This article titled “NHS reform plans for London could put lives at risk, warns thinktank” was written by Randeep Ramesh, social affairs editor, for The Guardian on Tuesday 13th December 2011 06.01 Europe/London
A “leadership vacuum” caused by the government’s plans for the health service puts lives at risks and is forcing hospitals into dire financial straits in London – the largest single region of the NHS – health thinktank the King’s Fund warns.
The thinktank has said that ministers are making a mistake by handing control of NHS budgets to GPs without any body or structure having oversight of the capital’s healthcare, especially in the politically sensitive area of closing down hospitals.
Currently, a strategic health authority and 31 primary care trusts work together to shut down and centralise services. All these will be swept away by 2014 when family doctors will be in charge of reorganising healthcare.
However, the King’s Fund report has found that GPs have failed to win patients’ confidence in London, and the capital was ranked the worst of all regions on 26 of 31 questions in last year’s GP-patient survey.
The fund is concerned that family doctors “are unlikely to be able to provide the leadership required” to reconfigure hospitals, potentially costing lives.
It goes on to say that by creating four trauma centres in London, 37 lives were saved in the first year because resources were targeted. Concentrating emergency care in fewer hospitals could save up to 500 lives a year in London, it argues.
To add to these problems, hospital trusts in London will carry a net deficit of £170m by 2014, according to the report. London’s NHS also faces much larger private finance initiative (PFI) commitments than elsewhere in the country, with an estimated £19bn in PFI costs due to be paid by 2048.
With the NHS having to make savings of at least 4% a year, many hospitals will not be viable in their current form. In north-west London, it warns, hospital trusts will have to find savings of £125m by 2014.
The financial crunch will mean well-known names will not be able to become foundation trusts, a requirement under Andrew Lansley’s health reforms. In the capital those identified by the report include Imperial College Healthcare, which includes St Mary’s, Charing Cross and Hammersmith hospitals, and Barts and the London. Instead, many hospital trusts are having to merge to save costs.
Chris Ham of the King’s Fund told the Guardian that “there is no way that [GPs] will fill the vacuum. The problems of patient safety and financial risk are too big. Therefore there is a real risk we will not go forwards but go backwards.
“Some people say that [London mayor] Boris Johnson will step into the vacuum,” Ham added. “He has a very good adviser, Pamela Chesters, who knows the NHS very well.” Chesters, paid £127,000 a year, is a former Conservative councillor who chaired the Royal Free Hampstead NHS Trust.
“The problem is the whole thing is done by default not design,” said Ham.
A spokesman for the Department of Health said that London would not be without help. “The NHS commissioning board will have a role in shaping services across London to deliver the best possible care for patients. The whole point of our modernisation plans is to ensure that the doctors and nurses who work in London’s hospitals and GP surgeries day in and day out are in the driving seat – they know better than anyone what services their patients need and where improvements can be made.”
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