This week the fuse was lit for the wholesale privatisation of the NHS - and the Com/Dem coalition is, as usual, carrying out its backstabbing behind smoke and mirrors spun by lackeys.
The NHS has for years become the battlefield for dodgy ideologies and has long been eyed by the Tories money-grubbing mates as a potential honeypot.
Battle lines have been drawn in Cambridgeshire and the western Kent borders, and now the South London Healthcare NHS Trust is on course to join them as it becomess another victim of 'New' Labours' driven PFI debt and severe Tory/LibDem cuts.
South London Healthcare NHS Trust was the first trust to be placed in administration after it reached the brink of bankruptcy and now special administrator Matthew Kershaw, who was parachuted in to run the trust last summer, says it should be broken up.
Mr Kershaw recommended:
- Improving "operational efficiency" of trust sites, including cutting the workforce.
- Developing Queen Mary's Hospital into a Bexley Health Campus, providing day case elective surgery, endoscopy and radiotherapy. It would be owned by Oxleas NHS Trust. Dartford and Gravesham NHS Trust would provide case elective surgery on an interim basis.
- Selling off "vacant and poorly utilised premises" around the Queen Mary's site and Bromley estate.
- A £20m to £25m annual payment from the Department for Health to cover the costly PFI costs which funded Queen Elizabeth Hospital and the Pru.
- Closing Lewisham Hospital A&E department with emergency care for south east London provided by King's College Hospital, St Thomas's, Queen Elizabeth and the Pru.
- Either shutting Lewisham Hospital's maternity unit or making it a standalone obstetric-led delivery facility.
- Making Lewisham Hospital an elective centre for non-complex inpatient procedures like hip and knee replacements.
- The sale of Orpington Hospital and Beckenham Beacon.
- Write-off of trust PFI debts.
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Kershaw was appointed to run the debt-ridden trust after it reported in July 2011 a deficit of £69m. In November 2011 he recommended the trust is dissolved and other organisations should take over the management and delivery of the NHS services it provides.
Kershaw says any debts (the trust was losing around £1.3 million a week) should be written off by the Department of Health so new organisations are not "saddled with the issues of the past." This would include bailing out massive PFI debts, which use up 16 per cent of the trust's income.
The bailout would provide a tasty sweetener for any private firms hoping to cash in on its difficulties.
He also recommended the Department of Health provides additional funds to the local NHS to cover the excess costs of the PFI buildings at Queen Elizabeth Hospital, Woolwich, and the Princess Royal University Hospital, Farnborough.
Lewisham Hospital's A&E services, including its acclaimed children's A&E, medical and surgical emergency care and maternity services, which incidently is not part of the trust, are all up for closure as part of his recommendations. Other organisations would take over the management and services - meaning hospitals not even part of his remmit are being drawn into the plan.
The fact that Lewisham is not connected with the trust doesn't seem to matter. 120,000 use Lewisham A&E each year. Over 30,000 children use the children's A&E. Over 4,000 babies are born in the hospital each year, but when have mere details ever got in the way of a Tory masterplan ?
Ominously, Kershaw said £42m could be saved by cutting 140 staff from the trust's three hospitals. Implementing his proposals would cost around £313m, while the trust's debts are expected to reach £207m by March 2013.
Health Emergency chairman Geoff Martin says the trust has been "ripped to shreds" through a "lethal combination of mismanagement, the brutal cost of financing failed PFI schemes and an obsession with a 'target-led' culture at the expense of patient care.
"The bottom line is that the same poisonous cocktail is still at the heart of the NHS under this government. The collapse into bankruptcy at South London Healthcare could easily be mirrored in other parts of the NHS, notably at St Helier Hospital just across town in south-west London.
"Not a single manager or politician responsible for this disaster has ever been called to account for their actions and the misery and anger that they have unleashed."
Unison's branch treasurer at Lewisham hospital Conroy Lawrence says the plan to break up the trust is cost-driven.
"If you take millions out of the NHS as this government is doing then A&E departments, maternity units and hospitals will close," he says.
"We have every reason to believe the people of Lewisham will now redouble their efforts to defend what is a popular and well respected hospital against what is nothing less than a political attack upon an inner-city community."
Solidarity General Secretary, Pat Harrington, said:
"The NHS represents the best of Britain. It is an example, even with all flaws, to the World. It saddens me to see it attacked by market jackals. We must defend it and uphold the worthy ideal that we should all contribute to provide a safety net for those who are in need. That's the true spirit of the British people, generous and caring, not the callous individualism that some would promote."
Thousands of people in the area protested when initial recommendations trickled out last year and there was widespread opposition from health professionals and politicians. It looks as though residents will need to take to the streets again.
Tory Health Secretary Jeremy Hunt is due to make a decision on the trust's future by February 1.
Report by Ian Bell