Blair’s decisive moment of NHS transition

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LABOUR’S re-spun campaign to close local Accident and Emergency Departments, and entire District General Hospitals, in favour of Regional Centres of Excellence got under way yesterday.

No longer is it an issue of the ‘cost’ of the NHS and closing ‘failing hospitals’, since this has led to Ministers being booed and jeered all over the country. Now the issue has suddenly been re-spun into one of modern medical treatment being so skilled and specialised that District General A&Es just cannot provide the required treatment – only Regional Centres of Excellence with a catchment area of 500,000 or more people can provide the necessary treatment, we are being told.

Training the numbers of specialists required is not an option according to Blair. His battle cry yesterday was that NHS professionals must help him sell this pathetic line to a hostile public.

One body that answered his call was the Blairite ‘Think Tank’, The Institute for Public Policy Research (IPPR). It immediately came to grips with the Save the NHS campaigners. It said that ‘Campaigns to save services currently provided in District General Hospitals could lead to more than 1,000 unnecessary deaths each year. . .’

It’s not every day that the hundreds of thousands of people who are campaigning up and down the country to save their local general hospital get accused of murder or manslaughter at the least.

The IPPR report sets out to prove that ‘patients will often be safer if they travel further for specialist treatment, rather than being treated at their local hospital.’

It adds: ‘But the research shows that these life saving treatments are more complex and can only be provided at a smaller number of specialist hospitals, with the right equipment and expert staff.

Specialist units also need to see enough patients to maintain staff skills. So even if cash resources were unlimited, there would be patient safety reasons for centralising these services.’

Closing District General Hospitals has suddenly become an enormously progressive duty.

Blair was equally to the point telling his audience of Primary Care Trust bosses and managers: ‘And, above all, we are in the decisive phase of reform. This is the watershed moment, when we pass from one type of system to another.’ He is talking about the transition from an NHS system to a US style private medical system.

Shutting down the main District General Hospitals will make a private system inevitable.

Blair lauded care in the community – the system that has destroyed mental health care.

He said: ‘There is a completely new focus on primary care. Practice-based commissioning will reduce unnecessary referral. Chronic disease can often, these days, be managed in primary care. The elderly can be looked after at home. Diagnostics tests and minor surgery can be carried out near to home, where patients want it to take place. . .Most people would actually be better served by care that was closer to home.’

So it is to be Regional Specialist Centres and care in the community. He adds: ‘There will be many more paramedics and nurses trained to treat people at home and stabilise a patient’s condition for longer journeys.’ With the longer journeys and the crowded roads it is obvious that fewer patients will be alive when they reach their ‘long distance destination’. This is not even reckoning with road, rail, air disasters or bomb attacks etc.

Blair supporters now spin a scenario of: ‘a pyramid structure whereby super regional hospitals and specialist centres would provide the most complex care, while the second tier includes local hospitals with minor injury units – a scaled down version of A&E-walk-in-centres and specialist GP services.’

Workers must redouble their efforts to defend their District General Hospitals. The trade unions must form Councils of Action to mobilise entire communities to occupy all hospitals threatened with cuts and closure. Such Councils of Action will prepare the way for a general strike to bring down the Blair government, to bring in a workers’ government that will maintain and develop the NHS.