Hospital services in London could close or be down graded as healthcare in the capital heads towards ‘a major financial and organisational crisis’, a report claims.
The BMA-commissioned report, London’s NHS on the brink, predicts real term cuts of £5bn by 2017 in the capital.
London faces unique challenges, the report claims. It has 14.8% of the English population but could suffer a much higher share of the expected cutbacks.
There are more mental health patients per head of population in London than other regions, the capital has rising patient activity and it has more PFI hospital schemes. The repayments for London’s 20 PFI hospital projects will have a lifetime cost of around £16.7bn - more than six times the basic cost of the buildings.
The report highlights proposals NHS London has made public, including reducing the number of people visiting A&E by 60% and hospital outpatients by 55%. Polyclinics, as proposed by Lord Darzi, will fill the gap.
The hospital network will be slimmed down, with the reduction of many district general hospitals to smaller hospitals, leaving a lower number of major acute hospitals. The report also highlights plans to reduce staffing in non-acute services by two thirds, shorten GP appointments and cut payment by results tariffs.
The study also criticises NHS London’s refusal to release a confidential report drawn up by management consultants McKinsey’s on the way a head.
Some reports have however indicated that London PCTs will face a funding gap in the region of £5bn by 2017. The health budget for London in 2009/2010 was £13 billion.
Dr Kevin O’Kane, chairman of the BMA’s London Regional Council, said: “We are calling for full disclosure of the proposals so that there can be a public debate. This is vital so that Londoners can have their say about local cuts and take a wider view of what is happening to the NHS.
“The truth is that most Londoners have no idea of what is happening to their health service. If people realised that we are heading towards financial meltdown involving cuts in bed numbers and hospitals closing or being down-graded, they would demand the opportunity to make their voices heard about these plans.”
A spokesman for NHS London said change was being driven by population growth and health inflation, with the downturn making it more urgent.
He said: “Healthcare for London will deliver an even better quality NHS for less money. Patients told us they wanted a more convenient and accessible health service. This meant localising services where possible and centralising where necessary.
“We already have the first of more than a hundred polyclinics open longer hours than traditional GP surgeries, providing care normally only available in hospital. We are also creating new world class specialist centres for stroke and major trauma which will save 500 lives a year. No change will lead to the death of the NHS in London by a thousand cuts.”
Read the full report.
