The Business of Saving Lives

The decision on whether or not Lewisham A & E and maternity units will be kept open will be made by the health secretary, Jeremy Hunt on 1 February.

Next weekend (26 January), the people of Lewisham will march again in protest at threats to essential services in their community.

It shouldn't come as a surprise to many readers of this website that vehement opposition to the  closure of local A & E and maternity units would be the preferred editorial line. So, with that expectation satisfied, let me start by listing a couple of the reasons I'm not against this particular closure.

I'm not against the closure of Lewisham A & E and maternity units because when I've had occasion to avail of their services, the staff at that hospital have looked after me with nothing but compassion, professionalism and integrity.

Unfailingly, my dealings with Lewisham hospital staff, from receptionists to consultants, have been exemplary.  It would therefore be unprofessional of me to base opposition to such a matter of public importance on my own subjective experience.

So for similar reasons, I'm not against the closure of Lewisham A & E because of the way they took care of my aunt after she'd been hit by a car while cycling. Again, I would only be attributing emotional resonance to the fact that these people were just doing their jobs. We mustn't let that get in the way of what's really important.

And what's really important is the stealthy dismantling of the NHS. I wish I could get away from this tired old story but the closures being proposed  in Lewisham are ideologically motivated, plain and simple.

They are not truly even being based on market rationale -- this is mere balance-sheet  hokum designed to allow the Tories push through an agenda that ensures their friends and benefactors are the ones who get their noses in the next trough of deregulation and/or public private partnership.

Last weekend (13 January), The Observer reported that the cost of closing Lewisham Hospital's A&E and maternity units would run to £195m. I'm no expert but I'd say that's a rather expensive way of saving money (if we are to actually believe that cost-cutting was the motive behind  the proposed closure).

But apparently, the administrator Matthew Kershaw whose idea it is, had an answer for this. He conceded that his recommendations would cost £195m by 2015/16 in transition and capital costs, but then to start generating a £19.5m annual payback after that. So by that reasoning, sometime around 2025/26, the financial cost of closing the NHS in 2013 would be recouped.

That's the financial cost, the price in human terms might prove a little less straightforward to calculate. The cost in terms of lives lost or blighted as the Golden hour runs down in the ambulance on the way to the next closest A & E; the cost to communities where expectant mothers -- in a what is a largely disadvantaged neighbourhood -- are forced to travel miles further in order to receive the care they need around birth. All the more egregious given the fantastically high standard of service under threat at Lewisham.

The withdrawal of these essential services isn't just an attack on the NHS, it's an attack on the very idea of community. This is an attack on the idea that the government -- which we vote for and to whom we pay our taxes -- has any responsibility in return.

The role of the Tory in government isn't to make Britain great again or even to promote free enterprise. The role of the Tories has become that of a crooked croupier in the Square Mile casino; fixing the house rules for those that can pay.  (From where does such a government draw its legitimacy if it is morally bankrupt in the eyes of the polity?)

One online commenter to the Observer article, Xenaphon (presumably not his/ her real name) was probably onto something when he/she wrote: "Lewisham Hospital, in a London borough that has 3 Labour MPs, is to suffer cuts because the Princess Royal Hospital in the London Borough of Bromley (3 Tory MPs) has an incompetent PFI trust. Typical. Anyway, how can a hospital make "a loss"? Are there other NHS hospital that make a profit? If they can bail out the banks with billions of pounds (to no obvious benefit to anyone except their managers' bonuses) then they can sort this out by the same method."

So to conclude, there might be a lot of reasons I don't oppose the closure of Lewisham A & E and maternity units but there's a well-worn slogan that encapsulates the one very compelling reason I do: 

Hospitals are for saving lives not money.

• For more coverage of protests, check out Transpontine, which covers events across southeast London.