Hospitals 'on brink of collapse'

Surgeons performing an operation Hospital beds are being closed, but demands are increasing

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Hospitals in England could be on the brink of collapse, leading doctors say.

The Royal College of Physicians said the triple effect of rising demand, increasingly complex cases and falling bed numbers was causing problems.

The college's report claimed urgent care was already being compromised and warned the situation would get worse unless something was done.

But the government rejected the suggestion, saying the NHS was ready for the challenges it was facing.

The college said in some ways the NHS had been a victim of its own success.

Advances in medicine had led to people living longer, but this meant they were increasingly developing complex long-term conditions such as dementia as a result.

It said this had been happening during a period of falling bed numbers - they have been reduced by a third in the past 25 years - and rising numbers of emergency admissions.

Poor standards

The RCP said standards were slipping in hospitals throughout England.

It cited the way older patients were repeatedly moved around wards, the lack of continuity of care while in hospital and tests being done during the night as some of the examples of how care was suffering.

The college also highlighted the results of feedback from its members, which showed concern about discharge arrangements and workload.

And it warned the problems could lead to another scandal like that surrounding the Mid Staffordshire NHS Trust, which became the subject of a public inquiry after regulators said poor standards had led to needless deaths.

Doctor Andrew Goddard of the Royal College of Physicians: ''The winter pressure is an all-year pressure''

Prof Tim Evans, of the RCP, said: "This evidence is very distressing. All hospital patients deserve to receive safe, high-quality sustainable care centred around their needs.

"Yet it is increasingly clear that our hospitals are struggling to cope with the challenge of an ageing population who increasingly present to our hospitals with multiple, complex diseases.

"We must act now to make the drastic changes required to provide the care they deserve."

The report said the solution lay in concentrating hospital services in fewer, larger sites that were able to provide excellent care round-the-clock, seven days a week.

But it also said this would require improvements in community services as there were many patients who ended up in hospital because of a lack of help close to home.

Jeremy Hughes, chief executive of the Alzheimer's Society, said: "These latest findings are alarming but, unfortunately, not surprising.

"It is painfully evident that the healthcare system stands on the brink of crisis.

"People with dementia are going into hospital unnecessarily, staying in too long and coming out worse."

Health minister Dr Dan Poulter said: "It is completely wrong to suggest that the NHS cannot cope - the NHS only uses approximately 85% of the beds it has available, and more and more patients are being treated out of hospital, in the community or at home.

"But it is true that the NHS needs fundamental reform to cope with the challenges of the future.

"To truly provide dignity in care for older people, we need to see even more care out of hospitals. That's why we are modernising the NHS and putting the people who best understand patient's needs, doctors and nurses, in charge."


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  • rate this

    Comment number 603.


    For decades the NHS has been loaded with PFI debt and manoeuvred into a position whereby it will be ripe for the picking by private companies.

    This was only possible due to, at best naive and at worst wilful, politicians of blue and red.
    Very sad indeed."

    OMG PFI I can't believe I've never heard of this until today thankyou HYS, this is the most disgusting scandal I've ever read about

  • rate this

    Comment number 602.

    @592.sandy winder
    "If the NHS is such brilliant model of healthcare why has no other country emulated it?"

    It was brilliant 50 years ago, but unaffordable now. Myths now propogated by bigots, control freaks, and nanny-statists - example: people implying smokers and drinkers should pay more (when they already self-fund) Perhaps the same people suggest charging the elderly more?

  • rate this

    Comment number 601.

    why is the government lying about the NHS - the PR line is that more money is being spent on the NHS whereas my local hospital has had to save circa £30m ANNUALLY for the last three years....the maths doesnt add up Why cant the government be honest and tell the public that health care is rationed

  • rate this

    Comment number 600.

    553 I think you find that now if you want anything cosmetic or not essential you will not be getting it at all unless your doctors say it is - unless you pay the full cost of it privately. You also can convince a series of consultants there are other reasons e.g. mental health issues associated, which is certainly tried by dishonest people, who fortunately are usually too thick to carry it off.

  • rate this

    Comment number 599.

    Just now

    "- we cannot afford free treatment at point of need for everyone...too many people abuse the service and expect the rest of us to pick up the tab. When your complaint is self inflicted you ought to be charged for your treatment. "

    Sportsmen, joggers , bad drivers, sexually careless , lightless cyclists, DIYers, Hikers, keyboard users , sunbathers, who else would you charge?

  • rate this

    Comment number 598.

    Charge the obese and type 2 diabetics who are overweight or obese (80% + of them) for treatment. Warn the overweight that this will happen if they won't lose weight. Type 2 diabetics are rapidly bankrupting the NHS

  • rate this

    Comment number 597.

    @558. You may not want Labour back if you don't like homeopathy. The last labour govt spent £10million setting up a specialist homeopathic hospital. That doesn't include the running costs. Snake oil is surprisingly expensive

  • rate this

    Comment number 596.

    Landi90 - given a choice would you prefer excellent customer driven care from private companies---or lackluster, stand in line, goverment mismanaged care. We would all prefer free( no such thing), well managed ,timely care. Managed by a politic free entity...but no such animal exists.

  • rate this

    Comment number 595.

    We need a public debate about what we want/ can afford from the NHS as it can no longer be all things to all people. At our hospital we have pared to the bone- closed beds, lost staff, redesigned the system to reduce length of stay, etc, but we still need to make huge savings over the next few years and it is difficult to see how much more we can do without seriously affecting quality of service

  • rate this

    Comment number 594.

    The problem is too much money spent on scandalous PFI initiatives and the employment of too many bean counters. But the government will of course get the press to put spin on the story and claim it is the fault of the public sector in general, releasing isolated incidents of poor care to make it easier to privatise.

    It all seems to be coming together exactly how they want it to.

  • rate this

    Comment number 593.

    It is clear that demand for NHS services is increasing - population increasing & "self-inflicted" illnesses increasing. It is also clear that "free at the point of use" is the correct means of delivery in a civilised society. Therefore we need to increase NHS services/staff. The only way to do this is to increase funding, so let's do it. Tax the biggest users eg. vat 25% on booze/cigarettes. JFDI.

  • rate this

    Comment number 592.

    If the NHS is such brilliant model of healthcare why has no other country emulated it?

  • rate this

    Comment number 591.

    Mass immigration made short term profits for companies... and long term losses for UK plc

    But that's not a problem because only the electorate gets to pay the price

  • rate this

    Comment number 590.

    the staff are under too much pressure.

  • rate this

    Comment number 589.

    While wealthy millionaires who go private for their medical treatment are in charge of the NHS, yes collapse of the NHS is inevitable.

    They do not beleive they should pay taxes to help the rest of us who cannot afford private healthcare.

    Money, greed and power of the rich is killing the rest of us.

  • rate this

    Comment number 588.

    Democracy (if Parliament counts as this) is nothing more than a system where everyone can make laws to live at the expense of others.

    What’s moral about Parliament forcing even poor people to pay (contribute) to the NHS? What’s moral about locking a man up because he wishes to keep his meagre earnings from Govt wastes?
    NHS is a socialist nightmare, 566.Whitefall is spot on!

  • rate this

    Comment number 587.

    @ 571. This is such a frustrating problem for healthcare staff. Imagine the scenario.. Mrs A. needs help with her food, but Mrs B. is laying in a soiled bed & needs attending to. At the same time it is medications time & Mrs C. cannot wait for her diabetic tablet any longer. There is no-one else around to help you. These are the situations we have to deal with & I feel so sorry for the patients.

  • rate this

    Comment number 586.

    551- Thats a sensible suggestion, lets put more strain on the NHS so it snaps even sooner.
    You forget my friend that the people who pay for prvate health care also pay N.I. so in effect they pay twice at he same time easing the burden on the NHS. And No I do not have private medical insurance just a little common sense.

  • rate this

    Comment number 585.

    "Why does everyone moan so much Ronald"?

    "Sad and lonely, Doris"

    "When i am waiting for my natural orifice surgery and i hear people moaning because of the wait i think "hey this is free , quit yo jibba jabba""

    "Well said Doris"

  • rate this

    Comment number 584.

    @566 Whitefall - you clearly dislike this country, and you clearly dislike your fellow countrymen / women.

    Have you considered emigrating ?


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