New NHS chief calls for small hospitals and better local care

The new chief executive of NHS England, Simon Stevens, has called for an expansion of local services so that patients can be treated in their own communities.

In what the Daily Telegraph describes as a "marked reversal of current policy", Stevens said the NHS needs to abandon its fixation with "mass centralisation".

He warned that British hospitals are among the worst in western Europe at caring for local populations and said elderly patients are increasingly ending up in hospital unnecessarily because they had not been given care that could have kept them at home.

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"A number of other countries have found it possible to run viable local hospitals serving smaller communities than sometimes we think are sustainable in the NHS," he said. "Most of western Europe has hospitals which are able to serve their local communities, without everything having to be centralised."

The Daily Telegraph suggests that Stevens wants the NHS to stop closing "cottage-style" hospitals – small hospitals with a handful of beds based in towns and villages.

However, an NHS source later told the BBC that Stevens was not suggesting the return of 50s-style cottage hospitals, nor guaranteeing that local hospitals would not be closed in the future.

The BBC also notes that the health service has, in recent years, emphasised the benefits of centralised services, in which significant benefits have been gained in areas such as stroke care and major trauma by concentrating specialist care.

Stevens, a former adviser on health to Tony Blair, will outline his vision for the NHS in a speech at the NHS Confederation conference in Liverpool next Wednesday.

The new chief executive has also claimed that waiting targets introduced by Labour have become "an impediment to care" in too many cases, and that the European Working Time Directive has made it harder to keep small hospitals open. He also suggested that businesses should financially reward employees for losing weight and adopting healthy lifestyles.