Fear for vulnerable patients as MPs attack push for elite trusts

The influential Public Accounts Committee claims vulnerable patients could suffer if services are axed as hospitals battle to overcome financial problems to become foundation trusts.

A report by the National Audit Office has already concluded that four in five of the 113 trusts affected face financial difficulties and two thirds are struggling with quality and performance problems.

But the difficulties are being compounded by the Government’s drive to find £20bn in NHS savings by 2015.

Four hospital trusts in the region have yet to win foundation status – Leeds, Hull, Scarborough and the Wakefield-based Mid Yorkshire trust. The Yorkshire Ambulance Service, Bradford District Care trust and Leeds Community Healthcare trust are also applying.

The Scarborough trust, which is already receiving a subsidy to keep vital services in place, is set to merge with York next year. Of the remaining organisations, the Mid Yorkshire appears to have the most difficulties and is planning a major reconfiguration of services next year.

Today’s report says any mergers or reconfigurations must not lead to cuts for vulnerable people.

“Reconfiguration will inevitably reduce the range of services provided by some hospitals,” the report said.

“The Department of Health will have to support otherwise unviable services in some parts of the country so that all local people have access to the healthcare they have a right to expect. Some patients may be put off going to their hospital appointments if they are too far away and using public transport is expensive or difficult.

“Inequality of access can only help to worsen the inequalities in health that currently exist.”

Committee chairman Labour’s Margaret Hodge said mergers or reconfigurations “may deal with the financial challenges involved but could leave some deprived communities with unequal access to high-quality healthcare, when hospital departments are closed and services moved”.

Chris Ham, chief executive of the King’s Fund think-tank, said: “Today’s report once again highlights the severe financial and clinical problems facing some hospitals.

“The Government needs to work closely with struggling hospitals to find solutions – this will include mergers and, in some cases, service closures.”

NHS Confederation deputy chief executive David Stout said: “The growing financial pressures across the system mean an increasing number of trusts are affected.

“We know there is no easy solution and some trusts face long-term and deep-seated issues. Propping them up with short term extra payments is not sustainable, especially at a time when the NHS is trying to find £20bn of savings.

“A long-term solution that provides the best outcome for patients and services will require radical change and reconfiguration.

“NHS leaders and politicians need to be honest with the public about how difficult this is going to be. This is not just about closing hospitals but about overhauling the way we provide services.

“Time is running out and we cannot afford to find ourselves in a situation where trusts go bust and care standards slip.”

The Department of Health has already ditched a target for all trusts to be granted foundation status by 2014.

In September, Health Secretary Andrew Lansley claimed 22 trusts were “on the brink” due to unsustainable bills for private finance initiative (PFI) projects but following detailed reviews only six are being given extra help.

Today he again blamed Labour for leaving parts of the NHS with a “dismal legacy of PFI bills, hidden bail-outs, and in some cases inadequate leadership to face these challenges and those of the future”.

“They swept these problems under the carpet for a decade,” Mr Lansley said.

“While there are plenty of top performing trust boards, we are determined to root out poor performance by shining a light into every area of the service.

“Tough solutions may be required for these problems, but we will help the NHS overcome them.

“We will not let the sick pay for Labour’s debt crisis.”

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