The government is trying to push through a last minute change to the law to make it far easier to shut down A&E departments and hospitals without full consultation.

Amendments tabled yesterday to the Care Bill – due to have its third reading in the Lords on Monday – give the government or Monitor the right to order any hospital they like to ‘reconfigure’ – in other words, close  – with little consultation, to benefit neighbouring struggling hospitals.

The move comes after Jeremy Hunt’s failed in his attempt to hastily close much of Lewisham Hospital and redirect its patients to neighbouring South London hospitals in financial difficulties. Campaigners succesfully defeated the plan in the High Court in July, where Hunt’s actions were ruled unlawful. In a letter to peers yesterday, health minister Lord Howe said that the amendments aim to ‘put beyond doubt’ that such closure moves by Hunt – anywhere in the country – would in future be lawful.

Louise Irvine, head of the Save Lewisham Hospital campaign, said

 “This Government are making profound changes to the law on the hoof to enable them to bully through hospital closures in Lewisham and around the country without the need to consult properly and thoroughly.

“The amendment to the Care Bill they’re trying to drive through at great speed, gives them unlimited powers to destroy any hospital, in any geographical area regardless of how successful it is, or how desperately needed it is by that community.

“It is very dangerous indeed if politicians quite deliberately sweep away the checks, balances and full consultation processes that are needed in current legislation to restructure and reduce health services for the population.”

South London Healthcare Trust was the first hospital to be put into administration, a process that means closure decisions can be taken without the normal level of public consultation required. Under the ‘administration’ procedure, closures can take place in less than 6 months, rather than having to go through a full public consultation process which takes around 2 years.

Protecting Private Finance Initiative debt repayments

Many commentators observed that the Lewisham move seemed designed mostly to keep South London’s ‘Private Finance Initiative’ debt repayments flowing to private investors at all costs – even if that cost was the downgrading of a neighbouring, financially successful hospital without PFI debts. If the government succeeds in changing the law at the eleventh hour, even those hospitals not carrying huge PFI debts could be sacrified – across the country – to redirect patients to those which are.

The £20billion of budget cuts, £3billion cost of reorganisation, and costs of running a market, means the NHS is struggling to afford to keep hospitals open and staffed safely. NHS establishment figures are increasingly vocal in calling on the public to accept that hospitals must close or downgrade as a result, though the publicly remains strongly opposed to closing local hospitals.

Hunt is still trying to appeal his defeat over Lewisham hospital – an appeal will be heard later this month. Richard Stein, lawyer for the Lewisham campaigners, accused the government of ” trying to move the goalposts…The Government no doubt hope to have the new draconian powers in place so they can use them to impose the cuts on Lewisham Hospital if they are forced by the court to reconsider.”

David Babbs, head of 38 Degrees said the government was

“trying to sneak through a law which allows them to force through cuts even if local doctors don’t agree. It is totally unacceptable and goes against all of the governments assurances that they want services controlled locally.”

It seems the government – which no longer has a full legal responsibility to secure a comprehensive healthcare service, following last year’s Health & Social Care Act – nonetheless still wants the right to interfere and impose unpopular closure decisions without having to go through the inconvenience of an extensive local consultation.

The move was condemned by Lord Phil Hunt, shadow health spokesman in the Lords, as ‘outrageous’.

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