Think tank chief calls for hospital closures to meet NHS budget

 

Twenty hospitals across the country must be taken over, merged or closed if the NHS is to improve patent care and keep within its budget, the head of a leading health think tank warned yesterday.

Professor Chris Ham, chief executive of the respected King's Fund, called for politicians to be "distanced" from having to make the decisions on which hospitals should shut – hinting that they were too likely to give way to local pressures.

He is the second senior health figure to call for a wholesale rethink of hospital provision in England.

Last week Peter Carter, head the Royal College of Nursing, said England had far too many acute hospitals in urban areas which was a drain on the system and should be replaced with care in smaller, community-based units.

More than two thirds of the £100 billion NHS budget is spent on long-term conditions that are increasingly being treated out of hospitals, which remain the most expensive part of the health service.

Writing in The Observer, Professor Ham suggested up to 20 hospitals needed wholesale reform.

"Several hospitals have large deficits and it is clear that existing services cannot be sustained either clinically or financially," he said.

"Financial pressures are increasing by the day and will adversely affect quality unless ministers recognise the urgent need to change the way services are provided.

"Up to 20 hospitals, around 10 per cent of the total in England, may not be financially sustainable and will have to be merged or taken over. Many others face financial or clinical challenges that require changes to the services they provide.

"Governments have ducked these issues for too long, while MPs have ignored clinical and financial evidence and backed campaigns to keep local hospitals and specialist units open."

The professor said decision-making power should be handed over from the Health Secretary to the Independent Reconfiguration Panel, who currently pass on their recommendations to ministers.

This would make sure vital conclusions are reached without political pressures, based solely on clinical and financial issues.

"Unfortunately, the process for 'reconfiguring' services is not fit for purpose," said Professor Ham.

"Under the current system, the secretary of state is the final arbiter, with contentious decisions referred to him by the Independent Reconfiguration Panel (IRP) – a body of experts charged with reviewing decisions that cannot be resolved locally."

He added: "Giving the IRP responsibility would avoid delays under the current process and ensure they are taken on clinical and financial grounds rather than for political reasons."

Senior figures in the Department of Health are aware of the need to reconfigure hospital services, but fear closures could be portrayed as examples of cost cutting to save money rather than being beneficial in their own right.

Such a portrayal would be politically toxic for David Cameron who delayed and amended the health reform bill in part to prove that the Coalition could be trusted on the NHS.

Trusts in danger

* Barking, Havering & Redbridge Hospitals

Received £140m in bailouts in the past five years. Measures to cut spending including ward closures have led to increasing waiting times.



* West Middlesex University Hospital

With £21m of debts, managers have indicated that an A&E unit may shut.



* Epsom & St Helier University Hospitals

The trust plans to cut 12.7 per cent from its £313m turnover in 2011-12.



* South London Healthcare Trust

Received nearly £100m in bailouts over the last two years. It closed the A&E and maternity unit at one of its sites in December, but is likely to need further action to balance the books .



* Barnet & Chase Farm Hospitals

Campaigners have fought for years to keep the A&E and maternity services open, despite doctors and managers saying that they were not financially or clinically sustainable.

News
i100 In this video, the late actor Leonard Nimoy explains how he decided to use the gesture for his character
Arts and Entertainment
Secrets of JK Rowling's Harry Potter workings have been revealed in a new bibliography
arts + ents
News
Down-to-earth: Winstone isn't one for considering his 'legacy'
people
News
news
Life and Style
ebookNow available in paperback
ebooks
ebookPart of The Independent’s new eBook series The Great Composers
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Sauce Recruitment: Retail Planning Manager - Home Entertainment UK

    salary equal to £40K pro-rata: Sauce Recruitment: Are you available to start a...

    Ashdown Group: Front-End Developer - London - up to £40,000

    £35000 - £40000 per annum: Ashdown Group: Creative Front-End Developer - Claph...

    Recruitment Genius: Product Quality Assurance Technologist - Hardline & Electric

    £18000 - £24000 per annum: Recruitment Genius: The role in this successful eco...

    Ashdown Group: QA Tester - London - £30,000

    £28000 - £30000 per annum: Ashdown Group: QA Tester - London - £30,000 QA Tes...

    Day In a Page

    HIV pill: Scientists hail discovery of 'game-changer' that cuts the risk of infection among gay men by 86%

    Scientists hail daily pill that protects against HIV infection

    Breakthrough in battle against global scourge – but will the NHS pay for it?
    How we must adjust our lifestyles to nature: Welcome to the 'Anthropocene', the human epoch

    Time to play God

    Welcome to the 'Anthropocene', the human epoch where we may need to redefine nature itself
    MacGyver returns, but with a difference: Handyman hero of classic 1980s TV series to be recast as a woman

    MacGyver returns, but with a difference

    Handyman hero of classic 1980s TV series to be recast as a woman
    Tunnel renaissance: Why cities are hiding roads down in the ground

    Tunnel renaissance

    Why cities are hiding roads underground
    'Backstreet Boys - Show 'Em What You're Made Of': An affectionate look at five middle-aged men

    Boys to men

    The Backstreet Boys might be middle-aged, married and have dodgy knees, but a heartfelt documentary reveals they’re not going gently into pop’s good night
    Crufts 2015: Should foreign dogs be allowed to compete?

    Crufts 2015

    Should foreign dogs be allowed to compete?
    10 best projectors

    How to make your home cinema more cinematic: 10 best projectors

    Want to recreate the big-screen experience in your sitting room? IndyBest sizes up gadgets to form your film-watching
    Manchester City 1 Barcelona 2 player ratings: Luis Suarez? Lionel Messi? Joe Hart? Who was the star man?

    Manchester City vs Barcelona player ratings

    Luis Suarez? Lionel Messi? Joe Hart? Who was the star man at the Etihad?
    Arsenal vs Monaco: Monaco - the making of Gunners' manager Arsene Wenger

    Monaco: the making of Wenger

    Jack Pitt-Brooke speaks to former players and learns the Frenchman’s man-management has always been one of his best skills
    Cricket World Cup 2015: Chris Gayle - the West Indies' enigma lives up to his reputation

    Chris Gayle: The West Indies' enigma

    Some said the game's eternal rebel was washed up. As ever, he proved he writes the scripts by producing a blistering World Cup innings
    In Ukraine a dark world of hybrid warfare and murky loyalties prevails

    In Ukraine a dark world of hybrid warfare

    This war in the shadows has been going on since the fall of Mr Yanukovych
    'Birdman' and 'Bullets Over Broadway': Homage or plagiarism?

    Homage or plagiarism?

    'Birdman' shares much DNA with Woody Allen's 'Bullets Over Broadway'
    Broadchurch ends as damp squib not even David Tennant can revive

    A damp squib not even David Tennant can revive

    Broadchurch, Series 2 finale, review
    A Koi carp breeding pond, wall-mounted iPads and a bathroom with a 'wellness' shower: inside the mansion of Germany's 'Bishop of Bling'

    Inside the mansion of Germany's 'Bishop of Bling'

    A Koi carp breeding pond, wall-mounted iPads and a bathroom with a 'wellness' shower