It achieves nothing to reduce facilities

17 June 2005

Grantham Journal article

Two weeks ago I saw Jenny Green, Chairman of Lincolnshire Hospitals Trust, which runs Grantham Hospital (and also the hospitals in Lincoln, Boston and Louth).

Our conversation was confidential and must remain so. But it was clear that, with the General Election out of the way, bad news was coming. I made it clear that I would never acquiesce in or be a party to any reduction in Grantham Hospital’s fundamental services or its credibility as a general hospital.

This week’s press release from Lincolnshire NHS was the worst sort of disingenuous PR double-speak - otherwise known as “spin”. If the Hospital Trust and the P.C.T. need to reduce bureaucratic overhead and non-medical costs – as they certainly do – they might start by firing the person who wrote it.

“All NHS healthcare organisations” it says, “need to deliver national quality standards at average or better than average costs”. That is a mathematical impossibility – and manifest nonsense.

What the release should have said is “we need to keep unit costs (the cost of treating each patient) down”. Since such a large proportion of hospital costs are fixed costs – theatres, capital charges, I.T., necessary administrative overheads and central services – reducing facilities is actually the worst way to go about this.

Fixed costs then fall on a reduced range of activities making all those remaining seem more expensive. So then yet further facilities have to be closed – a vicious circle which ends with the closure of the whole hospital.

Grantham Hospital is to be praised for getting an M.R.I. scanner. But it is crazy to use it only for one shift. It should be used round the clock, as long as referrals keep coming – and they do.

“With fewer patients needing to be admitted to hospital” the press release continues “the Hospital Trust will be able to reduce the number of inpatient facilities”.

On the contrary. The local population is expanding, and its average age increasing. The need for hospital admissions is likely to increase. In any event, decisions on admissions (and discharges) are for doctors alone. They should not be driven by financial considerations. It is deeply worrying if this is about to change.

The N.H.S. was the creation of all three parties. Its fundamental principles have never been under greater threat.