NHS chiefs have admitted they are looking at the financial implications of closing healthcare services across south-west London.
The Surrey Comet has been given a copy of a Healthcare for South West London presentation given to NHS London bosses in June, which shows three options for the future of A+E - one of which models options for removing A+E from Kingston Hospital and shows the finances associated with the move.
The admission and presentation appears to back claims from MPs Edward Davey and Susan Kramer that senior NHS chief executives have told them Kingston A+E and maternity unit are being "seriously looked at" for closure as part of 18 options which have been agreed but not made public.
The Comet has also seen an internal timeline which says "de-commissioning" and "re-commissioning" of services could take place as early as January 2011, after a public consultation in September this year.
A spokesman for Healthcare for South West London pointed to a line in the presentation which said no scenario was ideal and changes would occur to all hospitals, saying no decisions had been made.
But Edward Davey said the presentation proved Kingston A+E had been considered for downgrading.
He said: "Option three is one of the three local hospitals either Kingston or St George’s loses an A+E.
"We have had more meetings with chief executives.
"They have been told to shut up shop and delay things.
"They confirmed there were 18 options.
"We don’t know what they are.
"Clearly they are looking at them very carefully.
"I have again been told by a very senior person in the NHS that McKinseys are crunching the numbers.
"Either we kept quiet and colluded in keeping the public in the dark about major health changes across Kingston or we did what we did."
He has made Freedom of Information requests for more information including a copy of the South West London Strategic Plan - a document he said existed but is being kept secret until after the election.
Susan Kramer said: "If the NHS thinks its arguments are so powerful they should be putting them into the public arena."
Healthcare for South West London has focussed on the work of the 100 clinicians, to emphasise that medical need rather than money are driving the changes.
But a financial affordability taskforce, made of the finance directors of each Primary Care Trust (PCT) and hospital, have also been looking at the financial implications of any closures.
A statement from Dr Howard Freeman and Dr Martyn Wake, clinical directors of Healthcare for South West London, said the review was at an early stage but admitted finances were a part of the picture.
It said: "It is considering the services required, the financial implications, and the interrelationship between each service, but it has not reached the stage of considering any specific sites for closure of any services.
"Clinicians and local NHS organisations will be considering possible solutions to the challenges facing the sector, including more babies, an older population and potentially more illness increasing demand for healthcare services, and we will refine these ideas working with clinicians, patients and other stakeholders over the coming months.
"When clinicians have agreed the requirements they believe are needed to deliver the highest quality A&E, maternity, complex surgery, critical care and specialist children’s care, and local NHS organisations have considered the practicalities of the proposals then we will publish this information and invite public comment."
Sandra Berry, chairman of Kingston’s LINK, the patient involvement group, will meet with other patient groups on Monday to hear from the chief executive of NHS South West London sector, Ann Radmore, who is also chief executive of Wandsworth Primary Care Trust.
She said: "We have heard that umpteen options are being considered to get the facts together, to be totally rational, and make an informed decision, but somewhere they need to have a public consultation.
"They say they will do it but we don’t know when."
In north east London, patients are currently being consulted on cutting the A+E at St George’s Hospital in Redbridge concentrating casualty wards on two other hospitals, as part of the same London-wide review of healthcare.
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