Warning over NHS hospital closures in "creative destruction"
The National Health Service is entering a period of "creative destruction" when hospitals will need to close and services be reconfigured, the former head of the Department of Health's strategy unit warned this week. But Chris Ham, professor of health services management at Birmingham University, said there were serious doubts about whether politicians and health ministers "will be prepared to live with the consequences". He said: "My guess is that they won't." The 2001 election result in Kidderminster was "engraved on politicians' minds", Prof Ham said.
The council was taken over by "save our hospital" candidates and a Labour minister lost his seat after the local hospital closed its accident and emergency department but kept diagnostic and treatment services.
The change in the hospital's services was described by Prof Ham as "relatively small". However, he said, if the health service was to improve and get back into financial balance ministers needed to take "some brave but very unpopular decisions" over where and how care is provided.
"If they don't, where do they think they will find the money to keep services going as presently constructed?" he said.
In north-west London alone perhaps two large hospitals needed to close for services to be provided effectively, he said.
His warning came at a British Medical Association conference on NHS reform where James Johnson, the BMA's chairman of council, said the government, managers and clinicians had "probably [only] two years to get the NHS right" and ensure that it remained a tax-funded, free at point of use service. After that the big spending increases would cease, he said.
Doctors, he acknowledged, were sharply divided over the merits of the government's reforms. Some would fight them. But he, alongside Dr Hamish Meldrum, chairman of the BMA's GPs committee and Dr Jonathan Fielden, deputy chairmanof the consultants' committee, all acknowledged that the way hospital services were provided needed to change.
Prof Ham said the government's introduction of a supplier market, driven by new private providers, money following the patient, patient choice and more competition, was leading to "creative destruction" which would help enforce some of the changes.
But he and the senior BMA figures all judged that commissioning of services - primary care trusts and GPs deciding which services are bought where - remained the "Achilles heel" of the reforms.
http://news.ft.com/cms/s/c77e796a-c43f-11da-bc52-0000779e2340.html
The council was taken over by "save our hospital" candidates and a Labour minister lost his seat after the local hospital closed its accident and emergency department but kept diagnostic and treatment services.
The change in the hospital's services was described by Prof Ham as "relatively small". However, he said, if the health service was to improve and get back into financial balance ministers needed to take "some brave but very unpopular decisions" over where and how care is provided.
"If they don't, where do they think they will find the money to keep services going as presently constructed?" he said.
In north-west London alone perhaps two large hospitals needed to close for services to be provided effectively, he said.
His warning came at a British Medical Association conference on NHS reform where James Johnson, the BMA's chairman of council, said the government, managers and clinicians had "probably [only] two years to get the NHS right" and ensure that it remained a tax-funded, free at point of use service. After that the big spending increases would cease, he said.
Doctors, he acknowledged, were sharply divided over the merits of the government's reforms. Some would fight them. But he, alongside Dr Hamish Meldrum, chairman of the BMA's GPs committee and Dr Jonathan Fielden, deputy chairmanof the consultants' committee, all acknowledged that the way hospital services were provided needed to change.
Prof Ham said the government's introduction of a supplier market, driven by new private providers, money following the patient, patient choice and more competition, was leading to "creative destruction" which would help enforce some of the changes.
But he and the senior BMA figures all judged that commissioning of services - primary care trusts and GPs deciding which services are bought where - remained the "Achilles heel" of the reforms.
http://news.ft.com/cms/s/c77e796a-c43f-11da-bc52-0000779e2340.html
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