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Cottage hospitals could get new life(Yorkshire Post Via Thomson Dialog NewsEdge)Government aims to boost NHS care for people near their homes but critics ask: Where's the money? Simon McGee Political Editor SMALL hospitals are being handed a lifeline as the Government seeks to move services into the community. Some community hospitals are under threat of closure at present, but such units could now be offered the chance to flourish. There are about 350 community hospitals in England, mostly owned and run by primary care trusts (PCTs), and the White Paper insists they should have the chance to remain open. "Some community hospitals are currently under threat of closure, as PCTs consider the best configuration of services in their area," the White Paper states. "We are clear that community facilities should not be lost in response to short-term budgetary pressures that are not related to the viability of the community facility itself." And as well as saving the old, the White Paper said the Government would invite PCTs to bid for cash to create a new generation of community hospitals and smaller units. They will provide diagnostics, minor surgery, intermediate care and basic primary care closer to where people live. More details of these plans - first mentioned in the Labour manifesto - are due later in the year. About 50 new or refurbished community facilities are expected. They could take a similar form to the "polyclinics" introduced in Germany in 2004, which prov-ide a range of services with the involvement of doctors, nurses and other health professionals. Health Secretary Patricia Hewitt said: "Nearly 90 per cent of patient contact occurs in the community and is trusted, but we still spend below the European average on primary care. "Over the next 10 years I want to see five per cent of resources shifted from secondary to primary care, which will help to make primary and community services more responsive to people's needs." This five per cent is thought to amount to about GBP2.5bn from the NHS budget. Ms Hewitt said Ministers were working with the medical Royal Colleges to consider which specialities could be bought out of hospitals and nearer to people. But Shadow Health Secretary Andrew Lansley said the Government was "moving in the wrong direction". The White Paper "leaves many questions unanswered. Many primary care trusts are cutting back precisely the community-based services on which the care plan depends," he said. Liberal Democrat spokesman Sandra Gidley said the "hot-potch of ideas" would please nobody. "The Government prop-oses to build another 50 community hospitals but at present funding crises mean that one in four are threatened with closure. "The Secretary of State has decreed that hospitals should not be closed 'in response to short-term budgetary pressures' but has not proposed any further funding or support." WHITE PAPER: Key points HEALTH "MOTs" PEOPLE will be offered check-ups at key points in their life. The idea is they would give patients the option of having a health check-up to see if they are at risk of developing conditions such as heart disease and diabetes. In reality the "Life Check" will take the form of a questionnaire which patients complete either online or on paper. If problems are shown up they may be invited for a face-to-face consultation with a GP. Initially the check will be piloted in the most disadvantaged communities, focusing on young children and people approaching their 50s. It could then be rolled out for people at other key stages, such as women who have just had their first baby. But the cost implications are far from clear. Liberal Democrat health spokesman Steve Webb said: "A health MoT for everyone might sound attractive, but is highly unlikely to be cost-effective. "There is a real danger of surgeries being swamped by the 'worried well' while people in real need have longer to wait." GPs - BETTER ACCESS GP surgeries will be given incentives to open earlier and later, and make it easier for patients to register with the practice they wanted. There are also suggestions that some health services could be placed in more convenient locations, such as supermarkets, and pharmacies. The White Paper acknowledged that at present there were few incentives for GP practices to offer opening times that responded to patient needs. "This will enable them to choose practices that offer access that fits with their lives. Practices that offer opening hours that the public want will gain new patients and the money that follows them; those that don't, won't," the document said. The public will be questioned in regular surveys about how easy they find it to see a GP. Health Secretary Patricia Hewitt has already said GP practices could be encouraged to start longer opening hours to fit in with the demands of working people. She said the public were often pleased with the service they got from GPs once they saw them, but were not impressed by the problems they faced getting appointments at times to suit them. She also said a minority of GP surgeries were still operating restrictive booking policies, where patients have to ring between certain times on the morning of the day they want an appointment, and that this would also be tackled. TACKLING INEQUALITIES PRIVATE healthcare providers could be brought in to deprived parts of Yorkshire under plans set out in the White Paper to make sure people's needs are met. Areas like Barnsley and Doncaster - where patients have among the lowest GP/patient ratios in the country - will benefit from a focus in the White Paper on tackling the link between deprivation, poor health and the availability of relatively few GPs. Family doctors working in deprived areas could also be paid more to tackle stark inequalities in access to services, following pressure to reduce the health gap between the highest and lowest social groups. GREATER CO-OPERATION SOCIAL workers will be more fully incorporated in the NHS by being placed alongside GPs in surgeries. GP practices would expand, with so-called "super-surgeries" providing a wider range of treatments and services such as social care integrated into practices. The Health Secretary said that integrating social care services into the NHS would help carers - who would also benefit from the creation of a new respite service to give a break from caring for relatives or friends, as well as offering other support such as a helpline. Some funding for this would come from the Department of Health's central budget. |