The Tory government chose the weekend of the 72nd anniversary of the founding of the NHS to sound the death knell for acute services at St Helier Hospital, and at Epsom Hospital in Surrey.
Doomed: St Helier Hospital in Sutton
A 25-year-long battle to maintain and upgrade the buildings and services at St Helier seems to have come to an end on Friday with the announcement of a £500million new, but significantly smaller and less easily accessible hospital, close to the site of the Royal Marsden in Belmont.
The plans to reduce critical care capacity at the two existing hospitals has been criticised by campaigners as “reckless” in the context of the covid-19 pandemic.
Trades unions and health service activists who had been campaigning for decades against the cynical neglect of the facilities of St Helier warn that by gutting the hospital’s Accident and Emergency department, maternity, children’s care and other acute services, Mayday and St George’s Hospital at Tooting, too, will likely face greater demand on their services, with the potential to increase waiting times for routine appointments.
The Keep Our St Helier Hospital campaigners were particularly critical of the manner in which the decision to downgrade the hospital was taken, with a public consultation that was significantly curtailed due to coronavirus and announced at a “virtual” meeting of the Improving Healthcare Together (IHT) committees on Friday, where it was claimed that the proposed new hospital had “broad support”.
Sandra Ash, from KOSHH, described that claim as “disingenuous”.
“The IHT received only about 4,000 responses, not all of which will have been favourable,” Ash said, claiming that KOSHH had gathered 20,000 signatures in petitions conducted across south-west London from people “who emphatically reject the proposals”.
KOSHH’s and other petitions, Ash said, “have been totally ignored”.
“It is reckless to be reducing critical care capacity further than that which has delivered the worst death rate in Europe during the covid pandemic,” said Ash (pictured right).
“The plan is not actually about improving healthcare or anything else. It is about implementing cuts to reduce NHS provision and forcing resort to private providers.”
The weedling process of undermining health services in south-west London gathered pace under the Tories in 2015, with the “Sustainability and Transformation Plans”, when £23billion was to be cut from NHS budgets, with this part of London hit with a disproportionately large £1billion axed from its budgets.
“This was the main reason NHS managers decided to reduce the number of major acute hospitals in the area from five to four, or even three,” Ash said.
“This will just make it easier to privatise our NHS.”
Ash described the £500million Belmont proposals as “dangerous” and “utterly flawed”.
“They have decided that all acute services will cease to be provided at Epsom, St Helier and Queen Mary’s Hospital for Children. Patients needing A&E, maternity, children’s care, intensive care, emergency treatment or emergency surgery, or coronary care will instead have only a single facility in the Royal Marsden.
“That facility will have fewer beds, fewer consultants and be further away from most patients when it is needed in an emergency.
A map of south London CCGs and catchment areas illustrates the likely consequences for Croydon of the closures at St Helier
“It is certain to be insufficient to meet the needs of the population. Diversion of patients to other surrounding hospitals will not help, as those hospitals are already over-stretched.
“It is certain that the number of excess deaths will increase if the plan is implemented.
“Covid-19 has further exposed the inadequacy of NHS provision that was obvious well before the onset of the pandemic. Germany has about five times as many critical care beds as the UK, which has exacerbated our response to the pandemic. We have the highest number of deaths per thousand in Europe. This plan will reduce the number of beds in this part of London even further,” Ash said.
Germany has nine hospital beds per 1,000 population. In France, it is six per 1,000.
The IHT plan announced on Friday will see the NHS provision in south-west London reduced to about one bed per 1,000.
The covid-19 pandemic has also highlighted how vulnerable some receiving hospital treatments, such as cancer patients, are to such deadly viruses. Yet under the plans for Belmont, the new hospital will be sited right next to the Royal Marsden cancer care hospital.
“The proposed siting of the area’s only acute facility next to a hospital full of immune-compromised patients is an irrational one,” Ash said.
“There has been no study or costing of the patently safer, sensible and cost-effective solution of maintaining and improving services at Epsom and St Helier. The legitimacy of excluding this option, and the legal authority of the CCGs and IHT to take the kind of decision they have, is highly questionable.
“These plans have no medical or financial justification and will cause harm and increased deaths throughout south-west London.”
Ash said that KOSHH wants the public to lobby their borough councils “to refer these dangerous and reckless plans back to the Secretary of State for Health and Social Care. Councils have the right to reject these plans and it is their duty to do so.”
Although the threat of hospital closures has always been an election issue over the last decade, so far Croydon’s Labour-run council and the borough’s two Labour MPs have said nothing about the fate of St Helier and its likely impact on NHS services in this borough.
In announcing the decision to build the new hospital at Belmont, health service officials promised to improve the bus service to the Royal Marsden “into Merton and further south into Surrey beyond Epsom”. Which is nice of them.
Some of the drawings of the smaller, less-easy-to-access hospital at Belmont which was announced on Friday
They also said that they would be “exploring opportunities for primary care services at Epsom and St Helier hospitals, and expanding child and adolescent mental health services on the St Helier site”. Which sounds very much like an after-thought, and a sop.
In Friday’s announcement, it was claimed that “around 85 per cent of current services will stay put at Epsom and St Helier, with six major services being brought together in the new specialist emergency care hospital, including A&E, critical care and emergency surgery”.
A couple of “on-message” medical professionals were wheeled out to emphasise the positives, and ignore some of the more obvious flaws in the proposals.
Dr Andrew Murray, a GP and the clinical chair at NHS South West London Clinical Commissioning Group, said: “Today’s decision will see £500million invested to build a brand new emergency care hospital in Sutton and modernise Epsom and St Helier hospitals.
“This means people can get the care they need in refurbished buildings locally, with a brand new specialist hospital nearby if they need it. This will give our residents the quality of care they need in the buildings and facilities our NHS staff deserve.”
And Arlene Wellman, Epsom and St Helier Hospitals’ chief nurse, said: “This decision means we will get better hospital facilities, lifts that work and single rooms to care for patients with infections.
“What covid-19 has shown the NHS is that for all our communities survival rates are higher if specialist hospital staff work together in one team, in one place to care for the sickest patients around the clock – today’s decision addresses that.”
Many believed that when Daniel Elkeles was appointed as the chief exec of the Epsom and St Helier NHS Trust, he saw his prime role as implementing Whitehall cost-cutting and bringing about the down-grading of the hospitals.
Unique: MP Elliot Colburn, complete with his NHS pin badge
On Friday, job done, Elkeles said: “This is a hugely important and welcome decision about investing £500million here at Epsom and St Helier so we can provide high-quality healthcare for everyone for generations to come in a newly built emergency care hospital and refurbished existing buildings.
“It’s also important to remember that 85 per cent of the services are staying put at Epsom and St Helier Hospitals with urgent treatment centres open 24 hours a day, 365 days a year at both.”
The fate of St Helier and Epsom has been a political issue for two decades, with Conservatives keen to implement a scheme which would make it easier to privatise many of the services currently provided by the NHS. The Liberal Democrats who control Sutton Council and who, until recently, had two of the area’s MPs, have previously supported the scheme, though on Friday they sounded some disquiet.
For new Carshalton and Wallington Tory MP Elliot Colburn, the announcement has seen him claim a unique place in British politics, as the first Member of Parliament to support the closure of his constituency’s A&E unit.
Happy birthday, NHS!
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I feel your headline is inaccurate
Really? How?
Anybody thinking of opening a book on the likelihood of this new hospital being on budget and on time?
Except for the politicians, nobody really thinks it can be finished in five years – my bet is that we shall still be arguing about it then!
Tory-bashing article, inaccurate and biased. St Helier is not fit for purpose, outdated building, too expensive to maintain.
I’m not sufficiently informed about St Helier to say whether the decision to close it is a good one or not. (Although my A&E experiences weren’t brilliant, and I have always fared better at Mayday).
However, for Ash to claim that “it is about implementing cuts to reduce NHS provision and forcing resort to private providers” and ““This will just make it easier to privatise our NHS”, while implicitly lauding the German healthcare system is contradictory and shows a fundamental lack of knowledge about how the latter is funded and organised.
First, it is about 80% funded by the state – the rest of it is by private provision. Second, health insurance is compulsory and contributions dependant on income (i.e. you have to PAY for some of it); and there are co-payments for treatment. Third, GPs are private providers, reimbursed by their state for their services. Many (most?) hospitals are independent, albeit not-for-profit, and so on and so on.
I’d welcome a debate critically comparing the German healthcare system to ours, and whether ours could be adapted to resemble their evidently more effective model.
Yet the NHS is such a sacred cow, subject to such fierce ideological concerns, not least about “private providers” and “privatisation”; that just ain’t gonna happen.