The Threat to a Thriving Hospital
In October 2012, the residents of Lewisham received alarming news. Matthew Kershaw, a Trust Special Administrator appointed by the government, recommended closing the A&E and maternity units at University Hospital Lewisham. The proposal formed part of a rescue plan for the indebted South London Healthcare NHS Trust, which had amassed debts of Β£150 million and was losing Β£1.3 million per week.
The plan made little sense to locals. Lewisham Hospital was not even part of the failing South London Healthcare Trust. The hospital had consistently surpassed government A&E waiting time targets and was rated among the best in London by patients. The threatened cuts would have left Lewisham with only an urgent care centre, and 4,400 babies per year would have been diverted to King's College Hospital and Queen Elizabeth Hospital. The proposals also included closing children's wards and removing critical care, emergency, and complex surgery units.
The Roots of the Crisis
The underlying cause of the South London Healthcare Trust's financial troubles was the Private Finance Initiative, or PFI. The trust was paying Β£69 million per year for hospital rebuilds under PFI contracts. This represented the biggest debts in the NHS at that time. The trust's hospitals included Queen Elizabeth Hospital in Woolwich, Princess Royal Hospital in Orpington, and Queen Mary's Hospital in Sidcup.
The government's solution was to use emergency TSA powers, established under the Health and Social Care Act 2012, to bypass normal consultation processes. The TSA recommended closing Lewisham's successful services to force patients to use Queen Elizabeth Hospital and improve its financial viability.
The Campaign Takes Shape
Local residents refused to accept the closures without a fight. The Save Lewisham Hospital campaign, chaired by local GP Dr Louise Irvine, quickly mobilised opposition. On 24 November 2012, more than 2,000 people marched through Lewisham to protest against the plans. Over the course of the campaign, an estimated 40,000 people took to the streets in protest marches.
The campaign attracted support from across the community and beyond. Archbishop Desmond Tutu lent his support to the cause. Local politicians including Heidi Alexander MP for Lewisham East, Jim Dowd MP for Lewisham West and Penge, and Joan Ruddock MP for Lewisham Deptford joined the opposition. Mayor of Lewisham Sir Steve Bullock and Lewisham Council also backed the campaign.
The Legal Battle
When the government pressed ahead, the campaign took the fight to the courts. On 31 July 2013, Mr Justice Silber ruled at the High Court that Health Secretary Jeremy Hunt's decision to close Lewisham A&E was unlawful. The judge found that Hunt had exceeded his legal powers under the National Health Services Act 2006, describing the decision as "irrational and unlawful." The ruling noted that local people would have "to travel a long, long way further to get access to vital services."
The government appealed the decision. On 29 October 2013, the Court of Appeal upheld the High Court ruling. Lord Dyson, Lord Justice Sullivan, and Lord Justice Underhill dismissed the government's appeal, confirming that the Health Secretary did not have the power to implement cuts at Lewisham Hospital. Tony O'Sullivan, a director of children's services at Lewisham and Greenwich NHS Trust and campaign member, called it "a complete victory."
A Lasting Legacy
The legal victories established important limits on the Secretary of State's powers under the TSA regime. The case demonstrated that emergency powers could not be used to close hospitals that were not part of the failing trust being administered. Lewisham Hospital remains open today, providing full A&E services as part of Lewisham and Greenwich NHS Trust.
The campaign is remembered as a rare instance where a locally organised, self-funded campaign defeated the government in court. It showed what determined community action could achieve when local residents, medical professionals, councillors, and MPs united to defend their hospital.