It's been a busy week - meetings every evening, and Budget Council tonight.
I hope it won't be as long as the Health Overview and Scrutiny Panel meeting last night which finished at 12.15am. But it was a very important meeting, and I was impressed by the way in which everyone was listening intently throughout.
The topic was the threats to Kingston Hospital. I had proposed that we call a special meeting of the Panel, after several people voiced concerns at the last meeting, and I was very pleased that the major players were represented at the highest level.
So the Chief Executive, Kate Grimes, and the Chair of Trustees of Kingston Hospital, Christopher Smallwood, were there, as were Susan Kramer MP and Edward Davey MP
The key people we wanted to quiz were from Healthcare for South West London, who had commissioned the work on the future of the four hospitals in the area. The Chair, Sian Bates, attended, accompanied by Dr Martyn Wake, the Clinical Director, and Lucie Waters, the Joint Director of Strategy. Finally NHS Kingston was represented by Penny Taylor, as the Chief Executive could not be there..
I mention all these people because it indicates the seriousness of the issue.
You can read the background to the story on www.savekingstonhospital.org.uk.
I'm not going to go through the meeting line by line, but will pick out some things that stood out for me, mainly in answer to the questions I posed.
Back in November the two MPs had been briefed ("by four Chief Executives") that a document called the South West London Strategic Plan was due to be published on 18th December 2009. It listed options for reorganising St George's, St Helier, Mayday and Kingston Hospitals. In many of those options Kingston would lose A&E, Maternity or both.
At the last moment publication of this document was delayed, first to January, and then until after the election. At that point the MPs decided to go public on what they had been told.
We had asked Healthcare for SW London to release the Strategic Plan for the meeting last night, but they refused to do so. Instead they presented us with another report called The Case for Change, and spent a long time telling us about that. When we finally got a chance to ask questions, I pointed out that although The Case for Change was an important document because it dealt with the high level principles, it was not the document that we had asked them to talk about.
As it happens things had moved on since last night's meeting was first called. Someone had leaked pages from the SW London Strategic Plan to the MPs, and you can see copies of them here. Printouts of these four pages were included in the agenda papers.
So I then asked Healthcare for SW London whether the pages were genuine extracts from the document. They agreed.
I asked what the term 'Final draft, 18th December 2009' meant. This is clearly stated on the first page. They said that this was early work and not due for publication until after the election. Later we heard that it was in fact presented to NHS London on 25th January, so I'm still confused about what 'Final draft' means.
I then asked whether the tables on the fourth page showed 18 options, and that in 16 of these options Kingston would lose at least one service - A&E, Maternity or Inpatient Paediatrics. They agreed.
I finally asked whether in a third of the options Kingston would lose both A&E and Maternity. They agreed.
In other words, they agreed that the MPs had been correct in what they had said right from the beginning.
So I then drew their attention to a letter sent from Healthcare for SW London on 27th January, which was widely circulated. In this letter Dr Martyn Wake is quoted as saying "This work is at an early stage and has not considered any specific sites for closure nor have we agreed any numbers of hospitals that will be required to deliver A&E, complex surgery, critical care, or specialist children's care."
I said that the MPs had not been suggesting that decisions had been made and that this quote was very carefully worded - the phrase 'not considered' could be open to several interpretions. The overall impression given by the letter was that the SW London Strategic Plan did not exist and that the MPs were scaremongering.
(Indeed, the local Conservatives did take that meaning, and have rather foolishly been telling everyone that there was no substance to the MPs' claims.)
Dr Wake then apologised for misleading people.
Later in the meeting the Chair of Kingston Hospital Trust, Christopher Smallwood, said, as he was quoted in the press, that it was inconceivable that Kingston's Maternity and A&E could shut.
Edward Davey remarked that it may be inconceivable, given the reputation of the hospital, but that someone had conceived the inconceivable - in the Strategic Plan.
Susan Kramer stated that all four hospitals are good ones, and that the same arguments could apply to all four. However, Kingston was particularly vulnerable because the other three were all protected. We all recognise that St George's is of regional significance, but in addition Mayday serves the most needy population in the area and therefore could not reasonably be reduced. And St Helier has just been awarded a huge investment from the Government for a major rebuild.
Christopher Smallwood also could not commit himself to campaign against possible cuts, because it was, he felt, not appropriate for the role. But he did say that campaigning on the issue was something that the MPs should do.
Much more was said, all of which backed up the MPs concerns.
At the end I proposed a motion. The Conservative councillors said they agreed with two of the four points, and could agree to another one if part of the sentence was removed. I offered to remove the point that they could not support and to alter the wording of the other one.
It looked as though we were going to have a consensus, but right at the last moment they asked me to remove the statement about the options, claiming that it was unsubstantiated. I refused to do that because Healthcare for SW London had already agreed that it was correct! It seems that the Tories were playing silly games and were determined to find any excuse not to support my motion.
Anyway, we voted on the motion and it was passed by the LIberal Democrats on the panel, with the Conservatives voting against - even though they had told me that they agreed with all three points!!
This is the motion that went through:
"This Panel is now aware of the content of extracts from a document entitled ‘South West London Strategic Plan’, which is marked ‘private and confidential’, ‘final draft December 18 2009’. The document includes options for change, under which Kingston Hospital would lose at least one major service in 16 of the 18 options identified. 6 of the 18 options would include the loss of Accident and Emergency and Maternity provision as well as Paediatric In-patient provision; 12 of the options would involve the loss of Paediatric In-patient provision; 8 of the options would remove Elective Surgery provision.
This Panel:
(i) Thanks the Chief Executive and Chairman of Kingston Hospital Trust for their evidence this evening and wishes to pass on its congratulations to the Trust and all members of staff for their invaluable contribution to the healthcare of their community;
(ii) calls upon NHS London to publish this document immediately;
(iii) requests, under Standing Order No 9, that this resolution is referred to the next meeting of Full Council on 30 March 2010. "
So there we are. Back again on 30th March.