NHS faces prospect of hospital closures, former chief warns

1 Sep 11
The NHS will need to take ‘tough decisions’ in order to meet its efficiency targets, NHS chiefs have said, after warnings that some hospitals will have to close to balance budgets.

By Richard Johnstone | 1 September 2011

The NHS will need to take ‘tough decisions’ in order to meet its efficiency targets, NHS chiefs have said, after warnings that some hospitals will have to close to balance budgets.

Former NHS chief executive Lord Crisp has said that hospitals will have to close for the health service to cope in the future as it aims to release £20bnin efficiency savings by 2015.

Crisp, who was chief executive of the NHS in England from 2000 to 2006, has said that there is ‘overcapacity’ in the hospital sector, adding that overhauling hospitals would free up funds for community services to deal with the ageing population.

He said the overcapacity was a result of the decision by the Labour government in 1997 to tackle long waiting lists, but argued that the health service now has to deal with the growing numbers of older people and those with long-term conditions in the community.

Speaking ahead of the release of a book about his time running the NHS Crisp said there needed to be shift away from hospital‑led care. ‘There will be less need for large hospital outpatient departments and some services and whole hospitals will need to close or be merged with others.’

His comments come ahead of the NHS reforms in the government’s controversial Health and Social Care Bill, which has been revised and recommitted to Parliament, and will introduce more competition and choice into the NHS. The reforms will see local clinical groups taking over the role of commissioning health care from primary care trusts.

Commenting on Crisp’s remarks, NHS Confederation deputy chief executive David Stout confirmed the NHS ‘will have to make some tough decisions if the health service is to live within its means’.

He added that this shouldn’t be seen as a ‘counsel of despair’, as the savings can be made while improving the quality of care.

But he added: ‘This is a pressing issue and one that we must tackle now so that patients can continue to have access to the high quality care they expect.

‘NHS organisations must find new ways of delivering services if they are to respond to growing demands on healthcare and increasing financial constraints. In reality, this is likely to mean closing some hospital services, having fewer hospital beds and providing care in different ways, particularly in the community.’

The Foundation Trust Network said that NHS providers, especially acute and mental health foundation trusts and community trusts seeking foundation status, are looking at reorganising services to achieve greater efficiency. 

Chief executive Sue Slipman said: ‘Our members… have been making huge efforts to address problems of dealing with waiting lists, too many patients using A&E and helping those with long‑term conditions.

‘However they need the freedom to act quickly, in the interests of their local communities and the patients they serve, in order to reshape their services. Foundation trusts are not looking for central direction – they are looking for enabling reform, so that they can realise the full potential of being a foundation trust.’

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