'This report once again highlights the severe financial and clinical problems facing some hospitals. It has long been known that around 20 hospitals may not be financially sustainable, while many others face clinical challenges that require changes to the services they provide. The government needs to work closely with these hospitals to find solutions - this will include mergers and, in some cases, service closures.
'These issues have been ducked for too long. The recent announcement by the Secretary of State backing changes to services at Chase Farm hospital in North London signalled a welcome willingness from ministers to embrace the need for change. It is to be hoped that this will be followed by an honest dialogue with the public about the need for some hospital services to close.
'In responding to these challenges, there is an opportunity to move some services into the community and encourage the development of integrated care, with GPs, hospitals and community services working closely together to meet the needs of the increasing numbers of people with long-term conditions.'