What happens when the private sector plans hospital services for the NHS

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7094.1619a (Published 31 May 1997) Cite this as: BMJ 1997;314:1619

Authors' figures were wrong for Edinburgh …

  1. John J Owens, Chief executivea,
  2. Cairns Aitken, Chairmana
  1. a Royal Infirmary of Edinburgh, Edinburgh EH3 9YW
  2. b Bromley Hospital NHS Trust, Farnborough Hospital, Orpington, Kent BR6 8ND
  3. c Division of Public Health Sciences, UMDS, London SE1 7EH
  4. d MPA International Health Strategy and Planning, London NW1 2EW
  5. e 45 Hollybush Road Cardiff CF2 6SZ
  6. f Department of Public Health Medicine, St George's Hospital Medical School, London SW17 0RE
  7. g On behalf of the NHS Consultants' Association, Radical Statistics Health Group, and NHS Support Federation

    Editor—Allyson M Pollock and colleagues state that they had difficulty in obtaining business plans, planning documents, and accurate bed numbers from all the trusts that they looked at.1 None of the authors requested detailed information from the Royal Infirmary of Edinburgh NHS Trust; had they done so the trust would have corrected several mistakes in their assumptions, in the data that they used, and therefore in their conclusions. The Lothian acute services strategy was published in 1992, before the government introduced the private finance initiative. The bed numbers in that strategy are consistent with those being planned today and reflect the closure of smaller hospitals. The authors are wrong to assert that the private sector planned the size of the hospital and that, had public sector finance been available, different planning guidelines would have been used that would have led to a larger hospital.

    Table 1 provides the detailed bed numbers planned for the new Royal Infirmary. The article stated that bed numbers will drop from 1292 to 814 acute beds. The figure of 1292 overstates the current numbers by 156 (actual 1136). This overstatement is more dramatic because the authors omitted the Chalmers Hospital from the hospitals comprising the Royal Infirmary group. The current total of 1136 further falls to 1106 because of planned transfers of services to other trusts. Thus the true comparison is 1106 versus 869 acute beds. A further 30 hotel beds give a total of 899, a drop of 19%, not 37% as stated in the article. No private beds are planned, and inpatient activity is planned to rise by 12%, not fall by 28% as the article suggests.

    View this table:
    Table 1

    Bed complement at Royal Infirmary of Edinburgh NHS Trust

    The authors are wrong to suggest that the reconstruction of acute hospital services in Lothian was …

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