Wonks: Fight for hospital closures

The IPPR’s Richard Brokes argues today that, “people should be out on the streets campaigning for changes to NHS services to protect the health of their families, not to keep services the way they are.” 

This highly controversial argument will be a boon to the Government, who, it is revealed today, are very worried about the public’s rejection of NHS market reforms.

The IPPR argue that campaigns to save hospital departments may be causing “1,000 unnecessary deaths” a year. To do this they take Lancet research that shows that patients fare better in new, specialist units, and say that if patients were taken to specialist units, instead of local hospitals, more lives would be saved.

This sounds like research that will have to be looked at very closely, but one thing springs to mind immediately. Surely any benefit that can be gained from specialist units will be lost from the fact that patients have to travel further. If heart attack victims face a greater delay for treatment then surely more will die before they even get to the modern units.

It missed out on another thing. Cardiac units are just one service offered in local hospitals. Once services are shipped out of local hospitals, they tend to lose more and more. Surgery is diverted elsewhere, and so are A&E departments. Once those are gone, a community really does face problems in getting to other hospitals that can be many miles away.

There is nothing wrong with genuine modernisation. It is good to have specialist units backing up good local hospitals. It is also good for minor procedures to be moved out into well trained doctors’ centres. However, the research carried out by the IPPR seems questionable and aimed to give political cover, rather than being part of a genuine debate about which services are best provided where.

8 Responses to Wonks: Fight for hospital closures

  1. HenryG says:

    Policy wonks don’t decide general elections. Many Labour members are furious that our record on the NHS appears to be collapsing before our eyes. Our whole record on extra investment into the health services is undermined by the very visible planned closures of A & E services. Morale in the NHS is worryingly low too. It’s ‘our’ issue, just as the economy ‘belonged’ to the Tories until Black Wednesday. If we lose on the health, we’ll lose the election.

  2. Well quite! In my area, the hospital’s in danger of losing some surgical procedures not because of any need for more local or specialised services, but because they’re running a deficit. That is the reality of NHS modernisation for many people, not cardiac centres of excellence.

  3. snowflake5 says:

    The opposition and the unions have been very succeessful at giving the impression that thousands on thousands of NHS jobs are at stake.

    I was discussing the economy with my husband (as you do) and he remarked that apart from NHS job losses, everything seemed good, and was astounded when I told him that the redundancies only amounted to 900. “Is that all? They’re making a lot of noise about it, arn’t they?” was his response. He’s apolitical and does not pay close attention to the news, and I’m pretty sure that the public, like him, is under the impression that the situation is much worse than it actually is.

  4. It’s not just redundancies. It’s freezes on new recruitment, overtime bans, restrictions on agency staff when there aren’t enough permanent staff to cover basic services. My local hospital has had unacceptable delays in some areas not because of redundencies, but because their deficit is cutting off the financial flexibility they need.

  5. HenryG says:

    I agree to a point Snowflake, one of the difficulties of the unions and other pressure groups is that you only see them on the TV when criticising something. Of course they’ve got to represent their members’ interests, but it does add up to a grim picture. But on health it seems to be different – closing services isn’t union spin.

    I’ve a number of family members in the health profession and the picture they paint is not great. The deficits are really biting hard – the introduction of quite expensive car park charges for staff is tantamount to pay cuts for many. There are wards that have very little cover and the mood at the moment appears to be that things got better (around 2000) but are now ‘going backwards again’.

  6. Nick says:

    Have to agree – I also have family who work in the local hospital and morale is rock bottom. It’s not so much that there are huge redundancies, it’s more that the small number of redundancies could affect anyone and every time they’ve implemented one wave another wave comes round, so just a few dozen job losses leave thousands of staff under constant stress and worry.

    At the same time freezes on overtime and recruitment are leading to mounting pressure. It’s not so much that all the government’s changes are wrong, it’s more that they’ve gone for a big bang approach when incremental reform was needed.

    The other big problem is the sheer unpredictability of payment-by-results when there is no kind of financial cushioning for sudden changes in income.

    This issue almost certainly lost us a key council election in the ward where many medical staff live, and that was before it hit the local media. Regardless of the policy specifics, health is a political disaster for us at the moment.

  7. “However, the research carried out by the IPPR seems questionable and aimed to give political cover, rather than being part of a genuine debate about which services are best provided where.”

    Reliable statistics suggest that appropriate use of the opportunites provided by a senior position at the IPPR can significantly increase your chances of receiving effective treatment in the interview process for a job in the Number 10 policy unit.

    Those afflicted by an unquenchable desire to exercise power and influence without accountability may be well advised to seek a place on the IPPR’s treatment programme.

  8. HenryG says:

    There is a serious issue whereby these wonkers, spads and ministers all live within 2 miles of each other, spend all their time reading Robert Reich or Richard Layard and not actually meeting real live human beings. This is why participation in policy making through political parties is so, so important – it keeps things relevant and grounded. It is that will help us achieve our political success.

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