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NHS trusts `mean more wait for fewer beds'


Health Services Correspondent

The creation of NHS trusts has cut available beds and increased the number of people waiting for treatment, according to a survey published today, coinciding with the fourth anniversary of the establishment of first-wave trusts.

The study, by the trade union-funded Labour Research Department, shows that from 1991 to 1994, first-wave trusts lost 9 per cent of hospital beds. Numbers awaiting treatment increased by 11 per cent. Nearly three- quarters of first-wave trusts lost beds while just over a quarter gained them. The net loss among 50 comparable trusts was 2,701 beds, representing 9 per cent of total capacity.

Trusts with major bed losses were Epsom Healthcare, which lost 21 per cent, Nuffield Orthopaedic (18 per cent), and East Somerset Trust and United Bristol Healthcare (both 17).

Almost two-thirds of the trusts showed an increase in waiting lists at the end of the period while a third achieved a fall. The net increase in those awaiting treatment for 40 comparable trusts was 17,218 - an 11 per cent rise. Worst affected were Manchester's Christie Hospital, where the waiting list expanded by 125 per cent, Epsom Healthcare (85 per cent), and Mount Vernon and Royal National Throat, Nose and Ear hospitals in London (both 70 per cent).

The Government creation of a health care internal market will be almost complete this month. Twenty-five new NHS trusts will come on stream, after which 98 per cent of all NHS services will be provided through trusts.

The Labour Research Department survey looked at the first 57 English trusts, which became operational in April 1991. Its report said: "Taking beds and waiting lists as a measure of the performance of the first-wave trusts, there is no doubt that services have deteriorated in the trust hospitals since 1991."

Hospital beds in England as a whole fell by more than 9 per cent between 1991 and 1994, from 252,708 to 228,942. For general and acute care beds the fall overall was 6 per cent from 157,247 to 147,413.

Mental health trusts faredbadly with five of the seven established in 1991 experiencing bed losses ranging from 13 per cent at West Dorset Mental Health to 54 per cent at Cornwall and Isles of Scilly Mental Health. At the same time, those in England waiting for treatment increased between September 1991 and September 1994 from 947,800 to 1,071,101.

Department of Health statistics show an increase in throughput, measured by finished consultant episodes, and the proportion of people waiting for more than a year fell by half over the three years. The average length of stay in hospital has been sharply reduced and Labour Research claims there is evidence that repeat hospital admissions because of premature discharge have increased substantially.

The Department of Health said: "The number of beds is not an indicator of performance. What matters is the amount of time a patient waits and the numbers of patients being treated. The evidence is that trust hospitals have been treating more patients and treating them more quickly."

Responding to the survey, Tom Sackville MP, Parliamentary Under-Secretary of State at the department, said: "Using the number of beds as a barometer of success in the NHS only reveals Labour's ignorance of how modern health care works.

"With more and more day surgery, advanced laser techniques and other medical advances, it is possible to treat increasing numbers of patients using fewer beds. Had they bothered to do any genuine research, Labour would have found the same trend of reducing beds in every modern health service in the world."