PRUH were told to go, or diverted, to Lewisham, Darent Valley or Queen Mary's Hospital.

Commenting on this discovery John Hemming-Clark - who is standing in the London Assembly elections in May for the Bexley & Bromley Constituency - said,

"This is simply unbelievable and unacceptable. The "A Picture of Health" consultation report confirms Maternity National Service Framework (2004) and the DoE's Maternity Matters that maternity services should be "easier to access" and "delivered closer to people's homes". However, before the consultation has even finished, patients are being kept out of one of the Maternity Units that, it is planned, will remain after the consultation. The PRUH is supposed to be taking on some of the 3,000 expectant mothers per year that present to Queen Mary's. Instead, at present, it's the other way round with Queen Mary's bailing out the PRUH.

If the consultation report is approved, where are the future patients of the PRUH going to have their babies? In the kitchens?"

Consultation document already dead in the water

I attended - as an observer - a meeting of the Joint Committee of PCTs held on 3rd March where it was stated that 2,606 responses had been made to the A Picture of Health questionnaire.

I estimate that, bearing in mind that

1. the consultation period is already two thirds of its way through, and
2. most responses are received early on in a process

the total number of responses at the end of the review will not exceed more than about 4,000.

We are talking about the future health needs of more than a million people. 760,000 documents have been sent out which means a response of around 0.5%. A "response" includes not only a completed questionnaire but also:

1. a partially completed questionnaire,
2. just a letter, or even
3. just an answerphone message!

As such, despite Gill Galliano, Chief Executive of Lewisham PCT stating that response rates are "so far very positive" the fact of the matter is that no academic institution would accept such a minuscule response rate as a valid sample from which to draw any conclusions whatsoever.

As such, this unnecessary, expensive and bureaucratic process is already dead in the water.

Consultation Report a Sham

I have written to A Picture of Health to complain that none of the 3 "short list" options presented to local residents includes retaining Queen Mary's A & E.

In the full report 23 "long list" options were developed in which 70% proposed keeping Queen Mary's as a fully admitting hospital (13 options) or a medically admitting hospital (3). However, by the time that these 23 options had been mysteriously whittled down to 3, not one of the 16 options to have Queen Mary's as a fully or medically admitting hospital had been retained. The 3 short list options all include Queen Mary's as a borough hospital, the lowest type of hospital.

The final 3 options were selected and articulated by the NHS behind closed doors and has left the public with what amounts to Hobson's choice. None of the 3 options provide for a fully functioning A & E, non-surgical emergencies, emergency and complex surgery, trauma surgery, children's services - inpatients, assessment and treatment, doctor-led maternity unit with intensive care for babies, or midwife-led birthing unit.

In the questionnaire the residents of the Boroughs of Bexley and Bromley are permitted to select "none of these [3] options", having been told in the consultation report that to leave things as they are "is not an option"!

The consultation report is a sham, asking for residents to respond to closed questions relating to limited options preselected by NHS bureaucrats.