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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