South London Healthcare NHS Trust

Lord Tomlinson Excerpts

Thursday 31st January 2013 Lords Chamber

[Lord Tomlinson]

My Lords, I join in the thanks offered to the noble Earl for repeating the Statement. One has the feeling that, for someone so highly respected in this House, his heart was not really in the repetition.

Lewisham hospital is a local hospital which produces excellent local care—and I declare an interest as someone who uses its services. What the Minister has announced today is that he is not going to make the cuts quite as bad as they were—not quite as extensive. But, in effect, we are still having a very good service penalised in order to provide resources for the failures. Can I ask two specific questions arising from the Statement? At one point it states that,

“a non-admitting Urgent Care Centre at Lewisham may not lead, in all cases, to improved patient care”.

How does the Minister square that with some of the other statements made about the principles on which this reorganisation is based? With two further tranches of money—£36 million and £37 million—provided to the other sites which need to be improved, I ask him to comment on what the Secretary of State said at the end, namely that,

“there is a significant level of risk associated with achieving the identified savings. I recognise that the additional clinical safeguards I have put in place will marginally increase these financial risks but on balance”—

basically, “I think it might be all right”. Is this not another example of wishing being given a higher priority than factual decision-making?

[Earl Howe]

My Lords, perhaps I may put on the record my own recognition that Lewisham hospital is an excellent hospital. There is no question about that and there has never been any question about it. The hospital provides good care for local people and it is highly valued. Only this afternoon I had one noble Lord from my own Benches telephoning me to tell me of his personal experience of Lewisham hospital and its excellent maternity care.

The noble Lord asked me two specific questions. He quoted the Statement where at one point it was made clear that a non-admitting urgent care unit at Lewisham would not improve patient care. That is the precise reason why Sir Bruce Keogh recommended something different; namely, an admitting A&E unit with 24/7 cover. He looked at the recommendation and was not satisfied with it in terms of risks to patients. I hope that that is helpful to the noble Lord because I think he misconstrued what I was saying.

On the question of risk, any set of assumptions that relies on hypotheses around patient flows in the future and clinical referral decisions has to be, by its very nature, uncertain. It is the view of the trust special administrator and the review of my right honourable friend that the assumptions underpinning these decisions are reasonable, and that was backed up by Sir Bruce Keogh. But the noble Lord has a point because the implementation of these recommendations is going to be key, and that is why the TSA has recommended a programme board to oversee the implementation of these recommendations over the next few years. It is absolutely essential that commissioners and the providers in that area buy in to these proposals. We believe that they will, but it is important that if the financial risk is to be minimised, we get as close as possible to the forecast and predictions that the TSA has set out.