London Health Emergency HEADLINE-GRABBING complaints by top hospital consultants, backed by the BMA, are the latest reminder of the rolling crisis caused by the Tory government's creation of an "internal market" system in 1991.
They are not the only NHS professionals warning that the system is at breaking point.
• In February, top consultants and medical doctors from all 23 acute hospitals in South Thames region wrote to Stephen Dorrell, warning of a growing crisis in emergency services, with insufficient beds and health authorities refusing to pay for emergency patients.
They demanded the government step in to halt any further bed closures, and asked "How much is spent supporting the bureaucracy, annual contracting and the purchaser/provider split?"
• In February, March and April. more Trusts became publicly locked in conflict with their purchasing health authorities, claiming that impossible demands were being placed on them. Newham Healthcare Trust issued a press release denouncing the local East London and City Health Authority; it has halted all elective surgery.
Many other Trusts have still not signed contracts for the new financial year On May 8 leaders of the NHS Trust Federation warned Health Secretary Stephen Dorrell that hospitals across the country are facing the deepest crisis for years.
• There are signs that the Tories are on the retreat, seeking to defuse ISSN 0951-8657, Publisher: Aurora Ltd. PO Box 1H09 London N42UU.O 1996 Rights a damaging situation. Already an extra €25 million has been shared out between nine floundering Trusts-in Hampshire, Manchester, Leeds, Sheffield, Newcastle, Solihull, and parts of south east London. The two giant acute Trusts in Leeds have been given special sanction to overspend heavily this year.
• But many more Trusts are struggling for survival, including the Southampton University Hospitals Trust (E1/ million adrift), and London's Royal Hospitals Trust. More crises are waiting in the wings.
The market system which was seen Printer: Eastway Offset by Thatcher as an ideal device to enable the government to stand back and wash its hands of problems in the NHS is erupting into a predictable chaos in the run-up to the next election.
With normally subservient quangos and even pro-market consultants joining the outcry, Dorrell will have a battle on his hands to keep the issue from becoming a major electoral liability. Now is the time for campaigners and health unions to step up the pressure, with a real chance of forcing concessions and saving vital services.