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New figures show London’s health services under increasing strain

A greater proportion of the beds in London hospitals are now being used by patients from outside the capital than was the case before the reforms, despite the higher costs of care in London.

The proportion of care London hospitals provide to non-Londoners has increased from 11.5 per cent in 1988/89 to 14 per cent in 1994/95, according to The health economy of London, the second report to the London Commission, etsablished by the King’s Fund.

The finding confounds predictions that the introduction of the internal market in the NHS in 1991 would lead to a fall in the use of beds in London as purchasers moved contracts to cheaper hospitals outside London.

But although there have been improvements in the efficiency of hospital care in the capital, standards of primary care remain lower than those in the rest of England despite attempts over the past 4 years to improve matters.

Over one in four of London GPs work in premises below a minimum standard. The proportion of GPs achieving high targets for immunisation and cervical cytology screening is only about 56 per cent in London, compared with 86-94 per cent in England as a whole. Rates of GP minor surgery are also low in London.

London boroughs spend more on the social care of older people than authorities elsewhere, with older Londoners making more use of home care and meals on wheels. But residential care is very often provided outside London.

The health economy of London. Seán Boyle and Richard Hamblin. £15. King’s Fund: 0171 307 2591.