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Smaller hospitals win Government support

Published on 24/10/03 at 05:44pm

Smaller local hospitals are to become important centres for developing patient-centred care in a reversal of what the Government calls the "biggest is best" approach to NHS secondary care.

The practice of closing smaller local hospitals was started under the Conservative governments of the 1980s but has continued under Labour, despite frequent opposition from local communities.

In 2001, independent Health Concern candidate Dr Richard Taylor won the Parliamentary seat for Wyre Forest to highlight local opposition to the downgrading of Kidderminster hospital.

Health Secretary Alan Milburn has now signalled smaller hospitals will be included in a whole system approach to NHS care, with the emphasis on "redesign not relocate" for hospitals.

"Patients want more, not fewer, local services. Changing local health services does not necessarily mean centralising services, with fewer, larger 'super hospitals' Mr Milburn said. "New resources combined with reforms to the way care is delivered mean greater emphasis can now be placed on the role and importance of smaller hospitals".

The document 'Keeping the NHS local A New Direction of Travel' aims to support NHS trust managers to reconfigure services by looking at more sophisticated day surgery, building networks electronic or otherwise between small and large hospitals, and considering 24-hour access, including emergency services.

The plans have been welcomed by NHS professional bodies, including the Royal College of Surgeons. President Sir Peter Morris said: "With the introduction of the European Working Time Directive, which will require a marked reduction in the hours that doctors can work, it will no longer be possible for hospitals to continue in their present form.

"The redesign of services will enable hospitals to continue to provide a safe and high quality service to their patients, but there is no question that changes must occur. I am delighted to see that the Department of Health feels strongly that the public must be involved in every stage of planning and implementing the reconfiguration of hospital services".

An independent reconfiguration panel made up of NHS managers, clinicians, patients and members of the public has now been appointed to advise on service reconfigurations, including controversial hospital closures.

One hospital that may benefit from the new panel is the independent King Edward VII in Sussex, currently facing closure.

The charity-run hospital has faced a crisis ever since local NHS trusts said they could no longer justify commissioning its services, despite it being regarded as a centre of excellence. Massive local opposition means the hospital, which specialises in cancer and heart care, has been given until April to find a new source of funding.

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