Minister defends hospital readmissions penalties plan

Health Secretary Andrew Lansley today defended plans to impose financial penalties on hospitals if patients are readmitted as an emergency within 30 days of being discharged.

The Cabinet Minister insisted the move - where hospitals are paid for initial treatment but do not get paid again if a patient is brought back in with a related problem - would result in a "much better system" for both patients and hospitals.

"Instead of there being a divide between the hospital which undertakes the treatment initially and then hands over to a separate, completely separate, community therapist, then actually the hospital takes responsibility for the whole of that care," he told BBC Breakfast.

"What we escape from is the perverse situation at the moment where a hospital might discharge patients too early - and we have seen a 50% increase in the number of emergency readmissions - and then when the patient comes back as an emergency, the hospital gets paid again."

It has been argued that some patients are discharged too soon and without proper care plans in place.

The Conservatives have also said cuts to the number of hospital beds under Labour put pressure on NHS staff to discharge people without support.

Between 1998/99 and 2007/08, the number of emergency readmissions in England rose 52% from 359,719 to 546,354.

Mr Lansley's remarks come in advance of a speech he will give about the future of the NHS.

Speaking about his vision for the NHS, Mr Lansley will call for patients to be given more control over their health.

He will call for a greater focus on outcomes for patients and for the NHS to listen to what people want.

"My ambition is that we can achieve health outcomes - and quality health services - as good as any in the world," he will say.

"That we can achieve a unique combination of equity and excellence.

"And, buoyed by the knowledge that we have medics, nurses and scientists as good as anywhere in the world, I know that we can achieve this.

"We will empower patients as well as health professionals. We will disempower the hierarchy and the bureaucracy.

"I don't want the whole of the NHS to wait to hear what I have to say.

"I want the service to listen to patients, to take responsibility. To realise how much patients know about their need, especially for those living with long-term conditions.

"To give patients and care-users more control, exercising choices, through to personal budgets.

"To empower patients collectively, through patient-representative groups, impacting on the quality standards and commissioning guidelines, through to patients and the public locally, impacting on decision about access and designing of local services to meet local needs."

Mr Lansley will say that targets focused on processes, data returns and more Department of Health circulars will not achieve these aims.

Neither will "pointless structural upheavals or increasing the number of administrators in primary care trusts, nor even just by supplying more money", he will say during a speech in east London.

Speaking on BBC Breakfast, Mr Lansley said the Government was "very clear" that it would increase the NHS budget every year in real terms to meet the demands on the service.

"In order to meet those demands we have actually got to use our resources much better," he said.

"What I am saying today is in part about focusing on patient safety and on better care for patients.

"This safer, better care is also more cost effective and if I can cut, as I will do, the cost of bureaucracy, the cost of administration, cut out waste in the NHS, then we can get those resources to support increasing quality for patients."

Asked about whether the NHS could keep pace with demand, in particular for new cancer drugs, Mr Lansley said one of the objectives of cutting waste and working more effectively in the NHS would be in order to find money to fund new drugs.

"It should enable us not only to do the things we currently do better, but actually to do some of the things which really it is unacceptable that we should be one of the leading countries in western Europe, we have some of the best cancer research anywhere in the world, but yet sometimes it is our patients in our national health service who find that they don't have access to the latest new cancer medicines in circumstances where everywhere else in Europe they do.

"We can use those resources more effectively within the NHS and providing those medicines to patients will be one of the objectives of doing so."

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