Health Secretary Decisions Declared Unlawful And Quashed By High Court

2 August 2013

Health Secretary Decisions Declared Unlawful And Quashed By High Court

A ruling by Mr Justice Siber at the High Court has decreed that the decision by Health Secretary Jeremy Hunt to reduce services at a major London hospital has been declared unlawful by breaching provisions of the National Health Services Act 2006, concluding that Hunt had in fact acted outside his ministerial powers. The ruling is significant as it casts doubt over the reach and extent of governmental departments in their objective of overseeing major NHS overhauls through cost-cutting and extensive reorganisation.

Originally Hunt had announced to Parliament in January 2013 that casualty and maternity units at Lewisham Hospital in southeast London would be downgraded. Lewisham Hospital was originally threatened when a neighbouring trust, South London Healthcare Trust, which was losing £1m a week, was placed in administration. As part of plans to recalibrate local services, the administrator said Lewisham Hospital should make cuts to its maternity and A&E services - despite the fact it operated as a separate trust and was performing well.

Specifically the government facilitated the use of Trust Special Administrators (TSAs) in this case, incepted to expedite management of failing NHS trusts, however the scrutiny this ruling has placed them under may compromise the desire of the Department of Health to change legislation to expand their powers so that they could authorise broader service shake-ups beyond this trust in question.

Local campaigners, backed by Lewisham Council and local GPs, raised their voices to battle the governmental decisions with a focus on their overall objection: that Lewisham Hospital's successful services should not be shut down to solve problems at a neighbouring trust.

The ruling is therefore a major victory for the London Borough of Lewisham and the Save Lewisham Hospital campaign, a community-based campaign group made up of and supported by patients, community groups, GPs, hospital doctors, nurses and other health professionals. Specifically, Mr Justice Silber opined that the approved cuts by Mr Hunt earlier in the year, should never have been initially recommended and that the administrator had no powers to make decisions affecting Lewisham or any hospital outside SLHT, and significantly that Mr Hunt had breached the provisions of the National Health Services Act 2006 when he approved the plans.

Initial concerns of campaigners were that the reorganisation undertaken by the TSA was obscanturist in nature, lacking proper consultation and was expedited ‘by the back door’ lacking any requisite action to get the support of local GPs before even recommending changes at the initial stage.

Lewisham's Labour MP, Joan Ruddock, told The Independent: "This is the most significant community based battle that has ever succeeded in my political life. To take on the government in the high court, to win, is exceptional. We had a demo which tuned out 25,000 people for a local cause."

"The government has been utterly arrogant in its approach. They have failed to listen, not just to local people, but to the clinicians, and the whole medical establishment in Lewisham," she said. "It was an attempt to use legislation to bring about change through the back door that could never have been justified. This was an accountant's solution. This government is far too focused on the accounts, rather than the public service. This was a proposal that had no common sense attached to it."

Doctors called for an urgent review into Mr Hunt's actions.

"It is deeply worrying in the case of Lewisham Hospital that the High Court has found that the health secretary breached his statutory powers when making the decision to downgrade the emergency care department and maternity units at the hospital," said Dr Mark Porter, chair of the BMA Council.

"Doctors, healthcare staff and patients were concerned that the consultation period was too short and that local people needed more time to put their views across. It is vital that changes to services have the confidence of the local community and the NHS staff who work there."

A Department of Health spokesman said the government would appeal the decision.

"This judgment applies to one aspect of a package of changes which we believe are in the best long-term interests of patients and the public across south east London," the spokesman said. "As it stands, the South London Healthcare NHS Trust has been running at a loss of about £1m a week - money that has to be diverted from frontline patient care. We expect to continue other elements of that package of changes, including the dissolution of the South London Healthcare NHS Trust, planned for October 1…

"Experience in south east London certainly suggests that it can be necessary for changes to be made at more than one Trust in order to find a sustainable service model.  That's why we are appealing the decision, and considering our further options carefully. It is certainly the case that one way to put the matter beyond doubt would be to amend the primary legislation governing the administration process."

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