NHS Finance

20.06.11

More calls to close or sell off unsustainable hospitals

Professor Chris Ham, chief executive of the King’s Fund health think tank, has joined the calls for politicians to be distanced from decisions on the future of individual district hospitals, to ensure it is clinical need rather than local political concerns that informs the debate.

He has said that 20 hospitals across the country must be taken over, merged or closed if the NHS is to improve patent care and keep within its budget.

His call follows the comments last week by Dr Peter Carter, head the Royal College of Nursing, who said there are too many acute hospitals in urban areas. Privately, there is widespread support for greater centralisation of many hospital services, but it is often seen as political suicide for MPs to back such moves because of the expected backlash from constituents unhappy to see their local hospital closed or shrunk.

Research shows that more than two thirds of the £100bn NHS budget is spent on long-term conditions that are increasingly being treated out of hospitals. Hospitals, however, suck up the majority of NHS funding.

Writing in the Observer newspaper, Professor Ham said: “Several hospitals have large deficits and it is clear that existing services cannot be sustained either clinically or financially.

“Financial pressures are increasing by the day and will adversely affect quality unless ministers recognise the urgent need to change the way services are provided.

“Up to 20 hospitals, around 10% of the total in England, may not be financially sustainable and will have to be merged or taken over. Many others face financial or clinical challenges that require changes to the services they provide.

“Governments have ducked these issues for too long, while MPs have ignored clinical and financial evidence and backed campaigns to keep local hospitals and specialist units open.”

He argued that decision-making powers should be handed over from the Health Secretary to the Independent Reconfiguration Panel, who currently only make recommendations.

He said: “Giving the IRP responsibility would avoid delays under the current process and ensure they are taken on clinical and financial grounds rather than for political reasons.”

The Department of Health is said to be wary of such moves, which might suggest to people that hospitals are being closed purely to save money, rather than to increase the efficiency of care across the system.

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