UK government health service NHS could hit £30-billion funding gap

In view of a growing funding gap, the National Health Scheme in England would need to take urgent decisions about hospital reorganisation and GP care, according to its leaders.

NHS England warned in a report that by 2020-21 the budget - costs gap could touch £30 billion.

NHS chief executiveSir David Nicholson said the body was facing significant challenges and services needed to be concentrated in fewer hospitals.

He told BBC Radio 4's Today programme that the NHS needed to make sure that the way in which services were organised was in the best way for patients.

He said for for patients who suffered a stroke, specialist care was available at 31 hospitals in London, but often with some of the worst outcomes for patients.

He said with services now concentrated in eight hospitals, the outcomes were among the best in Europe.

He also added, preventative care and improved services for people in the community were crucial - and said, a drive to make the NHS more efficient and productive was absolutely necessary.

Sir David added, trying to maintain services in the same number of hospitals could lead to cutting down of staffing numbers on every ward, which was completely unacceptable to them in the NHS.

However, plans to make changes to health services had run into opposition in the past. For example, a bitter legal dispute had ensued over the issue of streamlining of children's heart surgery services.

Campaign groups in Stafford are struggling to maintain services at Mid Staffordshire NHS Foundation Trust - even though Stafford Hospital was central to a major scandal.

According to medical director professor Sir Bruce Keogh, a number of services had the potential to be concentrated at fewer specialist centres, such as treatment for heart attacks and strokes, operations on veins and arteries and bowel surgery.

He added a number of services would need centralisation for a limited time, giving the example of pacemakers which regulate a patient's heartbeat, and which could earlier only be implanted by specialist doctors in a small number of centres.

However, now the procedures were being conducted regularly in any hospital which employed a cardiologist.