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David Wrigley: How to fast track hospital closures—use clause 118

23 Jan, 14 | by BMJ

david_wrigleyLike a baby throwing their toys out of a pram, Jeremy Hunt is using the blunt instrument of legislation to hit back at patients and campaigners who beat him in the High Courts over his attempt to close Lewisham Hospital.

Lewisham was a successful, popular, high quality, and solvent London hospital. A neighbouring hospital was in dire straits owing to crippling politically engineered PFI debts, so Jeremy Hunt sent in his officials who decided the answer was to close Lewisham Hospital. No one could understand the logic. This decision immediately angered local clinicians, commissioners, and residents, and a huge and ultimately successful campaign stopped the closure process. It was ruled unlawful by the judge. Mr Hunt subsequently decided to spend thousands of pounds of tax payers money to appeal against this High Court decision—but again he lost. To waste a huge amount of tax payers money on these legal bills does make one question his judgment.

Jeremy Hunt was not a happy man. In order to stop local people blocking his officials in future cases he decided to add a last minute clause to the care bill currently moving through Parliament. Clause 118 is the number on NHS campaigners lips. It allows officials to close any English hospital with very little meaningful consultation. Even local council scrutiny processes—often seen as robust and fair—will be side-lined. It is a complete and utter affront to democracy. You would only expect to see such legislation in a Soviet style totalitarian regime.

Jeremy Hunt’s justification for clause 118 is that when a hospital is failing he needs to be able to close it down quickly for “patient safety reasons.” Hospitals fail due to poor management in most cases. Management who have been blinkered by the need to run their institution like a business and chase the money in order to survive. Mr Hunt would be better to totally remove competition from the NHS than spend his time pushing through the undemocratic clause 118. It is just another example of the disastrous marketisation of our English NHS that no one asked for and indeed very few people actually want in their NHS.

Shadow Secretary of State for Health Andy Burnham said this legislation should “send a shiver through every community” and he is right. No hospital will be safe in what is rapidly becoming known as the “hospital closure clause.”  The UK has fewer hospital beds per head of population than almost every other European country (we have 3.0 per 1000 population in 2011, well below the OECD average of 4.8 per 1000). The lack of beds leads to huge pressures in hospitals and the pressure valve that is A&E eventually blows. The one useful thing Jeremy Hunt could do would be to use the £3bn NHS surplus that we have to invest in more nurses, more beds in hospitals, and more social care for patients to be transferred safely back into the community.

This latest attack on the English NHS is another in a long list of coalition policy disasters for the NHS. In the name of democracy I ask politicians to withdraw clause 118 and listen to your electorate and stop selling off our NHS to the highest bidder and running it into the ground at every opportunity.

Competing interests: I declare that I have read and understood the BMJ Group policy on declaration of interests and I have no relevant interests to declare.

David Wrigley is a GP in Lancashire and a member of the BMA GP Committee. He also speaks for the campaigning group Keep Our NHS Public which is an apolitical organisation seeking to bring about a publicly funded, publicly provided, and publicly accountable NHS. He contributed to the recent book “NHS SOS.”

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