NHS should cut 30,000 beds to 'save money', think tank warns17 March 2010
Tens of thousands of NHS beds should be cut to save money and improve patient care, a think tank has warned.
Many regions in England have too many hospitals and too many beds and patients, a report by Reform said.
Instead, more patients should be treated in the community nearer their homes which is better for them and cheaper for the NHS, it said.
Its report said that around 32,000 of the 160,000 hospitals beds should be cut and it criticised politicians for standing in the way and opposing the changes.
Doctors warned such large cuts for purely financial reasons would be 'immoral and catastrophic' for patient care rather than improve services.
Regions including London, the North East and the North West should expect to close over a quarter of their beds, the report said.
The NHS has already reduced the number of hospital beds it provides by more than one third since 1987 but it should go further.
The health service must save at least £20bn over the next five years as the large increases in funding are coming to an end and demand for healthcare continues to rise with the obesity crisis and ageing population.
A key long-term Government policy has been to provide more healthcare in the community instead of in hospitals but the incentives in the system make it difficult to create significant shifts, the report said.
Hospitals are paid on the number of patients they treat and so there is little advantage for them to see patients treated in the community by GPs or nurses.
However illnesses suffered by patients has changed significantly since the NHS was established and more people are living with long-term conditions like arthritis, asthma, lung disease and heart disease. These patients need support to stay well at home, the report said.
Surgical technology has also improved so patients need to stay in hospital beds for less time and many operations are now carried out as day cases.
The report also highlights the number of beds being taken up by elderly patients who could be living elsewhere - so-called 'bed blockers'.
It also highlighted that many trusts are not using their maternity beds and said in some hospitals only half the beds are in use at any one time.
The report says London, the North East and the North West all have a much higher number of beds and hospitals per head than other parts of the country.
For example, the North East has 40 per cent more beds and more than twice as many hospital sites per head of population as the south of England.
The report criticises Tory leader David Cameron for proposing a moratorium on changes to district general hospitals and to maternity and A E services.
And it says health minister Mike O'Brien was wrong to interfere with plans to reduce hospital beds by Gloucestershire Hospitals NHS Foundation Trust.
Mr O'Brien accused managers of having "a lack of imagination" in proposing the cuts and wrote to the trust expressing his concerns.
The trust has said it needs to save between £27 and £30 million in the 2010/11 financial year due to reductions in public sector spending. It has now pledged to consult further on the plans.
Patrick Nolan, chief economist at Reform, said: "Health systems around the world are gearing up to shift care out of hospitals and into the community. The English NHS is rightly planning to do the same thing.
"Politicians would do best to engage local people in the choices facing their NHS services rather than foment short-sighted opposition to them."
Dr Mark Porter, Chairman of the British Medical Association's Consultants Committee, said: "Bed occupancy rates are already very high in the NHS, which is a principal cause of hospital-acquired infection. Cutting beds for purely financial reasons would be immoral and catastrophic for patient care.
"There can and should be reconfiguration of services when it is driven by the needs of patients, and the professional advice of clinicians. Some of these will result in changes to bed numbers.
"But the idea that service changes should be carried out quickly, that they can automatically improve quality, and that capacity in the primary care sector can immediately increase to cope with such changes, is nonsense."
A Department of Health spokesman said: "The local NHS is best placed to decide how best to meet the needs of patients in their areas.
"Efficiencies are about making sure that trusts can continue to provide high quality care at a time when spending is going to be tighter across the whole public sector.
"Each trust will have to decide how best it can do this and how it can best protect the needs of patients.
"This is achievable - focusing on improving quality, productivity and innovation across the NHS will not only improve care but also save money across the NHS."