Editorial: Sometimes hospitals have to close

 

Share
Related Topics

Yesterday's report from the Commons Public Accounts Committee paints a disturbing picture of NHS finances, less because of the actual bottom line, than because of the confusion, unaccountability and wide disparities it reveals. Three points should be of particular concern.

A surplus of £2.1bn across the NHS as a whole cloaks the reality that a substantial minority of trusts face acute financial difficulties. And one reason – though not the only one – is the burden of continuing payments for PFI projects. It would appear to be too late for an inquiry into who signed these deals, after what advice and on whose authority, and illegal to revise the contracts retrospectively. So the NHS is stuck with bailing out the trusts that cannot pay.

The second reason for concern is the seemingly ad hoc and inconsistent nature of government bailouts. MPs found no standard procedure to be followed if trusts went into debt, and no transparency in the way such help was provided and reported. Add the lack of real sanction for poor financial management, and this makes a mockery of any claim to sound accounting in the NHS. Nor did MPs find any sign that things would improve once the new commissioning boards were in operation.

The sharp disparities that exist between different trusts are a third reason for concern, but one that may hold part of a solution. PFI enabled trusts to build new facilities at the very time that the tide started to turn against big general hospitals. But people have an often irrational affection for their local hospital, which vote-hungry politicians have done little to discourage. Whenever there is talk of hospital closures or mergers – both of which need to happen – the argument tends to be dominated by claims about cuts. The clinical case for the concentration of expertise, and the management case for the best use of resources, must both be made much more forcefully than they have.

React Now

Latest stories from i100
iJobs Job Widget
iJobs General

Selby Jennings: VP/SVP Credit Quant- NY- Investment Bank

Not specified: Selby Jennings: VP/SVP Credit Quant Top tier investment bank i...

Ashdown Group: Senior Marketing Executive- City of London, Old Street

£40000 - £43000 per annum + benefits: Ashdown Group: Senior Marketing Executiv...

Ashdown Group: Marketing Manager

£40000 - £43000 per annum + benefits: Ashdown Group: An international organisa...

Ashdown Group: Internal Recruiter -Rugby, Warwickshire

£25000 - £30000 per annum: Ashdown Group: Internal Recruiter -Rugby, Warwicksh...

Day In a Page

Read Next
Ed Miliband created a crisis of confidence about himself within Labour when he forgot to mention the deficit in his party conference speech  

The political parties aren't all the same – which means 2015 will be a 'big-choice' election

Andrew Grice
 

Beware of the jovial buffoon who picks fights overseas

Boyd Tonkin
Aren’t you glad you didn’t say that? The worst wince-and-look-away quotes of the year

Aren’t you glad you didn’t say that?

The worst wince-and-look-away quotes of the year
Hollande's vanity project is on a high-speed track to the middle of nowhere

Vanity project on a high-speed track to nowhere

France’s TGV network has become mired in controversy
Sports Quiz of the Year

Sports Quiz of the Year

So, how closely were you paying attention during 2014?
Alexander Armstrong on insulting Mary Berry, his love of 'Bargain Hunt', and life as a llama farmer

Alexander Armstrong on insulting Mary Berry and his love of 'Bargain Hunt'

From Armstrong and Miller to Pointless
Sanchez helps Gunners hold on after Giroud's moment of madness

Sanchez helps Gunners hold on

Olivier Giroud's moment of madness nearly costs them
A Christmas without hope: Fears grow in Gaza that the conflict with Israel will soon reignite

Christmas without hope

Gaza fears grow that conflict with Israel will soon reignite
After 150 years, you can finally visit the grisliest museum in the country

The 'Black Museum'

After 150 years, you can finally visit Britain's grisliest museum
No ho-ho-hos with Nick Frost's badass Santa

No ho-ho-hos with Nick Frost's badass Santa

Doctor Who Christmas Special TV review
Chilly Christmas: Swimmers take festive dip for charity

Chilly Christmas

Swimmers dive into freezing British waters for charity
Veterans' hostel 'overwhelmed by kindness' for festive dinner

Homeless Veterans appeal

In 2010, Sgt Gary Jamieson stepped on an IED in Afghanistan and lost his legs and an arm. He reveals what, and who, helped him to make a remarkable recovery
Isis in Iraq: Yazidi girls killing themselves to escape rape and imprisonment by militants

'Jilan killed herself in the bathroom. She cut her wrists and hanged herself'

Yazidi girls killing themselves to escape rape and imprisonment
Ed Balls interview: 'If I think about the deficit when I'm playing the piano, it all goes wrong'

Ed Balls interview

'If I think about the deficit when I'm playing the piano, it all goes wrong'
He's behind you, dude!

US stars in UK panto

From David Hasselhoff to Jerry Hall
Grace Dent's Christmas Quiz: What are you – a festive curmudgeon or top of the tree?

Grace Dent's Christmas Quiz

What are you – a festive curmudgeon or top of the tree?
Nasa planning to build cloud cities in airships above Venus

Nasa planning to build cloud cities in airships above Venus

Planet’s surface is inhospitable to humans but 30 miles above it is almost perfect