Almost 7 times as many tourists as commuters are using the cable car during the week

London’s newest commuter route/tourist attraction opened to the public on 28 June this year. I was lucky enough to travel on it on its very first day of opening, and very lovely it is too. I was also lucky enough to use it a few times during the Olympics and enjoyed every second.

The cable car has, however, been billed by Boris and TfL as a "vital new river crossing for east London", not a tourist attraction, and indeed this was the justification for using public money to assist in its contruction.

Of course, as the adage goes, the proof of the pudding is in the eating – so how have people been using the cable car, or dangleway as it’s affectionately known, and for what purpose? Well, the good folks at The Scoop have posted about this, most recently looking at hourly numbers of users by day, which tell their own story. The chart below is based on the data obtained by The Scoop under the Freedom of Information Act and published earlier this week.

Source: TfL

The blue lines represent use at the weekend, the others weekday use. This vital river crossing is clearly being used as a tourist attraction, with peak numbers on Saturday and Sunday afternoon.

There are small numbers using it in the weekday mornings too (masked by the vastly larger numbers using at weekends on the chart), but how do those numbers compare with those using the tube/DLR to make the equivalent journey? I crunched the figures obtained by The Scoop to look at this in more detail.

* average for the hours of 10:00-19:00 calculated excluding Tuesday 16 October when the cable car was closed due to adverse weather conditions.

Source: author analysis of data from TfL obtained via 853blog.com

These “average use” figures show that on the cable car user numbers build slowly during the morning peak and jump dramatically after 10am. The tube/DLR, by contrast, has a spike in the number of users between 09:00 and 09:59, presumably commuters. Numbers then drop to a low level, climbing slowly but steadily through the rest of the day. But only during the 07:00-07:59 period do numbers using the tube/DLR match or exceed those using the cable car. Cable car user numbers peak in the mid morning-early afternoon and then decline towards the end of operations. This clearly suggests that the cable car appeals as a tourist attraction during the week as well as at weekends (albeit at a lower overall level than seen on the weekends).

The data obtained by The Scoop also, by sheer good fortune, allow us an insight into what happens to tube/DLR use when the cable car is closed. My hypothesis is that when the cable car is closed, urgent journeys transfer to the equivalent routes on the tube/DLR whereas non-urgent or leisure journeys are either not made or are delayed. 

So what happened on 16 October? The first chart shown above shows that there was a clear spike in use on 16 October after the cable car reopened – a spike which is not seen on any of the other weekdays at this time - that we can reasonably assume to be due to the closure and subsequent reopening.

Looking at hourly user figures for 16 October for the tube/DLR while the cable car was closed and comparing them to average figures for the same hours of the day during the rest of that week tells its own story. Tube/DLR journeys did indeed increase during the hours that the cable car was closed.

Number of users of tube/DLR and cable car on Tuesday 16 October, compared with average use on the other four weekdays in that week, 15-19 October 2012

	Hour of use
	10	11	12	13	14	15	16	17	18	19
Tube/DLR
Average weekday	8.25	8.5	11.25	12.25	12	19.75	20	20.5	16.25	17.25
Tues 16th	9	20	28	16	24	21	28	27	17	11
Cable car journeys replaced by tube/DLR	0.75	11.5	16.75	3.75	12	1.25	8	6.5	0.75	-6.25
Cable car
Average weekday	267.25	365.5	381	357.25	393.75	367.25	323.75	260.75	174.5	158
Tues 16th	0	0	0	0	0	0	204	558	257	204
Cable car journeys delayed							-119.75	297.25	82.5	46

Source: author analysis of data from TfL obtained via 853blog.com

For example, between 12:00 and 12:59 on 16 October, 28 people used the tube/DLR to make a journey equivalent to that covered by the cable car, compared with an average of 11.25 people making that same journey on the other days of the week. This picture continues even after the cable car reopens between 1600 and 1659. I estimate that over the period 10:00-15:59 46 journeys that would have been made on the cable car were instead made by tube/DLR. Contrast that with over 300 journeys that were delayed until after the cable car reopened. This suggests that almost 7 times as many weekday off-peak journeys on the cable car are potentially for leisure rather than non-leisure purposes.

Some might call this a triumph – an attraction that wasn’t asked for, built in a location no one thinks is sensible or necessary is attracting leisure users on wet weekdays in October? All well and good except that we’ve paid for it out of our taxes and are getting charged through the nose to use it! Time to bring the dangleway in from the cold and start including it in Oyster PAYG caps and travelcards. Then we might start to believe it’s a mode of public transport as well as a tourist attraction.

Closing Lewisham A&E is a done deal...

This short six minute snapshot of the audio from a two hour focus group meeting between TSA representatives and local mothers this morning, 29 November 2012, has two interesting elements:

1. Fifteen seconds or so in when one of the doctors invited by TSA to provide independent clinical advice suggests that "closing Lewisham A&E is a done deal", to much chagrin from the TSA representatives in the meeting, such that you can hardly hear the discussion that follows.

2. About 5 minutes in when the speaker from the TSA admits there are two polarised clinical opinions about whether or not Lewisham maternity services/A&E should close.

Keep on hammering them everyone, we can't afford to lose this battle.

Thanks to @loftspace for the audio.

Nick Raynsford's response to an email from a constituent about the SLHT restructuring

I've agreed to put this up on my blog to put into the public domain Nick Raynsford's response to being asked to give a robust response to the planned "restructuring" of South London Healthcare NHS Trust.

Original letter:

16th November 2012

Dear Mr. Raynsford

Re: South London Health Trust consultation

Reviewing the press and local news in the hope of an official response and strong opposition to the damaging ‘restructuring’ planned for SLHT. Alas not, unlike Heidi Alexander, MP and Mayor Steve Bullock in the London Borough of Lewisham, who have given robust responses. If, under the proposals, Lewisham loses its Maternity and Emergency services, this will put an enormous strain on an already challenged Queen Elizabeth Hospital and the surrounding population.

I strongly opposed the government's "reforms" of the NHS, which will result in the dismantling and selling off to private companies of one of our most precious and valued institutions. The NHS is one of the fairest, most efficient and cost-effective health services in the world http://bit.ly/T6HDqR (The Guardian)

Yet, according to the Faculty of Public Health's risk assessment, the government’s reforms will lead to a loss of comprehensive care, reduced quality of care, greater expense and greater health inequality http://tinyurl.com/c4fx6n5 (risk assessment)

This is a national tragedy and I will not vote for anyone who does not oppose these deeply damaging reforms.

Yours sincerely,

**********************

Nick Raynsford's response (email dated 28 November, 9 working days after the original email):

Dear constituent,

Thank you for your communication about the future of South London Health Care Trust (SLHT).

As the MP for the Greenwich since 1992 and Greenwich & Woolwich since 1997, I have been involved in a series of discussions over the years with Ministers and senior NHS managers about the provision of healthcare services in South East London.

While there have been many advances and improvements in healthcare over this period, particularly as a consequence of the substantial increases in investment in the NHS under the last Labour Government, the structures responsible for the delivery of hospital services in our area have never proved entirely satisfactory and have been subject to frequent change. The most recent of these changes is less than four years old. That involved the creation of SLHT, taking over responsibility for the hospitals in Greenwich, Bexley and Bromley, at the same time as a reconfiguration of services was initiated in line with the A Picture of Health proposals.

In my view, SLHT made some progress in improving the standards of healthcare in South East London, notably in the treatment of stroke patients with the new unit in Bromley, and in the maternity service offered at the Queen Elizabeth Hospital, Woolwich (QEH). The new urgent treatment unit at Woolwich has worked well with the A&E department, improving both waiting times and the quality of patient care.

However, SLHT was less successful in tackling the financial deficit which affected all three Hospitals. The problem was compounded by the decision of Andrew Lansley, then Secretary of State for Health, to halt implementation of the A Picture of Health reconfiguration plans in summer 2010.

Because of the persisting deficit, and despite his own responsibility for some of this deficit, earlier this year Lansley announced the appointment of a Trust Special Administration (TSA) to take over SLHT. I took part in the NHS debate which followed closely on the announcement to speak out against the decision. You can read my speech by following the link: www.publications.parliament.uk/pa/cm201213/cmhansrd/cm120716/debtext/120716-0002.htm#12071631000897, or feel free to contact my office for a hard copy.

The TSA, Matthew Kershaw, was tasked with preparing a report setting out proposals for the future of healthcare in South East London. That report was published in October and makes a series of recommendations, of which probably the most significant for Greenwich and Woolwich are:

• South London Healthcare Trust to be broken up;
• QEH to become part of a new Trust also incorporating Lewisham Hospital;
• Main existing services to continue at QEH, but A&E at Lewisham to be closed and replaced with an urgent care centre; this would leave just four A&Es in South East London, instead of five currently;
• Maternity services either to be also reduced to four, at the four A&E sites (QEH, King’s, St Thomas’, Bromley) or for an obstetrics-led maternity unit to remain at Lewisham in addition to the other four sites;
• Queen Mary’s Sidcup (QMS) to be a ‘campus’, run by Oxleas Trust, but with elective surgery run by Dartford and Gravesham NHS Trust;
• The Princess Royal Hospital Bromley to become part of King’s;
• An extensive ‘efficiency’ programme, likely to result in substantial reductions in numbers of medical, nursing and ancillary staff;
• Additional financial support to help cover the additional PFI costs at QEH and Bromley, and the SLHT accumulated deficit to be written off.

We are now in the middle of the consultation period on these proposals. I have met twice with Matthew Kershaw and once with Tim Higginson, Chief Executive of Lewisham Trust, to discuss the implications of the report, as well as meeting the Chief Executive of Oxleas NHS Trust, and the Chair of the embryo Clinical Commissioning Group (CCG) and the Head of its Business Support Unit in Greenwich, formerly the Primary Care Trust, to understand their perspective on the proposals. I have also met with Trade Unions representing NHS staff working in affected hospitals, and written to the newly-appointed Health Secretary, Jeremy Hunt, to set out concerns and request a meeting.

The main issues of concern in my view are:

• The closure of the A&E at Lewisham and reduction to just four A&Es in South East London could seriously compromise patient safety and impose excessive pressures on the remaining A&E services; the A&E at the QEH is working very close to capacity already and could not absorb substantial additional pressures;
• Similar considerations apply to maternity services, though the proposed obstetrics-led unit at Lewisham would reduce the pressure
• The viability of the proposed arrangements at Queen Mary’s Sidcup is questionable, nor is it clear why the Dartford/Gravesham Trust has been invited to run the elective work at QMS;
• The proposed ‘pathology hub’ at the QEH which had been part of the SLHT future plans is now uncertain;
• Community services are run on a different basis in Lewisham and Greenwich. Lewisham Trust runs services in Lewisham, while Oxleas runs Community Services in Greenwich and Bexley. This division may prove unsatisfactory.
• The scale of the efficiency savings proposed and potential job losses is very challenging and could undermine the safety and effectiveness of services;
• The margin of viability of Matthew Kershaw’s proposals is very fine and could easily be undermined by events, as proved the case with SLHT;
• The achievement of the plan depends on very positive commissioning decisions by the inexperienced new Clinical Commissioning Groups;
• The viability of a new Lewisham/QEH Trust is therefore high-risk, and this could be further affected by the proposed merger of King’s, Guy’s and St Thomas’ to form a single mega-Trust, also incorporating the South London and Maudesley Trust and Bromley.

These and other issues will undoubtedly be discussed in detail over the next few weeks before the consultation closes. Details of the consultation process and how to take part can be found at www.tsa.nhs.uk. If you have no internet access, feel free to contact my office for a hard copy.

It will be vital to continue to keep strong public pressure on Jeremy Hunt and Matthew Kershaw to maintain high-quality NHS services throughout Southeast London. The I Love the NHS campaign, organised by local Labour Party members continues to make an important contribution, organising public meetings and raising awareness. Please visit www.ilovethenhs.org.uk/greenwich to keep up-to-date with activity locally and to add your name to the Greenwich People’s NHS Charter, which sets out what local people believe their health service should provide, and acts as a blueprint for how we wish to see NHS services run in Greenwich. I am also happy to send you details on how to become more involved if you would like to give up some of your time and join the campaign.

In the meantime, you have my full assurance that this issue will remain a major focus of my attention over the coming weeks.

Thank you again for contacting me regarding this extremely important matter.

Yours sincerely

Nick Raynsford MP

The Rt Hon. Nick Raynsford MP

Labour MP for Greenwich & Woolwich

House of Commons, London. SW1A 0AA

t:  0207 219 5895

f:  0207 219 2619

w: www.nickraynsford.org.uk

Lewisham's maternity services then and now

Back in 2007 and again in 2008 I experienced Lewisham hospital's maternity services first hand, with the births of my children. The first time around I will be honest and say I didn't have a great time, and I've blogged about it before, in the context of a survey that was done in 2007 into the quality of maternity services and in particular women's experiences and perceptions of how they were treated. I felt I was treated quite badly while I was there, with midwives that were rude and insensitive, and little to no help with breastfeeding.

Second time around I was hopeful that things might be better - was that the case? Well, my blog post from shortly after Claud was born suggests a bit of a mixed bag. Breastfeeding support was pretty variable, but I was more prepared and more determined myself on that front, and the midwives were much more supportive, if a little brusque.

But of course, all of that is a long time ago in the context of changing services, and I think it's fair to say that the hospital trust has responded to the results of the survey in 2007 by making major changes to maternity services. The "building your trust" section of their website sets out in detail the things they've done, which include:

1. Building a new mother and baby centred birth centre, which opened in 2010 for non-complex deliveries. (Anyone know how much this cost? All wasted if it is closed as per one of Kershaw's recommendations...)

2. Employing more midwives

3. Increasing postnatal support (which was my major issue with the care I received)

4. Setting up a range of specialist clinics.

(It has to be said that they could do with having a quick overhaul of their website though - there are quite a few broken links floating around!)

There is no consensus that maternity services in Lewisham could or should be closed. And any changes would certainly not be being made because it would be better for the women who give birth at Lewisham hospital! This comment was posted on an earlier post of mine on this subject and I think it is quite telling:

Dr. Jane Fryer spoke at the Scrutiny and Overview Committee meeting of Greenwich Council on Thursday 15 November at Woolwich Town Hall and described clinician support for the proposals as "enormous".

Appendix E of the full Draft Report has a different picture. At paragraph 77, the Report describes divided and undecided clinical opinion: "At a further meeting of the external clinical panel on 22 October 2012 a conclusion was not reached and the panel recommended that further work is undertaken to examine each option in more detail. The basis of this recommendation was that there are different views on the expected population growth and birth forecasts within south east London over the next 3-10 years and agreement should be reached so that correct capacity requirements can inform the final recommendations. Further work is required on the detail of the two proposals so that a more thorough clinical assessment can be made; and that broader engagement in exploring these options should be sought through the consultation process."

Don't be fooled - Lewisham hospital handles 4,400 births a year, projected to rise to 5,000 a year within three years. There isn't space to accommodate these anywhere else in SE London and indeed on occasions the maternity unit at Lewisham becomes full as it currently stands. This point was made by a midwife from the hospital at the public meeting on 8 November.

We need to keep campaigning to keep the maternity unit open, and for it to be accompanied by a full admitting A&E in the interest's of patient safety.

Make sure you respond to the consultation (help with that here) and attend the public meeting tomorrow if you can.