The Killing of a South London Hospital

In the UK, as seen more broadly in Europe, there are a series of severe austerity measures being debated and brought into force. If one puts aside the ‘deficit/debt = bad, belt-tightening = necessary’ one-two punch being peddled by the political and financial establishments and instead examines the underlying causes of onerous debt and mooted sovereign default, a disturbing picture of wilful ignorance and incompetence emerges.

I live in the Borough of Lewisham in London. In the past ten years, the population of London has grown by 11.6% to over 8 million people, and the population of Lewisham stands now at 276,000 living at a density of 7,900 per square kilometre. Britain in general has a rising birth rate and very high net immigration. The British population is now 63 million, having grown 7% since the 2001 census. We are projected to grow to 70 million over the next fifteen years.

As a lifelong Londoner, I can assure you that the pressure on public services, transportation and general infrastructure is overwhelming. Regular breakdowns, station closures due to overcrowding and tremendous traffic of both the vehicular and personal kinds in every area of the city are the norm. As I often say, there’s always someone in front of you keeping you back and someone behind you pushing you forward, wherever you are. This sensation of pressure and crowding has palpably increased since I moved here in 1985.

In this context, two public policy decisions foreshadow a grim future for many Londoners. One is the looming decision to close Lewisham Hospital’s Accident and Emergency department and downgrade its maternity ward. The other is the suggested move by the Metropolitan Police to close fully half of their stations, to be replaced with part-time offices and ‘contact points’ in supermarkets and post offices where people can lodge complaints and report crimes.

You tell me how a borough, city or nation is to cope with a rapidly growing population on top of swingeing cuts to fundamental services.  Seriously. Please tell me how, because I certainly don’t know.

The closure of Lewisham A&E comes on the heels of several other closures in the surrounding area, and would leave the majority of south-east London with only two functioning emergency rooms to handle all triage for 750,000 people. Even the number of available beds is being reduced. To add insult to injury, Lewisham Hospital is actually one of the best-performing hospitals in Britain and is being closed due to mismanagement at other south London hospitals that will remain open. There is literally no justifiable argument for the closure of Lewisham’s A&E department. Unless…

1. One was cynical enough to suggest that the current Conservative-led government and their Liberal Democrat enablers have an active desire to privatise Britain’s world-famous National Health Service. From that angle, it makes perfect sense to close hospitals until the remaining public services are so overwhelmed and oversubscribed that only the private sector can fill the gap.

2. The deficit/debt crisis undermining sovereign finances worldwide is a direct byproduct of a debt-based monetary system that is itself ill-understood by those in government and actively supported by obfuscation from the financial sector.

Far be it from me to suggest such dastardly machinations.

In the spirit of believing in the process even when all evidence leads to the opposite conclusion, I sent a letter to my MP, Joan Ruddock, regarding this state of affairs. It is presented below in full.

Dear Ms. Ruddock,

I’ve written to you before on several occasions, but I feel that none of those letters has been as important as this one. I am of course referring to the proposed closure of Lewisham A&E. Much has been made of the fact that Lewisham just refurbished the A&E department at great expense, and mention has also been made of the jobs to be lost.

However, I want to direct your attention to a deeper issue here, one that I’m sure you have already thought of. The presence of a fully functioning hospital in Lewisham is a public service for a public purpose which transcends the vagaries of finance. The goal of government services is not to turn a profit, nor is it in fact to break even. The goal of government services is the provision of those services. To make a break from this essentially philosophical aspect of the central purpose of government, namely that of care towards the public, is not only a tremendous shift from the avowed raison d’etre of the NHS but a dangerous choice of ideology that will lead this country down a very dark path indeed.

Furthermore there is a demographic ignorance in this decision. London on the whole grew its population by 11.6% in the past ten years, and Lewisham now has 276,000 residents, ranked 13th for population density in the whole country. Lewisham is not only highly populous but also growing rapidly. How exactly are we to adequately care for more and more people with fewer and fewer doctors, nurses, hospital beds, maternity wards and emergency departments? Not to mention the proposed reduction of 24-hour police stations in the borough of Lewisham to only one. What sane approach to public care and policy sees 276,000 people living at a density of 7,900 per square kilometre with only one 24-hour police station and no A&E department as a desirable or sustainable outcome?

What exactly is it that the Borough of Lewisham intends to supply the public with? The government is planning to take away our emergency care, a maternity ward, several police stations, all against a backdrop of disingenuous hand-wringing claiming that there’s no money for public services because of the economic crisis. Let’s put that canard to rest: the Bank of England’s avowed policy of quantitative easing involves the electronic creation of ‘central bank money’ out of thin air with which it credits the reserve accounts of high street banks in order to stimulate commercial lending by those banks. There is no difference whatsoever between the central bank’s electronic creation of money for reserve account credit and the electronic creation of money for public service expenditure, other than the sea change it would produce in the efficacy and comprehensiveness of public services (as well as the downward pressure on bank profits). How many residents of Lewisham must die preventable deaths before this government decides to use its power of money creation for the good of the people instead of the good of the bankers? And don’t get me started on the seigniorage income the government willingly forgoes by leaving the Banking Act unamended so that private banks can create money electronically without legal penalty.

In short, how dare this government suggest that there isn’t money for the preservation of health and the saving of lives? How dare our elected representatives perpetrate through silence or ignorance this utter fiction? It behooves you as the elected representative of the people of Lewisham (who by all accounts came out 96% against the closure of Lewisham A&E during the ‘consultation’ – check the response to Recommendation 5 in the PDF link) to press our case in its entirety. 

For too long, Ms. Ruddock, the people of this country have been told rather than shown that they live in a democracy. Show us the democracy – 96% against, a historic protest last year with another on the way and above all no good reason to push through these unwarranted, unnecessary and unwanted measures.

I repeat, for the sake of those who will suffer needlessly or die if the emergency room and maternity ward are closed, show us the democracy.

With faith in your best efforts,

Mike Freedman

A big protest against the closure of Lewisham Hospital’s Accident and Emergency Department department is planned for Saturday 26th January 2013.

For those of you who are local enough or dedicated enough to brave the ice and snow to stand shoulder-to-shoulder with us on Saturday January 26th, you can find the details of the protest here. Come find me. I’ll be the guy who looks angry.

Download a FLYER HERE

If you would like to know more about how a debt-based monetary system makes the death spiral of crisis-bailout-recession-austerity inevitable, please explore the videos, animations and documents on Positive Money’s website.