Wednesday, October 27, 1999 Published at 14:19 GMT 15:19 UK
Intensive care 'failing patients'
Intensive care units save two out of every three patients
Many intensive care units in England and Wales are not saving lives because of clinical and administrative failures, a report has said.
Critical care experts have responded by calling for more resources. They warn that without new funds the government's pledge to improve care of cardiac and cancer patients will be very difficult to achieve.
However, the government says the problems are not caused by financial problems.
The Audit Commission report, "Critical to Success" examines the service provided by both intensive care (ICU) and high dependency units (HDU) in which seriously ill patients receive constant medical attention.
The Audit Commission researchers also found that between 1993 and 1998 the average number of beds in an ICU rose by 50% from four to six, and that costs are increasing at around 5 to 10% each year.
On average NHS staff save the lives of two in three ICU patients.
Andrew Foster, controller of the Audit Commission, said: "Staff in critical care units should be praised for providing a vital service in a very pressurised and traumatic environment.
"However, our report raises concerns that some hospitals are not making the best use of current resources."
He also called for more research into the reasons why some hospitals had higher mortality rates than others, saying "there are few ready explanations".
The Audit Commission report was welcomed by the Intensive Care Society, which represents more than 1,400 doctors and nurses.
Dr Paul Lawler, a past president of the society, said the UK spent only 1% of its small health care budget on intensive care, compared with 10% in the US.
He said: "Organisational changes must go side-by-side with an increase in critical care facility.
"In the meantime, frequent transfer of patients between intensive care units will remain the norm rather than the exception."
But Health minister Gisela Stuart told the BBC's Today programme that the report showed the problems were not necessarily due to financial problems.
"What's quite clear is that there is no direct relation between the number of beds [and the death rate]," she said.
"It's how you use them. A lot of it depends on the internal [hospital] management."