NHS reforms

03.10.12

Labour accepts the need for hospital closures

Shadow health secretary Andy Burnham has said he “will not allow” his party to oppose every hospital closure, and said he will support trusts with good clinical cases for reconfiguration.

He told a fringe session of the Labour conference in Manchester: “The district general hospital has to grow into something different: an integrated care organisation, working in the home, working in the community, and yes providing some things in the hospital, but changing fundamentally how it thinks and operates…One organisation providing physical, mental, social care.

“The implication of what I’m saying is that there will have to be changes to hospitals.

“My team will not be on every picket line of every hospital closure. I will not allow that to happen. It would not be credible for an ex-health secretary to adopt that position: I know that hospitals have to change.”

He said that if it’s a cost-driven reconfiguration that’s being “rammed through”, Labour won’t support it, but “if it’s clinically driven and will save lives”, it will. 

He said the current system incentivises admissions to hospital and more medical procedures, when in fact there should be financial incentives to keep people out of hospitals and in their home, since preventative care is both cheaper and better for the patient.

He said the tariff reinforces a ‘production line’ approach in hospitals and said: “My argument is for the full merger of health and social care. That, I believe, is the only way you can deliver person-centred high-quality safe care in the century of the ageing society.”

He said the fragmentation between health and social care meant the state often ended up paying for very expensive acute care in hospitals, because cheaper, earlier, home-based care wasn’t funded and because people themselves “in difficult times” won’t pay for it.

Burnham also indicated that foundation trust status should be something that can be revoked, not just granted.

In his keynote speech today, he will discuss the fact that hundreds of private companies are bidding for hundreds of contracts to provide NHS services in what he calls the first wave of competition introduced by the Coalition.

He has promised to repeal the Health & Social Care Act 2012 if Labour win power – but insisted this would not require another full-scale reorganisation.

Whilst Labour has not ruled out all competition in the NHS, Burnham will pledge to “repeal the market madness”.

If the party won the next election, he explained: “Private sector and charities would play a supporting role to a publicly owned, publicly accountable NHS.”

Burnham said: “The health service would not survive two terms of [David] Cameron … the NHS would not be a national service at the end of that. The Government is breaking down and privatising the system.”

He told BBC News: “Across England 396 community services are being put out to tender worth up to a quarter of a billion pounds.

“This is the single biggest act of privatisation that the NHS has ever seen. These contracts are being signed this week so the Government is now proceeding with privatisation at a pace and scale that the NHS has never seen.

“I wouldn’t create new organisations or throw the NHS upside down into another reorganisation because I will simply ask the organisation I inherit to work differently.”

Tell us what you think – have your say below, or email us directly at [email protected]

Comments

Mark   03/10/2012 at 15:02

How does the current payment regime ( with Non payment for readmissions. Marginal rates for increases in non elective admissions. Reduced payments next year making hospital obstetric work non viable) incentivise hospital work. Risk has been systematically shifted to the hospital sector this last 3 years. Im afraid the shadow health secretary is way off the mark.

Andy   04/10/2012 at 10:59

As an NHS clinician I agree with Andy Burnham when he says we need to do things differently, many younger NHS workers are up for the challenge, but unfortunately in the NHS the well paid dinosaurs rule so until they either change or relinquish control to those of us who care and believe enough in the NHS then we are either in for a rocky fruitless ride or stuck in the rut of "its always been done this way", either way its the patient caught in the middle and we need to keep sight of that.

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