Blair defends NHS reforms

Prime Minister Tony Blair has defended NHS reforms, arguing that "the best is yet to come" for the service.

Speaking to the NHS Confederation Conference, Mr Blair said: "The reason for change is the best reason there can be: better treatment for the patient. And the best is yet to come - more lives saved, stopping more pain and distress if together we remain steadfast."

The Prime Minister's speech came as two reports were published calling on the need for changes to A&E and heart and stroke services.

The reports, by Sir George Alberti, National Clinical Director for Emergency Care and Professor Roger Boyle, National Clinical Director for Heart Disease and Stroke, both argued that traditional A&E departments are not the only option when dealing with life and death situations and that specialist centres would be better equipped to deliver more complex care.

Commenting on his report, Sir George said: "Care for emergencies is good, and indeed there has been a transformation in A&E departments over the last five years. But there is increasing specialisation and we need to ensure that people are seen quickly by an experienced doctor or health professional.

"We have to be upfront and tell the public that, in terms of modern medicine, some of the A&E departments that they cherish are not able to provide this type of care and cannot and will not be able to provide the degree of specialist services that modern medicine dictates and the public deserves. That means we have to change services so we can deliver safe, high-quality care to everyone who needs it, when they need it.

"Every service cannot be offered by every A&E department - it never has been, and never can be - so it makes sense to create networks of care with regional specialist centres to give the best possible treatment to the sickest people. For the majority of people, care is still going to be as local as it ever was. Major emergencies affect a relatively small number of people. For most people, care will continue to be as local - or indeed more local - than ever."

Professor Boyle said: "By giving life-saving drugs to heart attack victims on their doorstep and using clinical judgments to by-pass A&E to deliver heart attack and stroke patients directly to specialists, we are acting only in the best interest of the patient. This is not driven by saving money but by the aim of saving lives."

Commenting on both reports, Health Secretary Patricia Hewitt, said: "The NHS is changing because medicine and patients needs are changing. As both National Clinical Directors have highlighted, the NHS in the future will save more people lives by taking the most seriously ill patients to the right specialist centre. But it will also give many people with less serious conditions more convenient care by taking A&E to the patient rather than expecting every patient who wants urgent care to go to A&E."

However, Dr Jonathan Fielden, Chairman of the British Medical Association's consultants' committee, said: "All too often change is driven by politics or the need to balance the books rather than what is in the best interests of patients. It is absolutely vital that there is meaningful dialogue both nationally and locally to ensure the right services are available at the right time and place.

"Delivering effective emergency care will rely on hospitals, GPs and other primary care clinicians, working collaboratively to plan how services will be provided. This is impeded when at the same time hospitals are being encourages to compete against each other to attract more patients to maintain financial viability in a market-based healthcare system."

(KMcA)