Despite the current Coronavirus crisis exposing how few hospital beds the UK has compared to other countries, this week a consultation proceeded which will mean less beds and less acute provision for many.
The NHS has already suffered a loss of 50 per cent of its hospital beds over the last 30 years and now has an average of just 2.54 beds per 1,000 people – one of the lowest amounts in an OECD nation. This figure is one of the worst in the developed world: Japan has 13 beds per 1,000 people, Germany has 8, France 6, and Italy has 3.18 hospital beds per 1,000.
The consultation that ended this week would leave hundreds of thousands in the affected area with even fewer beds – down to just 1.18 – 1.46 beds per 1,000 people.
The “Improving Healthcare Together 2020-2030” consultation has been slammed as “cuts by stealth” and has continued despite Britain facing a Coronavirus pandemic exposing NHS capacity already well below other comparative countries. The Epsom & St Helier NHS Trust consultation costing £2.2 million was completed this week despite social distancing measures meaning planned public meetings were unable to be held in the last fortnight.
Will Boris Johnson’s hospital building programme mean fewer beds?
The proposals for parts of South London and Surrey would mean taxpayers pay £511 million for fewer hospital beds and thousands having to travel further for emergency and acute medical services.
The consultation is part of what Boris Johnson boasted would be “the biggest hospital building programme in a generation.”
Before the general election, Boris Johnson made much of plans to build 40 new NHS hospitals that then turned out to be six. The much-vaunted Health Infrastructure Plan is meant to shell out an extra £2.7 billion for work in six NHS hospital trusts as part of a first wave of investment from 2020 to 2025.
Shadow health secretary Jonathan Ashworth questioned at the time: “whether across these reconfigurations, the end result will be more beds or fewer?” The Labour MP asked why investment in one of the six, in his constituency, Leicester Royal Infirmary meant “services closing, including maternity services, and a loss of beds?”
He also asked why in another, the Epsom and St Helier plan meant “moving from two acute services to one in a part of London where accident and emergency pressures are increasing?”
Reacting to the news that the consultation was going ahead despite the current crisis in NHS capacity, the shadow health secretary told The London Economic: “At this time of national crisis we must maximise NHS capacity across the board. Decisions on hospital closures should surely be suspended until we are through this crisis and reassessed based on what we need for the future.
“This emergency shows how we need more beds in the NHS not less. The last ten years have seen thousands of beds cut across the NHS. When we come through this we need a national bed review to increase bed capacity for the future.”
‘The NHS needs more staff and more hospital beds’
NHS England boss Simon Stevens admitted this week that “the NHS does need more staff and it does need more hospital beds” when asked in a Downing Street Coronavirus briefing why the UK has one of the lowest amount of doctors and nurses in the developing world according to the OECD. Stevens added: “we’ve been saying that for some time and that is what is going to be happening over the next five and the next ten years.”
However the NHS Chief Executive has been presiding over a process of downgrading NHS provision that has left parts of the country with less A&E and ICU units. Shockingly, despite the lack of NHS capacity exposed by the current Coronavirus crisis, this process appears to be proceeding.
Much of the £511 million public spend involved in “Improving Healthcare Together” proposals is set to be paid to the private sector to build a new acute facility while cutting acute provision in Epsom and St Helier hospitals. This would mean greater journey times for many of the 720,000 people living in the area to access vital services such as Accident & Emergency, consultant-led maternity, paediatrics, intensive care, cancer care, coronary care, emergency surgery and emergency medicine.
The consultation that ended this week failed to include an option to keep the present acute units open and instead invest in existing in more doctors, nurses and facilities at existing hospitals in South West London and Surrey. These hospitals were struggling to cope with demand even before the pandemic hit British shores. Depending which of the three consultation options is chosen, the Epsom & St Helier NHS Trust will be left 205, 81 or 50 beds short. – This in a population set to grow 24 per cent by 2039 according to the Office of National Statistics.
‘Cuts by stealth’ will ‘lead to more deaths’
Helen O’Connor of the GMB Union, representing many local medical staff said the NHS would be saddled with massive debts for the plan which she called “cuts by stealth.”
She slammed the Government for hypocrisy for building a field hospital in the ExCel Centre for Covid-19 patients while pushing ahead with A&E and intensive care unit (ICU) closures in South London and Surrey.
The regional union organizer told The London Economic : “despite the tragedy unfolding before our eyes and the devastating shortage of critical care beds, the Government is still proceeding with plans to close A&E, ICU and all other acute services at Epsom and St Helier Hospitals.
“At a time when the nation is facing its worst crisis since the Second World War, the government wants to downgrade major acute hospitals, reduce the number of hospital beds, reduce the number of consultant doctors and make it harder for people to get to hospital.
“The proposals will lead to more deaths.”
Coronavirus patients lead to ‘black alert’
Other local hospitals will be expected to take up the slack but they were all operating at near capacity before the current Coronavirus crisis. St George’s, Tooting and Croydon University Hospital were both under extraordinary pressure – St George’s declaring a “black alert”recently as it had run out of beds.
Before Daniel Elkeles became CEO of Epsom & St Helier Trust he led what Labour Hammersmith MP Andy Slaughter called “the biggest hospital closure programme in NHS history”with acute units cut in North West London leaving Northwick Park to take up the slack. Ever since it has been one of the worst-performing A&E departments in the country.
Local MP Gareth Thomas recently asked in the Commons when the funding for the 30 beds they had been promised to take up the slack would arrive.
Soon after, Northwick Park was forced to declare a “black alert” when it had to stop taking patients overwhelmed by Coronavirus sufferers.
‘Devastating shortage of clinical care beds’
Helen O’Connor of the GMB Union insisted: “all restructuring of the NHS must be stopped now. We need every effort on fighting Covid-19 and bed capacity to increase not decrease – particularly in intensive care.
“Despite the tragedy unfolding before our eyes and the devastating shortage of critical care beds, the Government is still proceeding with plans to close A&E, ICU and all other acute services at Epsom & St Helier Hospitals. The removal of these services at existing major acute hospitals will only result in death.
“After years of unnecessary austerity, NHS cuts have brought the health service to its knees and we are all now suffering because of it. The GMB is calling on the Government to put an immediate stop on all plans to close A&E, ICU and all other acute services.“
Helen said that working as an A&E nurse, medics always stressed treating someone within an hour of a critical accident is crucial to their chances of survival, and that this would not be possible for many if the proposals go ahead.
“Britain already has something like a quarter of the hospital bed capacity of Germany. We would have an eighth if this goes ahead,” said local campaigner Sandra Ash whose children and grandchildren all live locally too.
Sandra, one of many locals who have joined the Keep our St Helier Hospital campaign, added: “They are proposing to do this at a time when Britain’s appalling provision in terms of doctors and critical beds is being exposed by the Covid-19 crisis and we are going to have thousands more dying than necessary.
“The head of the NHS is saying we need thousands more beds not fewer. Yet they are proposing to have one or two less acute hospitals and to cut beds significantly at a time where hospitals are failing on all counts nationally and locally. Across the country communities are having to fight to keep their A&Es in a national drive for cuts in the face of all the evidence that we have.”
Boris Johnson’s plan means NHS asked to pay ‘interest only mortgage’
It is also unclear how the NHS trust would afford the interest payments on the £511m – set much higher than current historically low rates.
A newsletter to staff at West Hertfordshire Hospitals Trust – another of the six trusts flagged up for Boris Johnson’s hospital building project – recently warned: “The money is not a free gift but is a bit like an ‘interest only mortgage’ … The extra cost pressure due to capital charges would be around £20m per year.”
The Department of Health & Social Care would not comment but referred us to the local NHS spokesperson.
The spokesperson for NHS South West London insisted that bringing acute services onto“one site in a new purpose build specialist emergency care hospital will address the staffing challenges that we face and enable us to meet all of the quality standards.”
She added: “When we put together the changes in the population needs and the changes in technologies, treatments and the way services are delivered we have calculated that we will need the same number of beds in the future as we do now. We have modelled how many beds we need by looking at the increase we may need based on older population and likely population growth. We then looked at how medicine is changing and how technology is being used to shorten the length of time people need to spend in hospital and also the move to treat people in their own homes. A few years ago people undergoing a knee replacement would stay in hospital after their operation for between three and five days but now increasing numbers of patients go home on the same day as the operation.”
Dr Ruth Charlton, Medical Director of Epsom St Helier Hospitals NHS Trust also added: “The proposals for Epsom St Helier would see a brand new £500m hospital built in five years’ time, none of the existing hospitals closed and, crucially, increases in critical care beds and single rooms. It’s also about our NHS staff, who are already working more hours than they should to keep both sites safe. We cannot continue to rely on their goodwill, if there was ever a time to rally around them and improve their working conditions – it’s now.”
Foothills of the pandemic
With NHS hospitals expecting to be overwhelmed by the growing pandemic, it is shocking that long-term NHS restructuring still involves massive public spend on private sector contracts for new units while closing old, in what many losing local acute services see as “cuts by stealth.”
Hospitals in London suburbs are already being severely tested by the Coronavirus pandemic. When Northwick Northwick Park Hospital in Harrow became the first be overwhelmed by Covid-19 patients and have to divert patients to other hospitals, one senior director at another acute trust in London, who saw the “black alert” message, told the Health Service Journal: “Given we’re in the low foothills of this virus, this is… petrifying… The trusts in outer London seem to be hit much worse at the moment, probably about two weeks ahead of the rest of the country. Barnet, Lewisham and Greenwich, Epsom and St Helier, North Middlesex and Hillingdon are all struggling.
“I was in denial about the seriousness of this virus a couple of weeks ago, but not any more. I’m now on calls with commissioners about getting more people out of hospital and into the community, and they’re saying ’yes that’ll be done in the next week’, and I’m on the verge of screaming at them. Things are going completely nuts.
“And there’s a real problem with private care homes refusing to take patients back unless they’ve been tested for Covid-19. But that’s not the national guidance currently and there just aren’t enough testing kits to do it.”