Lewisham Hospital: A tribunal of the People, by the People and for the People

It is increasingly obvious that citizens worldwide are becoming disenchanted and disengaged with established government. This has been manifest in various forms of political and economic meltdown.

By Michael Mansfield QC and Elizabeth Woodcraft

It is increasingly obvious that citizens worldwide are becoming disenchanted and disengaged with established government. This has been manifest in various forms of political and economic meltdown.

Underpinning all the movements is a desire for accountability and transparency. Where this is not forthcoming ordinary people are finding ways of exercising democratic control and making their voices heard.

This cannot be better illustrated than by a remarkable initiative undertaken by the people of south London in Lewisham. In their midst is a fine community hospital which has achieved the highest medical standards, provided excellent specialist services and training and is economically viable. It is regularly cited in the top echelon of UK hospitals.

To the surprise of doctors and public alike in 2012 it appeared the hospital was earmarked for closure, a threat which has now been distilled into a massive downgrade.

The current proposals include the closure of A&E, all acute admitting wards (children, intensive care, emergency and complex surgery), and replacing a maternity unit supported by obstetrics and intensive care with a stand-alone midwife-led facility.

This so called reconfiguration has little or nothing to do with healthcare but everything to do with the financial crisis pertaining in a neighbouring healthcare trust.

This in turn has been brought about by exorbitant borrowing costs inflicted by previous government inspired PFI contracts.

None of this has the support of Lewisham hospital, its own trust, the clinical commissioning group, neighbouring hospitals and GPs let alone the people of Lewisham. The consultation exercise was a sham. Some significant individuals were not consulted at all. Others were given short notice and short shrift.

Result – public outcry early this year and a huge demonstration by 25,000 on the streets of Lewisham.

One of the ideas forged by this anger was to carry out what the government had failed to do: establish a proper inquiry to hear the evidence and voices of those so rudely excluded or ignored. In essence this became the Lewisham Independent People’s Commission of Inquiry.

Such a concept has a recognised history and precedent not so much in the UK but internationally. Bertrand Russell convened a tribunal of international civic conscience on Vietnam in 1966, which has recently reconvened on Palestine 2010 – 12.

In both cases there was a need to highlight unredressed violations of international law by USA in the first instance and Israel in the second.

Another similar tribunal took place in the Hague last autumn to focus on human rights abuse in Iran. These initiatives have been entirely motivated and organised by civil society. A permanent international people’s tribunal was set up in Bologna in 1979.

The Lewisham Commission had a panel of three (Baroness Warnock, Blake Morrison and Michael Mansfield QC – chair) appointed by the community campaign group, which also agreed a remit – to look at first principles of the original NHS vision, how it has become warped by the internal market and privatisation, and see where Lewisham stood in the overall ideological changes.

The Campaign team was extraordinarily well organised, its members brimming with information on every aspect of the issue, enough for a six month inquiry. We had a day.

A meeting was held in chambers where barristers agreed to prepare a witness template and take statements.  Others would act as advocates on the day. Even more would assist in compiling the final report.

The numbers wishing to give evidence were almost overwhelming. Doctors, nurses, patients, parents, waited patiently, sometimes for hours to tell their story to the evidence gatherers.

The Broadway theatre in Catford was booked for 29 June 2013, bundles were prepared, a running order agreed. Jeremy Hunt was invited along with Bruce Keogh, one of his advisers. They did not reply, nor did they attend. Their words were read by an actor.

Twenty five witnesses on the day were called, only one could not attend – a doctor on call in the A&E department. The evidence of another twenty was given from pre-recorded videos. Throughout the day more than 500 people attended the Inquiry. All were invited to make their own contribution by email, tweet or by writing comments on a scroll in the theatre foyer.

Members of the audience were in tears as witnesses spoke of the impact such changes would have on them as individuals, three bus rides for a mother in labour, long journeys across the borough for a Sickle Cell sufferer, losing the long established teams of known and trusted doctors and nurses for young teenagers in danger of slipping through the cracks in the system.

All were appalled as the exact financial implications of the debts incurred under the Private Financial Initiative were explained.   Everyone expressed gratitude to have been part of this important experience.

The full report of the Panel will be released in September.

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