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Polyclinics 'will drain money from hospitals'
Anna Davis28.11.08
LONDON hospitals face massive cash cuts as a result of sweeping changes to the health service, the Standard can reveal today.
Polyclinics and super-specialist centres being set up across the capital will drain patients and money away from traditional hospitals, a report shows.
The group in charge of the reforms today predicted London's district general hospitals could lose 15 per cent of their income but the changes will save lives and cut the time patients stay on wards.
The reforms, being brought in after a report by Lord Darzi, will see patients with severe illnesses treated in highly specialised centres, and those with minor problems treated at home or in polyclinics.
That will leave traditional hospitals with fewer patients and less money, because they are paid according to how many people they treat.
Healthcare for London, which is making the changes, today published its report on the future of local hospitals. David Law, who wrote it, said: "We wanted to flag up early to Primary Care Trusts that this is what's coming down the track, and they need to be in a position to respond to it. It is an early indication of what the changes could be."
Healthcare for London denied smaller hospitals will close as a result of the drop in income, which will hit in five years. To bring in more money, experts said, they should carry out more planned surgery and provide more rehabilitation services, while leaving more serious emergency cases to be dealt with by specialist hospitals.
Celia Ingham-Clark, who co-authored the report, said: "It would never be in the PCTs' interest to close their hospitals. Everyone is already busy and there is no spare capacity to drop anything - 90 per cent of the care that people need can be provided in local hospitals."
Campaigners fear closures and confusion. Geoff Martin, from London Health Emergency, said: "People understand what a district general hospital is, but this shows some will be downgraded to the level of community hospitals. It sounds like the worst fears of health campaigners are coming home to roost."
However, Ms Ingham-Clark said: "We are certainly not downgrading local hospitals. This is about making sure everyone is really good at their main area of business. This report just clarifies what local hospital business is."
Local hospitals would still have A&E departments, but would see a drop in patient numbers because less serious cases would be dealt with in urgent care centres or polyclinics.
Those in favour of the changes argue this means senior doctors in A&E departments would be able to deal with the most needy patients.
Critically ill patients would be sent to specialist stroke centres and major trauma centres across London.
Experts said MRSA levels would be cut by separating patients requiring emergency surgery from those needing planned procedures. They also believe lives could be saved by reducing unnecessary surgery at night.
But hospital staff could be forced to move jobs while some buildings will be left empty. The report said: "The risks associated with the changes proposed are considerable. This has to be set against the risks of the status quo, which falls short of patients' expectations, does not always deliver the best possible outcomes for patients, can be inflexible and difficult to access, and is not delivering equality of outcomes."
Ruth Carnall, chief executive of NHS London, said: "This report shows the local hospital has not changed much in 60 years, yet the health needs of the population have."
Reader views (3)
You live in a nanny state,what did you expect?
- Zeno, W. Richland, WA, USA
If 'polyclinics' mean that the grossly overpaid GPs who make terrible errors or don't seem to care have to be reorganised then bring them on. I believe the average salary for a London GP was something between £150k - £1m when figures were announced last year. On enquiry, I found out my own GP had at least 8 people registered at my address who don't live here. I assume they get paid for these 'ghost' patients? And I assume that cardiac surgeons, brain surgeons, ambulance paramedics and people who actually save lives as opposed to prescribe prozac or say 'come back next week if it's still the same' must be pretty galled at the GP's salaries? Time for change in my opinion.
- Real, London
It is interesting that the report makes little if no reference to the effects of the government's 'reform' agenda for the NHS. The commercialisation of the NHS through increasing use of the private sector, driven by payment by results and commissioning, has led to fragmentation of care and disruption of the patient pathway. Since the proposals rely heavily on planning, collaboration and networks, it is not clear how the two can be reconciled.
Are Lord Darzi and the politicians talking to each other?
- Jacky Davis, London
