Monday, 14 January 2013

The second letter to Jeremy Hunt

Dear Jeremy Hunt,

Last week in parliament you told Andy Burnham and the House that you would not close Lewisham Hospital's A&E department or the full acute maternity service if the TSA's recommendations do not fulfil the Secretary of State for Health's Four Tests.

We are writing to point out that Matthew Kershaw and his team have totally failed to meet the criteria set.

First, there must be clarity about the clinical evidence base underpinning the proposals.

Lewisham's Obstetricians and Gynaecologists have publicly stated that they will not support a stand-alone birth centre. The women of Lewisham put their faith in the expertise of these senior clinicians. We do not believe that a stand-alone centre is safe.

Many women in Lewisham will be considered as too high risk to use the facility and that due to the unpredictability of childbirth the few women who can use it will often require transfer. This will be dangerous in view of the travel time required to reach the proposed acute service at Queen Elizabeth in Woolwich.

The recommendations put much emphasis on the need for all hospitals to provide 24-hour consultant cover. There is evidence that this is not required for safety of patients. If you take this argument out of the recommendation, then the need for a huge maternity hub can no longer be defended.

Second, they must have the support of the GP commissioners involved.

GPs have unanimously and publicly told the Trust Special Administrator and Department of Health that they are against the proposals. As users, we put our faith in our GP commissioners who are experts in the field. Since they categorically do NOT support the proposals, the recommendations have absolutely no credibility

Third, they must genuinely promote choice for their patients.
The recommendations will reduce choice for maternity users.
We believe that the option of home birth will no longer exist, as women will not want to use a service that is not backed-up by a local acute service.

Women in the community have stated that they will not use a stand-alone facility due to the high risk of not having an acute service on site. It will become a very expensive facility for very few women.

A large percentage of Lewisham maternity users will be forced to use Woolwich as they will be considered too high risk to use a stand alone birth centre. Already a high proportion of the population are transferred to hospitals such as St Thomas' and Kings, and this proportion will only increase, since the criteria for using the birth centre on the same site as the level 3 service is already very limited. A large portion of the population will therefore have no access at all to a local maternity experience.

It is known within the medical profession and within the community that continuity of care suffers with an increase in the number of 'hand overs' between professionals. All Lewisham residents will suffer as they will receive antenatal care in the community, care in labour by another set of midwives and then yet another change with postnatal care, which will take place both in the hospital and within the community. This will be made even more complicated by many women choosing to use other hospital trusts for the actual birth.

There are serious safe-guarding and child protection implications involved with such hugely complicated care packages.

Fourth, the process must have genuinely engaged the public, patients and local authorities

We insist that you acknowledge the fact that there has neither been enough time nor resources allocated to have genuinely engaged with the public, patients or local authorities.

We have already outlined in detail the many instances in which there has not been a proper consultation. Please refer to our letter dated 10th January 2013.

We contacted Matthew Kershaw during the consultation period to share our concerns that the women we represent had not been properly consulted. We were offered a one-to-one meeting with a member of the TSA team at 8pm on the night before the deadline for public responses to the consultation. No-one can claim that this was a serious attempt to garner women's views.

The service-users of Lewisham's Maternity Service Liaison Committee demand that Matthew Kershaw's absurd and dangerous recommendations should be consigned to the rubbish bin where they belong.

Yours sincerely,
Jessica Ormerod
Service-user Chair Lewisham MSLC

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