Thursday, 20 December 2012

An MSLC Merry Christmas to you all

Dear readers,

The work of the MSLC continues apace both in campaigning to stop the ridiculous proposals to close Lewisham's maternity services and in its day-to-day work to oversee those maternity services we are so desperately trying to preserve.

Today the MSLC met for the first time since the proposal to close Lewisham Hospital's maternity services was announced.

At the meeting we discussed the TSA, the responses from Lewisham Hospital, Public Health and the MSLC lay membership. We considered how to keep up the pressure on the Department of Health to save the acute services of A&E and Maternity in Lewisham.

Here's a summary of our strategy:

The TSA: where we go from here.
The TSA consultation closed on December 13th. The TSA, Matthew Kershaw, will submit his recommendation to Jeremy Hunt, Secretary of State for Health, on the 7th January.

The final decision will be announced on the 1st February by Jeremy Hunt in parliament.

It is vital that we don't lose momentum with our campaign. We must take our case to the Department of Health and to our local MPs. The members of the MSLC will prepare their own letter to the DoH.

We shall also prepare a pro forma letter which you will be able to download from our facebook group for inspiration to send your own response.

Your MPs:

Jim Dowd - Lewisham West and Penge

Heidi Alexander - Lewisham East

Joan Ruddock - Lewisham Deptford

Or write to
Jeremy Hunt - Conservative Secretary of State for Health

Andy Burnham -  Labour Shadow Secretary for Health

For more information on the TSA's time-table please see

Our area for concern will focus on two points:

1. The Unsustainable Provider Regime is an inappropriate use of legislation. The UPR was brought into law in order to deal with failing single hospitals. In the case of the TSA it has been used to reconfigure services throughout SE London. This is also the first time the UPR has been used and so we are providing a test case in one of the most highly deprived areas in the United Kingdom.

There has not been enough time to properly consult health professionals, service users, managers or commissioners or do the requisite work for this level of service reconfiguration.

2. The Lansley 4 Tests and Maternity Matters:

In 2010, the Secretary of State introduced ‘four tests’ to be applied to NHS
service changes. In producing the final report the TSA is required to take these
tests into due regard. If Lewisham loses its maternity services and A&E the Department of Health will strip Lewisham residents rights to its own minimum service agreement.

The Four Tests are summarised here:

1. The changes have support from GP commissioners

  • Although we cannot answer on behalf of GP commissioners, there are a significant number of GP commissioners who do not support the TSA's recommendations.

2. The public, patients and local authorities have been genuinely engaged in the

  • This is so far from the truth that it would be laughable should it not be so distressing.
  • There have been a grand total of three public meetings convened by the TSA. 
  • Many members of the public have reported that these meetings were undisciplined and obfuscatory.
  • The two focus groups for maternity services were badly managed and, critically, badly planned so that they provided the only chance for service users as a group to express their disquiet at losing a local maternity service. 
  • Seldom heard groups such as refugees, asylum seekers, travellers, young parents and other marginalised or disadvantaged groups were not consulted at all.

3. The recommendations are underpinned by a clear clinical evidence base

  • Lewisham Hospital, Guys and St Thomas' and Kings reject option 1 (to disperse Lewisham maternity to St Thomas', Kings and Bromley).
  • Lewisham Hospital have accepted a modified option 2 (to retain an obstetric led unit at Lewisham with minimal changes to services).

4. The changes give patients a choice of good quality providers

  • If the Department of Health go for option 1 Lewisham women will not any choice at all. 
  • St Thomas' and Kings are capped - this means that they cannot accept any extra women outside their area unless they are referred as high risk patients. 
  • Women will be forced to use the service at Queen Elizabeth Hospital in Woolwich. 
  • QE has been traditionally very unpopular with women due to its clinical reputation. 
  • It is also nigh on impossible for many women in Lewisham to reach especially as 50% of Lewisham residents don't own a car and rely on public transport.

Maternity Matters
Maternity Matters was a commitment made in 2005 by the then government to offer women a wider choice in maternity care.

  1. Choice of how to access maternity care 
  2. Choice of type of antenatal care
  3. Choice of place of birth - depending on their circumstances, women and their partners will be able to choose between three different options - a home birth, birth in a local facility, including a hospital, under the care of a midwife, birth in a hospital supported by a local maternity care team including midwives, anaesthetists and consultant obstetricians. For some women this will be the safest option.  
  4. 4.choice of place of postnatal care

Thank you to everyone who came to the meeting this afternoon and many thanks for all of those who couldn't make it for your valuable contributions over the last few weeks and months.

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