Government plans to boost emergency and intensive care were yesterday greeted with derision by doctors' leaders, patients' groups, and managers, who said that the proposals would resolve little without new funding.
To reassure the public after a series of high-profile cases sparked concern over adequate provision, Stephen Dorrell, Secretary of State for Health, unveiled new guidelines and promised new reports this year on specific action being taken by health authorities.
Better management of existing facilities was the key, he said. He promised another Patient's Charter for casualty departments and a review of emergency care outside hospitals.
He warned health authorities that their commitment to paediatric intensive care (PIC) is to be reviewed immediately.
Mr Dorrell said the issues raised by the report earlier this week into the death of 10-year-old Nicholas Geldhard would have to be addressed. He said that the report had revealed "important failures in the service he received".
Nicholas was ferried between four hospitals in the search for treatment, after being refused admission to PIC units in Manchester, Liverpool, and Sheffield that had no beds.
The Secretary of State backed the expansion of the High Dependency Units (HDU), an intermediate level of care which would free up more IC beds.
Mr Dorrell's statement to the Commons yesterday will push critical care higher up the health service agenda, following scores of cases in which patients were transported hundreds of miles to find beds, were refused admission, or forced to wait on trolleys in hospital corridors.
Critics say without extra funding, improvements will be erratic. They point to the increase in emergency admissions, up 13 per cent since 1992.
Harriet Harman, Labour's spokeswoman on health, accused Mr Dorrell of failing to address the real cause of the crisis, a shortage of beds and specialist staff.
"It is a disgusting insult to doctors who agonise as they have to turn away desperately ill patients, for the Secretary of State to accuse them of misusing intensive-care beds," she said. The Intensive Care Society says there is a shortfall of 500 IC beds. The Government maintains that there are 2,500, although the figure includes coronary-care beds.
Sir Leslie Turnberg, president of the Royal College of Physicians, agreed that there were "insufficient intensive-care beds". He criticised new guidelines on the admission to, and discharge from, IC and HDUs.
James Johnson, chairman of the British Medical Association's Consultants' Committee, said Government proposals had to be backed by new resources.
Mr Johnson said operations were being cancelled because of a lack of beds. Earlier this week it was revealed that the liver of ecstasy-victim Leah Betts was sent to Spain after two British transplant centres had turned it down, because although they had suitable patients, they had no IC beds.
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