Managers at St George's Hospital, in Tooting, south-west London, have outlined the need for efficiency savings of pounds 2m in a confidential document leaked to the Independent. The cuts will entail the closure of three wards.
But, ominously, it adds: 'To survive it (the cuts) . . . we are going to have to bury some cherished assumptions about our status as a London teaching hospital.'
Senior staff will make a decision on the options outlined in the document next Wednesday, the day before Sir Bernard Tomlinson is due to pass his report on the reshaping of London's health services to Virginia Bottomley, the Secretary of State for Health.
Ian McCartney, Labour's spokesman on the NHS, said the dilemma faced by St George's was another illustration of the disastrous effects of the Government's reforms. 'The market has ravished London,' he said.
Andrew Dillon, St George's chief executive, said that staff who had seen the document, St George's Group: The Challenge for 1993/94 and Beyond, recognised the need to meet the changes dictated by current climate.
Income is expected to fall by between pounds 3.5m and pounds 5.8m next year, between 3.1 and 5 per cent of the hospital's pounds 140m budget, as local health authorities, chiefly Wandsworth, move towards paying only for required treatments.
The document says it would be impossible to absorb the reduction simply by becoming more efficient, though it is expected that pounds 2m could be trimmed next year on top of pounds 2m savings made in the current financial year.
Solutions outlined to meet the the shortfall include the extensive application of day care and day surgery with a smaller number of beds being used for 'increasingly short spells of technology-intensive treatments'.
In addition, Mr Dillon suggests a cut in the number of 'bed blockers', patients who have been in the hospital for more than 28 days, though nowhere does he detail how this might be achieved.
However, these measures alone would still not be sufficient. 'This means closing hospital beds. The scale of the problem . . . suggests that, with an approximate saving of pounds 400,000 per ward, we should plan to close three wards (84 beds) to generate the necessary savings,' the report says.Reuse content