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| Version 4 | Version 5 |
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| A&E campaigns 'will cost lives' | A&E campaigns 'will cost lives' |
| (10 minutes later) | |
| Campaigns to save local A&E departments from closure could lead to more than 1,000 unnecessary deaths each year, a report has warned. | Campaigns to save local A&E departments from closure could lead to more than 1,000 unnecessary deaths each year, a report has warned. |
| The Institute for Public Policy Research (IPPR) said specialist units were better placed than local hospitals to deal with high-risk patients. | The Institute for Public Policy Research (IPPR) said specialist units were better placed than local hospitals to deal with high-risk patients. |
| The report comes as Tony Blair is due to urge managers to make the case for reorganising NHS services in England. | The report comes as Tony Blair is due to urge managers to make the case for reorganising NHS services in England. |
| Financial concerns must not drown out arguments for change, the PM will say. | Financial concerns must not drown out arguments for change, the PM will say. |
| The best is yet to come with more lives saved, stopping more pain and distress Tony Blair Heart tsar's case for reform | The best is yet to come with more lives saved, stopping more pain and distress Tony Blair Heart tsar's case for reform |
| Mr Blair will outline the government's case for NHS reform in a speech to local health managers and doctors at the NHS Confederation on Tuesday. | Mr Blair will outline the government's case for NHS reform in a speech to local health managers and doctors at the NHS Confederation on Tuesday. |
| He will say service improvements in NHS hospitals are being implemented to ensure the very sick have speedy access to specialist care but also to treat people more conveniently closer to home. | He will say service improvements in NHS hospitals are being implemented to ensure the very sick have speedy access to specialist care but also to treat people more conveniently closer to home. |
| "The best is yet to come with more lives saved, stopping more pain and distress," he will say. | "The best is yet to come with more lives saved, stopping more pain and distress," he will say. |
| But critics of the reforms say they will put patient lives at risk and are being carried out to cut costs. | But critics of the reforms say they will put patient lives at risk and are being carried out to cut costs. |
| Range of reforms | Range of reforms |
| Meanwhile, two government advisers, Sir George Alberti and Professor Roger Boyle, are due to publish separate reports arguing the case for reform of services. | Meanwhile, two government advisers, Sir George Alberti and Professor Roger Boyle, are due to publish separate reports arguing the case for reform of services. |
| They will push for a range of urgent care services, including out-of-hours GPs, walk-in-centres and a bigger role for paramedics, alongside specialist units. | They will push for a range of urgent care services, including out-of-hours GPs, walk-in-centres and a bigger role for paramedics, alongside specialist units. |
| Professor Boyle, the national director for coronary heart disease, told the BBC: "The message is quite a simple one. Modern medicine moves on, the new technologies need to be made available to everybody, they do require more specialised care, and they require more specialised investigation. | Professor Boyle, the national director for coronary heart disease, told the BBC: "The message is quite a simple one. Modern medicine moves on, the new technologies need to be made available to everybody, they do require more specialised care, and they require more specialised investigation. |
| "We have to move the patients to the expertise rather more than we do at the moment." | "We have to move the patients to the expertise rather more than we do at the moment." |
| The IPPR finding is based on data showing how many extra lives could be saved if everyone had access to new techniques to treat heart attacks. | The IPPR finding is based on data showing how many extra lives could be saved if everyone had access to new techniques to treat heart attacks. |
| Some district hospitals are not as safe as they should be and that point has not been effectively made Joe Farrington-Douglas | Some district hospitals are not as safe as they should be and that point has not been effectively made Joe Farrington-Douglas |
| If heart attack care was reconfigured to ensure universal access to emergency angioplasty, around 500 extra lives could be saved every year, it said. | If heart attack care was reconfigured to ensure universal access to emergency angioplasty, around 500 extra lives could be saved every year, it said. |
| Last year only 1,600 of 61,000 heart attack patients were treated in a specialist unit. | Last year only 1,600 of 61,000 heart attack patients were treated in a specialist unit. |
| Also there is evidence that people who have suffered severe injury are more likely to survive if they are treated in specialist centres rather than local hospitals. | Also there is evidence that people who have suffered severe injury are more likely to survive if they are treated in specialist centres rather than local hospitals. |
| The Royal College of Surgeons and British Orthopaedic Society estimates that universal access to specialist trauma centres could save around 770 lives a year. | The Royal College of Surgeons and British Orthopaedic Society estimates that universal access to specialist trauma centres could save around 770 lives a year. |
| Reconfiguring services | Reconfiguring services |
| The IPPR researchers said people should be out on the streets campaigning for changes to the way hospitals provide services rather than campaigning to keep traditional services open. | The IPPR researchers said people should be out on the streets campaigning for changes to the way hospitals provide services rather than campaigning to keep traditional services open. |
| "We're not saying that hospitals should close, we're talking about reconfiguring services," said IPPR research fellow Joe Farrington-Douglas. | "We're not saying that hospitals should close, we're talking about reconfiguring services," said IPPR research fellow Joe Farrington-Douglas. |
| He said: "The NHS and government should be able to demonstrate how changes will improve care and local people should hold the NHS to account, but they need to understand that preserving the local hospital will not always be in their best interest if something life-threatening happens." | He said: "The NHS and government should be able to demonstrate how changes will improve care and local people should hold the NHS to account, but they need to understand that preserving the local hospital will not always be in their best interest if something life-threatening happens." |
| He added: "Some district hospitals are not as safe as they should be and that point has not been effectively made." | He added: "Some district hospitals are not as safe as they should be and that point has not been effectively made." |
| Dr Jonathan Fielden, chairman of the BMA's consultants' committee said decisions on reconfiguration must be based on "good evidence". | Dr Jonathan Fielden, chairman of the BMA's consultants' committee said decisions on reconfiguration must be based on "good evidence". |
| "It is absolutely right that there is a public debate about the way our health services are delivered in the future and it is vital that patients and clinicians are properly informed and engaged in these discussions," he said. | "It is absolutely right that there is a public debate about the way our health services are delivered in the future and it is vital that patients and clinicians are properly informed and engaged in these discussions," he said. |
| Case against | |
| Prof Christopher Marks, cancer surgeon and chairman of the independent campaign to save the Royal Surrey Hospital in Guildford, said: "What local people want is access to excellent care which they can get to easily." | Prof Christopher Marks, cancer surgeon and chairman of the independent campaign to save the Royal Surrey Hospital in Guildford, said: "What local people want is access to excellent care which they can get to easily." |
| He accepted that some complicated cases must go to specialist centres, but warned centralisation of services in Surrey would see a doubling of minimum ambulance times, which could compromise care. | |
| "Thanks to the money that the government has put in, particularly to A&E, the service has improved marvellously, and it is a pity to throw the baby out with the bath water when you have spent all this money." | |
| Dr Richard Taylor, the independent MP for Wyre Forest, who campaigned against the closure of his local hospital in Kidderminster, admitted that campaigns to save local facilities were driven in some part by emotion. | |
| But he warned that downgrading A&E units left them unable to cope. | |
| "There has got to be compromise that keeps adequate facilities at a wider range of acute general hospitals than these super-specialist centres alone." |