Mad – and getting madder

It’s increasingly difficult for rational people to understand Government policy on the NHS. As the idiocies pile up, one on top of another, the only clear game plan seems to be to create chaos. This is a great excuse for announcing in a few years that the NHS just isn’t working, we can’t afford it anymore, a US style system makes more sense… And while we drift steadily in that direction, there are of course big bucks to be made by the private sector along the way.

The latest bit of idiocy is the plan to bypass all existing consultation processes in order to close down hospitals. The HSJ story explains how this will work.

The inevitable consequence of Government policy is that a load of hospitals will be forced into financial crisis. Hospitals have been saddled with huge PFI debts at the same time as their income has been slashed. Independent Sector Treatment Centres have been encouraged to cream off the cheapest and easiest cases, leaving hospitals with fewer and more costly patients. Darzi’s proposals are about pulling enormous chunks of health care out of hospitals and shifting it into (privately run) polyclinics. A lot of District General Hospitals also face the closure of A&E units, maternity units and children’s wards under Darzi’s plans. So, fewer ‘customers’, and a reduced income stream.

Having forced hospitals into financial ruin, the Government now proposes to punish them by arbitrarily closing them down. The estimate is that 2.1% of NHS and Foundation trusts will fail each year. This isn’t clinical failure (i.e. poor patient care). This is financial failure, of hospitals that have been driven into deficit as a direct result of Government policy.

The plan is that a ‘special trust administrator’ will draft a report on the organisation’s failure, a quick and dirty 30 day consultation will follow, and the Secretary of State will take a final decision to close down hospitals after 35 days. Existing consultation requirements under the 2006 NHS Act will not apply. Local people will have little or no say. Council ‘Health Scrutiny Committees’ will be sidelined.

A Department of Health spokesman said, ‘The existence of a robust, transparent, unsustainable provider regime will act as a spur to improve NHS performance’. Many normal people would struggle to see how closing hospitals improves NHS performance, but there you go.

A rather saner NHS Chief Executive commented, ‘Continuity of care and continued access to essential hospital services must be preserved… NHS hospitals are not commercial enterprises – we can’t just shut up shop due to financial bankruptcy’.

The ‘NHS failure regime’ is now out for consultation. Trade unions, patient groups and professional organisations may wish to respond.


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