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)

Start your day with The Independent, sign up for daily news emails
Have you tried new the Independent Digital Edition apps?
ebooksAn unforgettable anthology of contemporary reportage
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating

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

iJobs Job Widget
iJobs General

Recruitment Genius: Digital Marketer

£18000 - £25000 per annum: Recruitment Genius: This is a fantastic opportunity...

Recruitment Genius: Sales & Marketing Administrator

£16000 - £18000 per annum: Recruitment Genius: Ideal candidates for the role m...

Recruitment Genius: Digital Communications Manager

£25000 per annum: Recruitment Genius: A 6-month part-time contract (24 hours a...

Recruitment Genius: Trainee Vehicle Inspectors / Purchasers

£20000 - £40000 per annum: Recruitment Genius: Trainee Vehicle Inspectors / Pu...

Day In a Page

Sepp Blatter resignation: The beginning of Fifa's long road to reform?

Does Blatter's departure mean Fifa will automatically clean up its act?

Don't bet on it, says Tom Peck
Charles Kennedy: The baby of the House who grew into a Lib Dem giant

The baby of the House who grew into a Lib Dem giant

Charles Kennedy was consistently a man of the centre-left, dedicated to social justice, but was also a champion of liberty and an opponent of the nanny-state, says Baroness Williams
Syria civil war: The harrowing testament of a five-year-old victim of this endless conflict

The harrowing testament of a five-year-old victim of Syria's endless civil war

Sahar Qanbar lost her mother and brother as civilians and government soldiers fought side by side after being surrounded by brutal Islamist fighters. Robert Fisk visited her
The future of songwriting: How streaming is changing everything we know about making music

The future of songwriting

How streaming is changing everything we know about making music
William Shemin and Henry Johnson: Jewish and black soldiers receive World War I Medal of Honor amid claims of discrimination

Recognition at long last

Jewish and black soldiers who fought in WWI finally receive medals after claims of discrimination
Beating obesity: The new pacemaker which helps over-eaters

Beating obesity

The new pacemaker which helps over-eaters
9 best women's festival waterproofs

Ready for rain: 9 best women's festival waterproofs

These are the macs to keep your denim dry and your hair frizz-free(ish)
Cycling World Hour Record: Nervous Sir Bradley Wiggins ready for pain as he prepares to go distance

Wiggins worried

Nervous Sir Bradley ready for pain as he prepares to attempt cycling's World Hour Record
Liverpool close in on Milner signing

Liverpool close in on Milner signing

Reds baulk at Christian Benteke £32.5m release clause
On your feet! Spending at least two hours a day standing reduces the risk of heart attacks, cancer and diabetes, according to new research

On your feet!

Spending half the day standing 'reduces risk of heart attacks and cancer'
With scores of surgeries closing, what hope is there for the David Cameron's promise of 5,000 more GPs and a 24/7 NHS?

The big NHS question

Why are there so few new GPs when so many want to study medicine?
Big knickers are back: Thongs ain't what they used to be

Thongs ain't what they used to be

Big knickers are back
Thurston Moore interview

Thurston Moore interview

On living in London, Sonic Youth and musical memoirs
In full bloom

In full bloom

Floral print womenswear
From leading man to Elephant Man, Bradley Cooper is terrific

From leading man to Elephant Man

Bradley Cooper is terrific