Jos Bell, Public Sector Troubleshooter Responds To Trust Special Administrator

Dear Matthew Kershaw


I doubt that you will read this but I will write it anyway.


As someone with a sizeable background in troubleshooting the public sector it is very clear to me – and to an increasing number of others – that the decision to recommend the closure of Lewisham A&E is based upon not one single form of sound practice. Indeed it is a highly dangerous move which will result in unnecessary deaths. It is also fundamentally – and fatally – flawed in both the clinical and the economic sense.


Firstly, Lewisham has just undergone a high profile ( thankyou Gareth Malone!) re-furb which adds to the clinical excellence of the provision for the patients in a densely populated area which has a high demand for a safe, effective and accessible A&E/NHS services to which they are entitled

Lewisham needs to re-pay it’s PPI on the new re-furb – it cannot do so without income from patient usage. To remove the service undermines the business plan

Lewisham will not achieve Foundation status as required by the government if financial security cannot be projected

Lewisham also has a dedicated paediatric A&E with a good quality reputation

Lewisham is one of the most densely populated areas in the UK with an increasing population.

Lewisham people have a health profile which requires speedy access to reliable NHS provision


Lewisham people will find the alternative of Woolwich to be unacceptable for a range of reasons, including :

  • very difficult to access via public transport – the hospital is some distance from the train stations, with no direct bus routes 
  • lower quality facilities and provision
  • existing pressure on numbers and waiting times

Lewisham people are more likely to opt for Kings College A&E – which is both easier to access and has a far higher quality delivery than QE Woolwich.

However this facility is already operating at capacity.


The key points are :

  • this decision will put Lewisham people at great risk
  • it is foolhardy, uneconomic and uniquely contrary to announce the closure of a newly opened high quality setting in favour of an over-stretched, hard-to-reach, poorer quality setting.
  • it is obvious that this is a political and ideological decision rather than one based upon sound principles of clinical safety and economic efficacy

Evaluation :

  1. Perhaps you would like to spend some time in QE Woolwich A&E and ask your relatives to take a trip to see you on public transport via a few random points dotted around Lewisham?
  2. Perhaps you would like to do the sums again to include a patient, GP and population health impact cost assessment ?
  3. If not, you should commit to speaking in person to the first families who suffer bereavements as a result of this frankly insane service re-alignment.

If the answer to these 3 options is no, it will be obvious that you have no care for sound economic principles or indeed people or patients – which is the whole point of the role of government and health management in particular.


As it is, I write this from an NHS hospital bed, looked after by wonderful caring expert staff. Had I not been able to access this service I would have required drastic surgery & been paralysed for some considerable period – causing a drain on additional recourses over a protracted period.

Ipso facto : speedy expert intervention is cost effective!


Please do not let the people of Lewisham suffer because of mismanagement by other trusts and political thugs who seek to destroy the NHS


my regards


Jos Bell