“THE top medical official responsible for running the NHS in London has admitted that the service is at times unsafe for patients because doctors and nurses are spread too thinly.
In his stark assessment of the state of the service, Dr Andy Mitchell, medical director for NHS England in London, said London hospitals were at “breaking point”. It is unprecedented for an official at this level to give such a damning critique of the NHS and comes before a report by NHS England tomorrow that shows the capital’s health system is “unsustainable”.
The report says that keeping all London’s hospitals running in their current form would lead to a £4bn shortfall over the next seven years.
Health chiefs say half the casualty departments in the capital will have to shut to make the service sustainable. The problems in London are seen as a precursor to those in the rest of the country — the NHS faces a £30bn funding gap by 2020.
“At times, throughout the week, even throughout the day, services aren’t safe,” Mitchell said. “I feel anxious sometimes about saying it is unsafe, because I, of course, have got a responsibility to change it and improve it, but we are trying to patch up all the time.”
He added: “What we cannot do is carry on with the idea that all hospitals provide a whole range of services. That is completely unsustainable and would become, frankly, unsafe, and is becoming unsafe in many areas.”
NHS England says the health service cannot afford to staff all its hospitals at safe levels, especially at weekends. Mitchell says the public must face up to the reality that the hospitals are so overstretched that they are getting a poor service. “They [the public] don’t understand now how watered down these services are,” he said. “Their expectation is that, as they walk into hospital, they get high-quality service and, in fact, they don’t in many places.”
The problems are not restricted to London. Sir David Nicholson, the outgoing chief executive of NHS England, has warned of a massive funding gap if NHS services are run in the same way as they are now.
Tomorrow, health chiefs in London will explain that with zero financial growth planned for the NHS and increasing demands for services from a growing and ageing population, the public must accept that hospitals must be shut or downgraded to medical centres.
The report says: “London’s hospital services are becoming increasingly unsustainable, both clinically and financially. In many cases they are no longer fit for purpose.”
To make the NHS more affordable and safer, the number of A&E units in London should be reduced to about 50% while the number of paediatric and maternity departments should be cut and centralised in larger units, NHS England says. This would make it easier to staff the hospitals at safe levels. The number of hospitals carrying out emergency surgery and treating patients who have suddenly become seriously ill will also be reduced.
No doubt that this article and the recording support the contention of this website. More money by itself is not enough. Rationing overtly will help, but again is not enough. Open exit interviews could change the culture eventually, but not fast enough. Reconstruction and change of hospital/trust ownership may well be needed to energise the workforce, and to clear out those employees who give the UK Regional Health service hospitals one of the highest sickness and absenteeism rate in the world. What I believe….
Updated 14th October.
Also covered by the Daily Mail
And the BBC in “London Hospitals are at breaking point”.
It seems the Jimmy Saville affair supports this post headline:
Comment from the BMJ: Supporting poorly performing (NHS) hospitals to improve.