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 1063.

    If we want healthcare for everyone the nhs is the cheapest and the best however they could save a fortune by sending out emails for apointments rather than letters to those who have email addresses but the nhs needs more money I believe we should have a lottery where all proceeds go to the nhs

  • rate this

    Comment number 1062.

    Personally I'd like to see the NHS abolished. At least then I could spend the money currently taxed me for that purpose on private health insurance and then actually get healthcare that I need when I need it, unlike the possibility of getting some 2nd rate care 5 months down the line or not at all with the NHS.

    And have enough left over to pay for the extortionate car parking.

  • rate this

    Comment number 1061.

    YAY Socialised health!
    Lets set up an NHS so it's free to all. But, since I have no money, I'm going to garnish all of your wages. But that's still not enough, so I'm going to borrow more money at interest, and make you pay for that too through income taxes. The debt is so big now that you won't be able to pay for it in your life time, but that's OK, your kids will be forced to pay for it :)

  • rate this

    Comment number 1060.

    For all those who relate the NHS to socialism not working, have a look at G4S, private carehomes, soaring energy charges and train fare increases to see what the private sector can do for you. Of course, if you're rich you'll be fine, but for the rest .......

    I thought this government might destroy the NHS and it's turning out to be true.

  • rate this

    Comment number 1059.

    1021.Expat Andy

    What party formed the NHS? Which is the subject here after all, if you want to hijack a sensible debate with extreme political views and insult people who respond, try not to be offended when it is reciprocated.

  • rate this

    Comment number 1058.

    Is no one gobsmacked about the reported figure of £2billion the NHS spends on treating alcohol related conditions. Heaven knows how much on treatments for drugs and other addictions/self inflictions. Seems like we have got our priorities all wrong here. Before these people are treated - get their credit card details first and do a credit check too. They may not be good for the cost of treatment.

  • rate this

    Comment number 1057.

    I would have thought that they would want to get the engineers in to have a look at the foundations then...
    Seriously though, alarmist outbursts like this aren't helpful to any debate. When are we ever going to have a calm rational discussion about these issues...?

  • rate this

    Comment number 1056.

    The NHS is here to stay,and any government that thinks otherwise will lose power permanently- the electorate will never allow it. Sure,they can snip away at the edges withPFI etc,but the morals of our society will alway see that there is free quality care for those who need it.We do not live in a heartless, every man for himself society such as the US.

  • rate this

    Comment number 1055.

    Too high a population in England, and an NHS that provides free treatment to those who are not entitled to free treatment. Only provide free treatment to those with a valid National Insurance number, and only those with a National Insurance number who have been here a minimum of five years.

  • rate this

    Comment number 1054.

    If the Health Minister is right and " ...we are modernising the NHS and putting the people who best understand patient's needs, doctors and nurses, in charge.". Why then isn't he listening to the people who ' best understand the service ', that he's put in charge, telling him it ain't working ? Seems a bit of a paradox to me.

  • rate this

    Comment number 1053.

    look at who is running Surrey Community Healthcare, not the NHS but Virgin! But is has all the appearance and bearing of an NHS organisation, even uses the NHS logo,
    Yes appearances are designed to be deceptive.
    Seamless uniformity on the surface but several tiers of terms and conditions for folk doing exactly the same work - lower wages and no pensions available for some!

  • rate this

    Comment number 1052.

    Personally I suggest a massive and brutal crackdown on cost of living hikes. Renationalise the Railways. Increase wages.

    Then individuals will be required by law to take out health service insurance. By crushing private sector hikes in cost of living etc we can ensure the population has the money to put into health care insurance.

  • Comment number 1051.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 1050.


    Who indeed against "massively less government waste"?

    Is it from experience you argue for Govt police, courts, army, legislature?

    From experience 'to have human nature indulged & improved' by profit?

    Have you not seen profit, if not 'secondary', distracts & corrupts?

    You would throw-in a Fire Service, not to have a protection racket?

  • rate this

    Comment number 1049.

    Same tired formula, run a previously excellent service into the ground through mismanagement and underinvestment, privatise off the support aspects like cleaning, catering, transport, appoint an incompetent to head up the national industry, privatise to "save" the service, give all the shareholders next years maintenance budgets. Share price then drops, corporations buy up cheap.

  • rate this

    Comment number 1048.

    The NHS needs steamlining I cannot understand why it undertakes things like cosmetic correction surgery, fertility programmes (when there are children who need homes!), sex changes etc In the meantime reduce the managers and Ban smoking that would be a start!!

  • rate this

    Comment number 1047.


    You're immoral. Fact is the socialists are taxing everyone else's Grannies (and their own), and our unborn children to pay for the debt from the borrowing to fund your "free" healthcare & subsidise your poor health choices (smoking, diet, drinking etc & no exercise).

  • rate this

    Comment number 1046.

    1045. john

    We all Pay for the NHS but we Don’t get the hospital care we Need.

    But we don't all pay. That's part of the problem. We have millions for whom the NHS will be forever free as they don't contribute to society financially. If you can't, fine, if you can't be ar%ed, the system can't afford you.

  • rate this

    Comment number 1045.

    They just want the privates the NHS.
    That’s why they have run it in to the ground.
    They want to sell the NHS for money!
    We all Pay for the NHS but we Don’t get the hospital care we Need.

  • rate this

    Comment number 1044.

    @1037 The point, as you clearly agree with is they are "left of centre". The difference is they make it work, and a lot of people, myself included, have been hoping for Westminster to take note.

    Would you support a move in their direction?

    I mean, it's still socialist, so I hope that wouldn't be a problem.


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