The cost of care

THE expected u-turn over the closure of wards at two community hospitals in North Yorkshire reveals more than just the importance of 41 beds. It is a lesson in how the dangers of hastily-conceived NHS cuts and implementing them without the support of GPs and other clinicians could imperil the health of patients. As such, it should be as relevant in Whitehall as in Whitby or Malton.

The report by the National Clinical Advisory Team is deeply critical of the scheme in North Yorkshire despite the high quality of care offered in people’s homes by community nursing teams. Amongst mistrust, blame and a lack of co-operation, the loss of “the essence of what is being developed for patients” is the most serious charge, with the influence of Government-led austerity measures becoming too great.

It is also worrying that the report highlights an apparent question mark over the future of the community hospitals. They must be kept open because they are vital for the local population, particularly for the high number of older people, and allow major city hospitals the time to treat conditions of greater seriousness or complexity.

The re-opening of wards in North Yorkshire is also relevant beyond the county borders. With the coalition’s controversial NHS reforms currently “paused”, Andrew Lansley, the Health Secretary, should take note of the problems and costs which have arisen in Whitby and Malton. They happened because changes were not supported by GPs or other stakeholders.

It will be very difficult for the Government to carry out the biggest shake-up in the history of the NHS unless doctors have at least begun to be persuaded of its merit.

Whether in North Yorkshire or nationally, changes have to be driven by more than just the desire to save money. More than six decades after it was set up, the NHS deserves better than a salami-slicing by officials far from the front line.