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 723.

    697 ChrisMather

    Some bureaucracy is essential, but it needs to be carefully controlled to ensure productivity. So put all admin and managerial staff on a 3 shift system, 24/7. Tell them that they will come off it when they have put into place efficient, productive systems. And that includes IT staff - you don't go home till the problem's fixed! A real taste of Victorian values!

  • rate this

    Comment number 722.

    668.elliehallmark @653 "Totally agree. I hope he goes to work. If not, he needs to go home"
    I suspect that the original poster was in fact a troll, probably a member of the BNP or UKIP stirring up trouble. I for one don't understand why so many E Europeans want to live in this pit of a country but if they're paying in and given we have a reciprocal EU agreement what's the problem?

  • rate this

    Comment number 721.

    I'd bet the vast majority of those elderly patients are English/British/whatever the politically correct term is. They will have worked all their lives and paid NIC's and tax.
    However, the NHS can only have a certain budget, I wonder how money much goes to "new" uk citizens who have paid very little or zero, but expect the benefits for themselves, their children or their elderly relatives?

  • rate this

    Comment number 720.

    We need to protect the NHS from Jeremy Hunts.

  • rate this

    Comment number 719.

    allan at 462 said:

    Its the governments responsibility to look after the welfare of its citizens - sadly the tories dont want to.

    But at least any Conservative gov't. does try to encourage the populace to make an effort not to abuse the system and for its individuals to have a sense of self-responsibility: a concept that is rejected by the Socialists.

  • rate this

    Comment number 718.

    "Obama's medicare bill. He wants to change medical care in the USA to mimic our NHS"

    Obamacare is nothing like the NHSm it is mandatory private health insurance - insurance companies can refuse to cover existing conditions or any named at the point of policy being taken out.

    Come to mention it, that IS similar, but with only one health insurance company: the treasury.

  • rate this

    Comment number 717.

    Socialized medicine not all it's cracked up to be, eh?

  • rate this

    Comment number 716.

    @64, you ruined an excellent comment with the first sentance. Exclude that and you have a very valid point:-)

  • rate this

    Comment number 715.

    Politicians controlling our hospitals is akin to the inmates running the asylum!

  • rate this

    Comment number 714.

    @678 'Tio Terry'
    I agree, to a point. However, Nigel Lawson (conservative) first introduced PIPs to enable savers to protect their savings for the future.

    It's my view that responsible savers on low/medium incomes need more protection of their savings as they already pay too much tax on their earnings + higher VAT. Have you seen the interest on cash ISAs lately? Just short of criminal!

  • rate this

    Comment number 713.

    Judging by the Highest Rated Comments, the majority seem to believe that the solution to NHS woes is simple: just pump more money into the system. The truth is, of course, that it's their arguments that are 'simple.' Will there ever be a cure for public silliness, emotional diarrhoea and incapacity to understand that governments (of all shades) genuinely try to grapple with complex problems?

  • rate this

    Comment number 712.

    Expat Andy

    "Gov't interference" brought about national standards way back hence the UK has the standard 3 pin plug. Prior there were many different sockets and voltages throughout the UK.

    Suggesting a free market brings about uniformity is idiocy. History records the opposite.

    It would be more expensive if different hospitals were supplied different voltages and sockets a la "free market"

  • rate this

    Comment number 711.

    It appears that the current disgraceful system of many GP practices is in near collapse with appointments only available if you can get through on the telephone at 08:30-35hrs same day.

    Many cannot take a day off work on the off-chance of getting an appointment.

    I only got into see a nurse when I stated I'd have to go to casualty instead (who I understand would send a charge to the GP)!

  • rate this

    Comment number 710.

    Wow! They really have managed to convince people that pretty low wages are riches now haven't they if you're suggesting that 25k is the level at which you can start paying a premium for NHS services.

    Next, they'll want to set our aspirations to be achieving National Minimum Wage...

  • rate this

    Comment number 709.

    I am a Nurse working in a busy general hospital on a medical ward, & I agree that things are at breaking point. Doctors & Nurses are overworked, & us Nurses are underpaid by far! The workload is FAR too much & the entire system is overloaded! There are simply too many people needing complicated care. PLUS the system of notes / record keeping is antiquated in this modern age! IT IS IN A CRISIS

  • rate this

    Comment number 708.

    We are told to eat healthily , don't smoke etc., and they are now complaining that people are living longer . I'll stick to my ciggies and help the NHS out .

  • rate this

    Comment number 707.

    I'd rather fight socialism here than emigrate and fight socialism elsewhere"

    Not that you know what socialism actually is. But then you claimed to be able to singlehandedly achieve and maintain wealth on your own on a desert island. I guess you could accumulate cowrie shells to pay yourself for food you catch and shelter you build. Who'd you pay to defend you against headhunters?

  • rate this

    Comment number 706.

    I think its safe to say there's no 1 reason why the NHS is on the brink. Lack of money being pumped in, too many people to look after thanks to Labour opening the flood gates and letting in every Tom, Dick and Harry, society itself having changed since the NHS was created with soaring levels of obesity and smoking related problems. Im sure theres even more.
    Deal with the causes to fix the problem

  • rate this

    Comment number 705.

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

    Are you unaware that all westernised counties HAVE done so? It's only the US that hasn't. The problem is we want Dutch/German levels of healthcare on US-level taxes. Tax in many countries is much much higher to pay for it all. High taxes = best level of heathcare. Our choice.

  • rate this

    Comment number 704.

    What confuses me is how the government can spend money on items such as foreign aid and the like and turn round to us, say we are in a crisis because we have no money, let's make some cuts. OR maybe WE should decide where our money goes and what we want cut? I dont want to give my money to other countries till we sort ours out to a suitable condition!


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