Cuts to local hospitals are cuts, not consolidation

No matter how much health boards try and stay out of elections, even a hint of a hospital closure does tend to feature heavily in them.

This week NHS Fife became the latest health board to have its budget decisions reach the front pages of the newspapers.

A £30.8m gap in the health board's 2016/17 budget will be plugged by cutting hospital beds, according to reports in the local papers.

The gap could rise to £42m next year and £49m in 2018/19, the board meeting heard on Tuesday. There is also a £11.1m shortfall for the Fife Health and Social Care Partnership, which is less than a month old.

NHS Fife director of finance Chris Bowring said: “All measures to deliver savings toward the £30.8m in 2016/17 will reduce the pressure in future years," the Dunfermline Press reported.

This is the latest in a series of proposed or rumoured consolidation of NHS services across Scotland which have emerged during the election campaign. Rumoured changes at the children's ward at St John's in Livingston and Vale of Leven hospital have been two of the most high-profile.

The National Clinical Strategy clearly makes a case for redistributing funds from acute hospitals into the communities, and this will provide an easy narrative for health boards to hang onto when proposing changes.

But most of these proposed changes are not the redistribution of funds, they are cuts.

The big headline in the National Clinical Strategy, and one which made the SNP manifesto, is the establishment of centralised specialist treatment centres.

However, the strategy also describes the need for smaller and rural hospitals and primary care hubs to support communities. Under the current direction of travel, these are being closed.

As health boards firefight bed blocking, reducing the number of overall beds available seems short-sighted, especially when the integrated joint boards appear to be a long way from solving shortfalls social care.

If someone has an intermittently acute condition, like COPD for example, they need access to short-term beds so they can rest and be cared for while their carer gets a well-needed rest.

If the health boards are not careful, these type of patients will be travelling further and staying longer in their diminishing number of hospital spaces.

At least they can’t be accused of interfering in party politics – none of the parties have outlined how the National Clinical Strategy could be realised in detail, or how much it would cost.