London bed cuts 'threaten health service': Government urged to think again over accident department and acute care closures. Celia Hall reports

CLOSURES of London hospital beds and accident and emergency departments must be halted to stop the capital's health services collapsing, according to a report published today.

Robert Maxwell, chief executive of the influential King's Fund, an independent health research organisation, says there is 'every reason to listen to the mounting concern' generated by the changes to London health services over the past two years.

He says that the Government has to 'think again, particularly about the pace of change and its leadership. There is intense pressure on acute beds, and on A & E departments, a serious loss of morale and a sense that deals are being done behind closed doors which are not communicated to those (patients and staff) principally affected by them.'

The report, What Next for London's Health Care? says that however necessary the changes, there are 'grave problems in London's hospitals about admitting emergency patients, long waits on trolleys and rising waiting lists for elective (non-urgent) patients.'

Referring to the failure last Friday of an appeal against the closure of the accident and emergency department at St Bartholomew's Hospital - signalling the hospital's closure in five years - he says that 'great care' must be taken before such steps are implemented.

He says: 'Undoubtedly there are arguments for rationalising facilities to keep pace with medical advances, reduce overheads and enhance quality but these are not easy messages to put across. It is difficult for the public to accept a need for major changes at well- loved institutions . . '

The report points to the widespread increase in emergency admissions both inside and outside London, the reasons for which are still unclear. Two years ago, the Tomlinson report proposed major improvements in GP services and premises, this year costing pounds 84m, and rationalisation of the London hospitals. But. while the Government anticipated a loss of 2,000 to 2,500 acute service beds, designed to save pounds 50m, it has been estimated that 2,500 beds have already been closed.

He condemns the 'piecemeal' closures of beds, more often brought about by financial pressures in the reformed NHS rather than properly managed hospital planning.

'The effect within institutions has often been devastating. While bricks and mortar are not everything, they enshrine institutional tradition and identity. Closing beds by itself simply restricts services with relatively little saving and a disproportionate effect on service levels. This is precisely the opposite of an intelligent response.'

While Mr Maxwell applauds improvements in primary care, he warns that the 'family oriented model of British general practice' will not work for the homeless, commuters, tourists and mobile young people.

But primary care must be much wider than improved GP services. More community provision might include more nursing and residential homes, 24-hour GP surgeries and community-style hospitals.

Mr Maxwell says that ministers should maintain special funding for the capital over the next three years in return for agreement from London health authorities about the changes they will make.

This was essential as in several areas the 'financial situation is one that threatens to go out of control and to drive damaging cutbacks in services.'

He suggests the growth of the NHS market in London should be held in check while the health services are reorganised.

(Graph omitted)

News
Alan Bennett has criticised the “repellent” reality shows which dominate our screens
tvBut he does like Stewart Lee
Life and Style
The Google Doodle celebrating the start of the first day of autumn, 2014.
tech
Arts and Entertainment
Sheridan Smith as Cilla Black and Ed Stoppard as her manager Brian Epstein
tvCilla Episode 2 review: Grit under the glamour in part two of biopic series starring Sheridan Smith
Sport
David Moyes and Louis van Gaal
football
PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
News
ebooksAn unforgettable anthology of contemporary reportage
News
i100
Life and Style
Vote with your wallet: the app can help shoppers feel more informed about items on sale
lifeNew app reveals political leanings of food companies
News
Former Governor of Alaska Sarah Palin, left, with her daughter, Bristol
newsShe's 'proud' of eldest daughter, who 'punched host in the face'
Sport
New Zealand fly-half Aaron Cruden pictured in The Zookeeper's Son on a late-night drinking session
rugby
Arts and Entertainment
Salmond told a Scottish television chat show in 2001that he would also sit in front of a mirror and say things like,
tvCelebrity Trekkies from Alex Salmond to Barack Obama
Life and Style
Carol O'Brien, whose son Rob suffered many years of depression
healthOne mother's story of how London charity Maytree helped her son with his depression
Arts and Entertainment
The cover of Dark Side of the Moon
musicCan 'The Endless River' carry on the tradition? See for yourself
Life and Style
food + drink
News
Rob Merrick's Lobby Journalists were playing Ed Balls' Labour Party MPs. The match is an annual event which takes place ahead of the opening of the party conference
newsRob Merrick insistes 'Ed will be hurting much more than me'
News
A cabin crew member photographed the devastation after one flight
news
Voices
A new app has been launched that enables people to have a cuddle from a stranger
voicesMaybe the new app will make it more normal to reach out to strangers
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

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

iJobs Job Widget
iJobs General

Pharmaceutical Computer System Validation Specialist

£300 - £350 Per Day: Clearwater People Solutions Ltd: Pharmaceutical Computer ...

High Level Teaching Assistant (HTLA)

£70 - £90 per day: Randstad Education Birmingham: Higher Level Teaching Assist...

Teaching Assistant

£50 - £80 per day: Randstad Education Birmingham: Randstad Education is the UK...

Senior Java Developer - API's / Webservices - XML, XSLT

£400 - £450 Per Day: Clearwater People Solutions Ltd: Our client is currently ...

Day In a Page

Secret politics of the weekly shop

The politics of the weekly shop

New app reveals political leanings of food companies
Beam me up, Scottie!

Beam me up, Scottie!

Celebrity Trekkies from Alex Salmond to Barack Obama
Beware Wet Paint: The ICA's latest ambitious exhibition

Beware Wet Paint

The ICA's latest ambitious exhibition
Pink Floyd have produced some of rock's greatest ever album covers

Pink Floyd have produced some of rock's greatest ever album covers

Can 'The Endless River' carry on the tradition?
Sanctuary for the suicidal

Sanctuary for the suicidal

One mother's story of how London charity Maytree helped her son with his depression
A roller-coaster tale from the 'voice of a generation'

Not That Kind of Girl:

A roller-coaster tale from 'voice of a generation' Lena Dunham
London is not bedlam or a cradle of vice. In fact it, as much as anywhere, deserves independence

London is not bedlam or a cradle of vice

In fact it, as much as anywhere, deserves independence
Vivienne Westwood 'didn’t want' relationship with Malcolm McLaren

Vivienne Westwood 'didn’t want' relationship with McLaren

Designer 'felt pressured' into going out with Sex Pistols manager
Jourdan Dunn: Model mother

Model mother

Jordan Dunn became one of the best-paid models in the world
Apple still coolest brand – despite U2 PR disaster

Apple still the coolest brand

Despite PR disaster of free U2 album
Scottish referendum: The Yes vote was the love that dared speak its name, but it was not to be

Despite the result, this is the end of the status quo

Boyd Tonkin on the fall-out from the Scottish referendum
Manolo Blahnik: The high priest of heels talks flats, Englishness, and why he loves Mary Beard

Manolo Blahnik: Flats, Englishness, and Mary Beard

The shoe designer who has been dubbed 'the patron saint of the stiletto'
The Beatles biographer reveals exclusive original manuscripts of some of the best pop songs ever written

Scrambled eggs and LSD

Behind The Beatles' lyrics - thanks to Hunter Davis's original manuscript copies
'Normcore' fashion: Blending in is the new standing out in latest catwalk non-trend

'Normcore': Blending in is the new standing out

Just when fashion was in grave danger of running out of trends, it only went and invented the non-trend. Rebecca Gonsalves investigates
Dance’s new leading ladies fight back: How female vocalists are now writing their own hits

New leading ladies of dance fight back

How female vocalists are now writing their own hits