Mike Farrar, chief executive of the NHS Confederation writes…
… the need to make £20bn of efficiency savings by 2015 “means our finances are under more strain than ever… I am deeply concerned that the gravity of this problem for the NHS is not widely understood by patients and the public. There is a real risk we will sleepwalk into a financial crisis that patients will feel the full force of”.
“There are three scenarios,” he adds. “The NHS maintains service standards but goes bust while doing so; it sees standards slip but maintains financial balance; or it keeps improving and stays in the black. Clearly, we all want the third option.”
Farrar says remaining solvent while preserving quality of patient care “means radically re-orienting services to reduce hospital stays and offering new forms of care. Put bluntly, this means fewer beds and fewer hospital-based jobs”.
Closing some hospital units as part of a drive to centralise key medical services will both drive up standards and save money, he argues.
Areas to think about:
- Farrar believes that it is possible to continue to deliver high quality care via the NHS, even with a static real terms NHS budget and with the need to make significant efficiency savings over the coming years to keep pace with growing demands on the service. How would his solution of re-orientating the NHS look in practice?
- Local populations are often inordinately attached to having a local hospital, regardless of the objective quality of service delivered by it or the overall needs of the NHS. This leads in turn to political pressure to keep open small, local and financially-struggling hospitals. Should they be allowed to close in order that funds may be diverted to fewers, larger, more cost-effective and higher quality centres?
- How might community services need to be expanded in order to meet the health care needs of a population if smaller general hospitals close?
- Do you think it will be possible to drive through these changes? Will the introduction of a more fluid, patient-choice & market-driven ethos as outlined in the Health and Social Care Bill currently going through Parliament facilitate these changes?