Lord Crisp said: “In the late 1990s waiting lists, A&E and standards in cardiac care were the big issues and we dealt with them. But the challenge now is dealing with the numbers of older people and those with long-term conditions. They need support in the community. That means a shift away from hospitals. There will be less need for large hospital outpatient departments and some services and whole hospitals will need to close or be merged with others.\”
Dialysis is increasingly conducted in the community, while GPs are taking on more responsibility for things such as minor surgery and diabetes care. Lord Crisps’ remarks come as ministers are considering the future of A&E, maternity services and children\’s units at three hospitals in north London. Under the plans drawn up by the local NHS one hospital – Chase Farm – could lose its services. Local campaigners have been fighting the proposals and a decision is expected in the coming weeks. The decision is seen as a key moment in the government\’s policy on hospital changes because, in opposition, the Tories promised to fight such closures.
Lord Crisp has admitted the NHS under his stewardship in the Blair years should have scaled back on hospital services. In particular, he admitted that the scale of hospital building projects probably went too far. More than 100 new hospitals or rebuilds were given the go-ahead. He said: \”By 2005 there was no hospital that was not thinking it was going to grow. We had major problems with very bad facilities, [but] perhaps we could have built smaller or consolidated on fewer sites.”
However, it is essential any changes made are done to benefit patients and not just to save money, and that they should be carried out with proper consultation and engagement. Lord Crisp\’s intervention comes after similar warnings by various experts. The King\’s Fund and NHS Confederation have both put the case for scaling back on hospital care in recent months.
Katherine Murphy, of the Patients Association, agreed the government should not be afraid of making difficult decisions. She said: \”What is the point of having brand new hospital buildings if there are not enough funds to treat people in them?\” However, she also warned: \”We must never forget that by merging services, there will be patients who may struggle to get to them because they are too far away.\”
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