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Tuesday, 11 January, 2000, 11:49 GMT
NHS chief: 'Only cash will solve the malaise'

Flu Many people are suffering from flu

Stephen Thornton, chief executive of the NHS Confederation which represents NHS trusts and health authorities, is not convinced that the current crisis in the health service is due to a severe outbreak of flu. Instead, he believes the service is struggling to cope because it is badly in need of extra resources.

There is one important step that the government could take immediately to improve the ability of the NHS to cope with increased demand during the winter, Mr Thornton believes.

He wants ministers to scrap efficiency saving targets imposed on the health service by successive governments.

The NHS is running too fast and hot. NHS hospitals have been encouraged by successive Governments to become more and more 'efficient'
Stephen Thornton, chief executive, NHS Confederation
Mr Thornton believes these targets are crude, and impossible to achieve without an inevitable reduction in the quality of service to patients.

He said: "The NHS is running too fast and hot. NHS hospitals have been encouraged by successive Governments to become more and more "efficient".

"This means that average bed occupancy has gone up from 70% or so in the 1970s to over 90% today.

"This leaves very little spare capacity for the winter peaks.

"At the same time the turnover of patients in the NHS has increased with the average length of stay in hospital reduced."

Flu nightmare
Mr Thornton said the government's own research shows that if hospitals operate at occupancy levels of more than 90%, it is an absolute certainty that there will be periodic bed crises however well they are managed.

Stephen Thornton Stephen Thornton says resources are urgently needed
In view of the negative impact of this inappropriate approach to efficiency the requirement for a three per cent efficiency saving in the latest planning guidance for the financial year 2000/01 must be regarded as counterproductive, he said.

"If this requirement remains then there is a real danger that bed occupancy can only rise further next year."

"The system needs to stop being run at dysfunctional levels of capacity. It is not efficient to run a system at this sort of level.

"It is de-motivating for staff and leaves the NHS with little capacity to cope with even small fluctuations in demand.

"Crude efficiency savings of three per cent were possible in the 1980s and early '90s, but no longer - huge savings have been made and the NHS is tightly run.

"What we need is a new approach to efficiency based on strategic capital investment which will produce real efficiency improvements for the future.

"At the moment "efficiency" in the NHS has come to mean a dilution of quality."

More resources vital

At the moment "efficiency" in the NHS has come to mean a dilution of quality
Stephen Thornton, chief executive, NHS Confederation
Mr Thornton said much greater levels of investment in the NHS and in related social care support systems were needed.

Without it, the current crisis was doomed to be repeated in future years.

"I am struggling to see how we can get our planning any better than we have got it this year.

"We had primary care working with the hospital service, working with social services, working right across the piece to get this right.

"Unless we have significant additional resources available for the NHS next year, I fear that we could have exactly the same problem in January 2001 as we have got this January."

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10 Jan 00 |  Health
Flu: An NHS nightmare

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