emergency admissions and from frail older patients for whom most of the appropriQ: WHEN IS an ate NHS beds have now inquiry not an Cose down.
But on closer examination inquiry? the findings are rather less A: When it's a New Labour inquiry! The 4,000 beds are not what they appear. 2,000 of T hat is the simple taem are supposca to be "intermediate" beds: these are not hospital beds at all. long awaited but but nursing home beds -ultimately point- almost all of which are priless inquiry into the availability of hospital vately run by pront secking firms: expanding this sector is a further privatisation of sioned 18 months ago when what was part of the NHS. Frank Dobson was just an Indeed Alan Milburn has and published in the midst stamped the closure of NHS of an entirely predictable community hospital beds in Dobson asked for the that this is not the "intermereport to be prepared not by diate" beds Mr Smee is any independent or open- proposing. minded researcher but by This leaves call for 2,000 front-line SHORTCH NHS "general and acute" Peter Pan. beds over 3 years: surely this Department of Health's chief economist, and by implica- chronic problem of an NHS is at last recognising the which cannot cope with any closely involved with the dis.
surge in emergency demand? astrous run-down of hospital Well not quite. Because while calling for more beds sive on the one hand, Mr Smee last 20 years seems oblivious to the loss of At first sight it might have seemed that the report when The problem is published by whether by design or neglect offered sweeping and bold - it appears that Mr Smee conclusions. It declared that the NHS will need another examination of the likely 4,000 beds in the next three impact on hospitals of the years if it is to cope with the Private Finance Initiative, mounting from
Outlook the Tory scheme to get nest hospitals funded by private industry and leased back to the NHS. And he did not think to include this in his report PFI has become a by-word for bed losses: even those costly plan admit that in many cases 25-35% of acute dozen or so PFI schemes already under way could casily wipe out the 2,000 "extra" beds called for by the inquiry.
But neither the phrase nor the initials •PFİ Call found in the 100-pages of Mr Smee's which appears to have been concocted in near-paranoid secrecy, with no attempt to seek the views of health unions or user groups.
The other vital missing link in the report is any discussion of how much its prothe money should come from.
While many of the 25,000 acute beds which have closed since 1982 have gone as a result of increases in day surgery and shorter lengths of stay in hospi. have been increased PECSSUTC! health authorities and Trusts, many of which are again staring down the barrel of deficits this year Without extra cash alloca• tions, extra beds will bo obe battle to balance the hangs the so-called "intermediate" beds in nursing homes. First Dobson, Alan Milburn have year-long silence over the findings the Royal Commission on continuing care of the elderly, which rec. ommended that homes should be covered from the means-tested charges administered through social services.
Until this question answered, the so-called "consultation" on the possible shape of the future NHS in ellort.
Mr Smee put forward three possible - uncosted - variants: "Maintaining current require an additional 8,000 so-called "closer to home" option, (more accurately the *back bedroom DIY option which would slash acute beds by almost ten percent, almost double the numand require an extra 10,000 GPs. This, like the other two options would also require 7,000 beds and 15,000 residential beds.
But because they are run by the private sector for profit, it is impossible to ensure that nursing and ressdential beds expand in number, or that they are provided where Whole areas of the country. including most of London. average provision of nursing home places. The result is -as a separate report by the National Audit Office has numbers of frail elderly stuck inappropriate acute hospital wards lack of suitable alternative beds and care 1h,0N0 patients esthd be to 6,000 patients could one time, while hospitals struggle and social service budgets are Scence breaking point.
The system isn't working. It didn't need 18 months of secretive deliberations in a that.
We need a halt to any further bed closures, the abandonment of PFI. and the establishment of NHS nursing home places together with a scrapping of the charges if the s goal of a comNHS is to PACHCHOIC achievca in tae medium his means more cash for revenue, more NHS capital, and an immediate campaign tessiona, statt that the NHS will require whatever system is adopted.
Alan "Moderniser" Milburn has belped waste 18 months while things have the second half this Labour government. tion of resources we need, he could be taking the blame in 12 months for another electorally damaging NHS win-