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Tuesday 18th June 2019

Closing hospitals is for the best

4th March 2011

Dr Greg Parston, Chair of the Public Management Foundation, argues that closing hospitals or reducing what they do can be in the best interests of an effective and efficient health service.


The coalition government’s NHS reforms have sparked widespread debate over health outcomes, privatisation fears, and the viability of change at time of unprecedented efficiency savings.

But these arguments are about the wrong things because they will only change the NHS’ patterns of money flow, responsibilities for service procurement and levels of accountability.

They ignore the fact that what is needed is change to the NHS’ infrastructure - to the provision of care.

It needs to close unneeded hospitals and transfer resources out of expensive inappropriate facilities in order to meet the rapidly changing patterns of need.

We do not need as many hospitals, particularly with estimates that over the next decade as much as 60% of the NHS clinical budget will be spent on the chronic conditions of older people, who can be cared for in facilities other than hospitals.

But at present, we do not have enough low-level chronic facilities or home care professionals because the NHS is so dominated by acute hospital and medical professionals.

Torbay has changed its approach and seen dramatically decreased hospital admissions for the elderly and a 30% reduction in occupied hospital beds since 1999.

But we are continuing to keep on using hospitals instead of more appropriate alternatives.

Diluting commissioning power among GPs is not the answer either.

Commissioning health care must be about managing and reshaping the overall provision of care.

In this respect, the planned reforms only protect the status quo.


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