Patricia Hewitt would help the health service meet its target

The health secretary, &to=http:// ' target=_blank>Patricia Hewitt, today signalled that NHS hospitals face the possibility of closure if they fail to attract sufficient numbers of patients.

Speaking at the International Convention Centre in Birmingham in her first public address as the newly appointed health secretary, Ms Hewitt echoed her predecessor, John Reid, by saying it was possible that some services could close if patients deserted them.

Ms Hewitt raised the spectre of service closures as she pledged to push forward with the patient choice agenda, an initiative which aims to offer people the option of picking from a range of hospitals and &to=http:// ' target=_blank>treatment centres to receive their care, including private providers.

Ms Hewitt also said she had no plans to backtrack on increasing use of the private sector to provide services, as she announced that private companies would be carrying out an extra 1.7m operations, such as hip and knee replacements, for the NHS over the next five years, at a cost of £3bn. She said this would help the health service meet its target of no patient waiting longer than 18 weeks from GP referral to treatment by 2008, tells the Guardian Unlimited.

According to This is London, the plan is to farm out more of the NHS's routine operations to bring down waiting lists. That goal is politically urgent: the Government's new target is to reduce the maximum wait for any operation to 18 weeks. And the Prime Minister has signalled that he wants to think radically, rejecting former health secretary John Reid's suggestion that the work farmed out would be limited to 15 per cent.

Ms Hewitt says using private providers in this way does not compromise the principles of the NHS because all such treatment will still be free at the point of delivery. Her critics say it is the thin end of the wedge. They point to the high cost of such operations and to the unfairness of successful NHS hospitals being barred from bidding for the work even if they have the extra capacity.

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