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)

Life and Style
The new Windows 10 Start Menu
tech
News
More than 90 years of car history are coming to an end with the abolition of the paper car-tax disc
newsThis and other facts you never knew about the paper circle - completely obsolete today
Arts and Entertainment
There has been a boom in ticket sales for female comics, according to an industry survey
comedyFirst national survey reveals Britain’s comedic tastes
Arts and Entertainment
Hilary North's 'How My Life Has Changed', 2001
books(and not a Buzzfeed article in sight)
PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
News
ebooksAn unforgettable anthology of contemporary reportage
Arts and Entertainment
Mystery man: Ben Affleck and Rosamund Pike in '‘Gone Girl'
films... by the director David Fincher
News
Kim Jong Un gives field guidance during his inspection of the Korean People's Army (KPA) Naval Unit 167
newsSouth Korean reports suggest rumours of a coup were unfounded
News
people'I’d rather have Fred and Rose West quote my characters on childcare'
Life and Style
stoptober... when the patch, gum and cold turkey had all faied
Travel
Bruce Chatwin's novel 'On the Black Hill' was set at The Vision Farm
travelOne of the finest one-day walks you could hope for - in Britain
Arts and Entertainment
Gay and OK: a scene from 'Pride'
filmsUS film censors have ruled 'Pride' unfit for under-16s, though it contains no sex or violence
News
people
Life and Style
Magic roundabouts: the gyratory system that has excited enthusiasts in Swindon
motoringJust who are the Roundabout Appreciation Society?
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

Welsh Year 6 Teacher required in Barry

£100 - £110 per day + Plus travel scheme: Randstad Education Cardiff: The Job:...

Business Analyst - Surrey - Permanent - Up to £50k DOE

£40000 - £50000 Per Annum Excellent benefits: Clearwater People Solutions Ltd:...

Welsh Teacher Year 2 required in Caerphilly

£100 - £105 per day + plus Travel Scheme: Randstad Education Cardiff: The Job:...

Year 4 Teacher

£100 - £125 per day: Randstad Education Chelmsford: Would you like to work in ...

Day In a Page

Ebola outbreak: The children orphaned by the virus – then rejected by surviving relatives over fear of infection

The children orphaned by Ebola...

... then rejected by surviving relatives over fear of infection
Pride: Are censors pandering to homophobia?

Are censors pandering to homophobia?

US film censors have ruled 'Pride' unfit for under-16s, though it contains no sex or violence
The magic of roundabouts

Lords of the rings

Just who are the Roundabout Appreciation Society?
Why do we like making lists?

Notes to self: Why do we like making lists?

Well it was good enough for Ancient Egyptians and Picasso...
Hong Kong protests: A good time to open a new restaurant?

A good time to open a new restaurant in Hong Kong?

As pro-democracy demonstrators hold firm, chef Rowley Leigh, who's in the city to open a new restaurant, says you couldn't hope to meet a nicer bunch
Paris Fashion Week: Karl Lagerfeld leads a feminist riot on 'Boulevard Chanel'

Paris Fashion Week

Lagerfeld leads a feminist riot on 'Boulevard Chanel'
Bruce Chatwin's Wales: One of the finest one-day walks in Britain

Simon Calder discovers Bruce Chatwin's Wales

One of the finest one-day walks you could hope for - in Britain
10 best children's nightwear

10 best children's nightwear

Make sure the kids stay cosy on cooler autumn nights in this selection of pjs, onesies and nighties
Manchester City vs Roma: Five things we learnt from City’s draw at the Etihad

Manchester City vs Roma

Five things we learnt from City’s Champions League draw at the Etihad
Martin Hardy: Mike Ashley must act now and end the Alan Pardew reign

Trouble on the Tyne

Ashley must act now and end Pardew's reign at Newcastle, says Martin Hardy
Isis is an hour from Baghdad, the Iraq army has little chance against it, and air strikes won't help

Isis an hour away from Baghdad -

and with no sign of Iraq army being able to make a successful counter-attack
Turner Prize 2014 is frustratingly timid

Turner Prize 2014 is frustratingly timid

The exhibition nods to rich and potentially brilliant ideas, but steps back
Last chance to see: Half the world’s animals have disappeared over the last 40 years

Last chance to see...

The Earth’s animal wildlife population has halved in 40 years
So here's why teenagers are always grumpy - and it's not what you think

Truth behind teens' grumpiness

Early school hours mess with their biological clocks
Why can no one stop hackers putting celebrities' private photos online?

Hacked photos: the third wave

Why can no one stop hackers putting celebrities' private photos online?