Education And Debate

NHS Update Freeman Hospital: the will to survive

BMJ 1994; 309 doi: (Published 13 August 1994) Cite this as: BMJ 1994;309:461
  1. S Kingman
  1. London W43BU

    The future looks uncertain for the Freeman Hospital trust in Newcastle upon Tyne. There are plans to rationalise the health service in Newcastle by shifting resources from secondary to primary care, and by providing more services locally for people who live in the region but outside Newcastle. These could reduce the level of contracts that purchasers place with the trust in the future. Staff at the trust say the service they provide is good value for money, but purchasers do not seem to take this into account. Instead of choosing from a “shopping list” of priced procedures, purchasers are forcing the trust to dovetail its prices to meet their budgets. There is also concern at the potential impact on the trust's financial situation of reduced working hours for junior doctors and the Calman proposals on training.

    Turbulent times lie ahead for the health service in Newcastle. The Freeman Hospital, now entering its fourth year as a trust, is coming to grips with the unpalatable realisation that a hospital's geographical accessibility to patients seems to count more than whether the treatment it offers is good value for money or of better quality.

    No one at the Freeman any longer expresses surprise that - contrary to the government's promises when the NHS reforms were launched - the money does not follow the patients. The grim truth is that, once again this year, the purchasers want the trust to treat more patients for less money. And at the same time, purchasers in the region are making plans to divert more resources from secondary to primary care and to attempt to change general practitioners’ referral habits so that patients obtain care closer to home, rather than travelling to Newcastle for it. Their choice will become restricted.

    All this puts the trust in an unenviable …

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