Think-tank calls for 30,000 NHS beds to be axed 'to save money'

The NHS should cut more than 30,000 hospital beds to save cash and improve patient care, a thinktank said today.

Regions including London, the North East and the North West should expect to close over a quarter of their beds, it said.

The move would save cash and create competition which would drive up standards, according to Reform.

The centre-right thinktank also called on the Government and opposition parties to stop interfering in local decision-making about NHS ward closures.

Its study - Fewer hospitals, more competition - says the NHS has been right to reduce hospital beds by nearly a half since 1987, from 270,000 to 160,000 in England.

The latest challenges in health care - helping people manage long-term conditions such as diabetes and improving the quality of life for survivors of disease - are less reliant on hospitals, it said.

These conditions can be mostly managed in the community, which cuts cost and moves care away from hospitals, it said.

The report also highlights the number of beds being taken up by elderly patients who could be living elsewhere - so-called "bed blockers".

"The highest rates of occupancy are for geriatric and acute plus geriatric care, with 92% and 87% respectively.

"These high rates of occupancy could reflect the blocking of beds by patients who could be treated in the community."

The report says London, the North East and the North West all have a much higher number of beds and hospitals per head than other parts of the country.

For example, the North East has 40% more beds and more than twice as many hospital sites per head of population as the south of England.

Bringing every region into line with the south of England would mean a 32,000 cut in the overall number of beds, from 160,000 to around 128,000.

The NHS budget should also fall given the need to reduce public spending.

"The NHS should not be immune from the drive to reduce public spending," the report said.

"The structural deficit in the public sector is due to sustained over-spending and the largest part of that spending was targeted on the NHS."

Furthermore, the report criticises Tory leader David Cameron for proposing a moratorium on changes to district general hospitals and to maternity and A&E services.

And it says health minister Mike O'Brien was wrong to interfere with plans to reduce hospital beds by Gloucestershire Hospitals NHS Foundation Trust.

Mr O'Brien accused managers of having "a lack of imagination" in proposing the cuts and wrote to the trust expressing his concerns.

The trust has said it needs to save between £27 and £30 million in the 2010/11 financial year due to reductions in public sector spending. It has now pledged to consult further on the plans.

Reform's chief economist, Patrick Nolan, said: "Health systems around the world are gearing up to shift care out of hospitals and into the community. The English NHS is rightly planning to do the same thing.

"Politicians would do best to engage local people in the choices facing their NHS services rather than foment short-sighted opposition to them."

A spokeswoman for the Department of Health said: "The local NHS is best placed to decide how best to meet the needs of patients in their areas.

"Efficiencies are about making sure that trusts can continue to provide high-quality care at a time when spending is going to be tighter across the whole public sector.

"Each trust will have to decide how best it can do this and how it can best protect the needs of patients.

"This is achievable - focusing on improving quality, productivity and innovation across the NHS will not only improve care but also save money across the NHS."

Mark Porter, chairman of the BMA's consultants committee, said: "Bed occupancy rates are already very high in the NHS, which is a principal cause of hospital-acquired infection.

"Cutting beds for purely financial reasons would be immoral and catastrophic for patient care.

"There can and should be reconfiguration of services when it is driven by the needs of patients, and the professional advice of clinicians. Some of these will result in changes to bed numbers.

"But the idea that service changes should be carried out quickly, that they can automatically improve quality, and that capacity in the primary care sector can immediately increase to cope with such changes, is nonsense.

"It is also bizarre to argue for more competition, given the amounts of public money that have been wasted as a result of private sector involvement in the NHS, and the cost and bureaucracy associated with the market."