Tread carefully on cuts to avoid another Mid Staffs, NHS told

By Tony Hudson

The NHS' efficiency drive has to be handled carefully if it is to avoid examples of appalling levels of patient care highlighted by the recent Francis report, according to an influential group of MPs.

A new report by the public accounts committee (PAC) says while the NHS virtually met its savings target of £5.9 billion over the last year, this was mainly due to freezing the wages of its workers.

Following the Francis report, which detailed widespread neglect by the Mid Staffordshire NHS Foundation Trust, the PAC expressed concern over the prospect of further cuts having similar results.

Committee chair Margaret Hodge urged the need for radical changes to the way the NHS operates in order to meet its savings targets.

"The NHS must fundamentally change the way that healthcare is provided to secure the level of savings needed in the future, for example by moving services out of hospitals and into the community," she said.

She added while it was understandable for people to be concerned at the prospect of hospitals closing down or reducing their services, it was up to the Department of Health to make the case for the move being in the patients' interest as well as being cost effective.

"Unless this is done urgently, the department will continue to face resistance to change and the NHS will struggle to deliver the savings it needs," she warned.

The NHS is already facing challenges as patient groups are voicing deep concern about the standard of care currently provided.

"What our survey shows is that public confidence in out-of-hours services is worryingly low and that is not always as easy as it should be to get an appointment with a GP," Patients Association chief executive Katherine Murphy said.

"We need an NHS in every community that operates effectively, safely and compassionately during and outside office hours. Keeping people out of hospital and living independent, healthier lifestyles means delivering more integrated and accessible community based care."

The Department of Health estimates a saving of up to £20 billion over the next four years is needed in the NHS in order to live within its means.

The PAC report cited concerns from patient groups and professional bodies over the possibility of treatments like cataract and bariatric surgery – which may not be urgent, but make significant improvements to a patient's quality of life – being rationed in order to meet the NHS' targets.

Labour's shadow health minister Jamie Reed said the report was yet more evidence against the government's strategy of savings through cuts.

"This is the third time this week that the government has been told by experts that its cuts to the NHS are hitting patients. Ministers cannot go on ignoring these warnings," he said.

"Ministers are failing to make the long-term efficiency savings and the NHS is cutting the 'low-hanging fruit' instead – rationing care and cutting staff numbers."