Health spokesmen disagree on how hospital closures should be managed

BMJ 2010; 340 doi: (Published 23 April 2010) Cite this as: BMJ 2010;340:c2238
  1. Zosia Kmietowicz
  1. 1London

    The health spokesmen for the three main political parties clashed over the best way to manage changes in health services when they took part in a debate on 22 April.

    Health secretary Andy Burnham defended decisions made by Labour in recent years to close some hospital maternity, children’s, and emergency departments to allow the same departments in hospitals nearby to specialise. The decisions had all been very difficult, he admitted, and affected his own constituents in Manchester.

    When the shadow health secretary Andrew Lansley promised to put a stop to further changes should the Conservatives win power in May Mr Burnham accused him of insincerity.

    Mr Lansley explained that he was not against change but that any hospital closures should be based on evidence and take into account the wellbeing of patients.

    But Mr Burnham responded that he was saying what people wanted to hear and when Mr Lansley tried to explain further Mr Burnham added he had dug “himself into a large hole.”

    Meanwhile the Liberal Democrats health secretary Norman Lamb argued that a centralised decision making system did not work and that he favoured empowering locally elected health boards to make decisions about which services best suited the population. This would make services more accountable but the decisions needed to be evidence based so that if a service was moving into the community it had to be shown to be better than one provided by hospitals, said Mr Lamb.

    The debate was organised jointly by the BMA, the King’s Fund, the NHS Confederation, and the Royal College of Nursing.

    On the subject of minimum pricing of alcohol Mr Lansley said, “I agree with Andy,” after Mr Burnham described Labour’s intention to focus primarily on tackling large discounts on alcohol. It was these which meant teenagers “could afford to drink every night of the week,” said Mr Burnham, although he did not rule out legislation on a minimum price per unit of alcohol at a later date.

    Only the Liberal Democrats favour a swift move to introduce a minimum price of alcohol. Mr Lamb contradicted Mr Lansley’s assertion that minimum pricing would have a significant impact on low income families and said that “big business was having an impact on policy.”

    Mr Lamb promised that the Liberal Democrats would deliver proposals on social care within a year if they win the election saying they favoured a compulsory contribution similar to that put forward by Labour. However, the Conservatives said they preferred a voluntary scheme—an idea dismissed by both Mr Burnham and Mr Lamb who said a voluntary policy would have only a 20% uptake which would benefit only 10% of those who need help.

    Although all three men agreed that foundation trusts were a good thing they had different ideas on the role of private providers in the NHS. While Mr Burnham repeated his mantra of “NHS first” in the provision of services, Mr Lamb said there should be a level playing field for all providers while Mr Lansley said that “patients deserve to have the best possible care from whoever can provide it.”


    Cite this as: BMJ 2010;340:c2238

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