Move to seven-day care mooted as MPs debate making it easier to close hospitals

The proposal has been put forward as an amendment to the Care Bill, which is having its second reading in the House of Commons. It was inserted by the House of Lords in response to the Government's High Court defeat in relation to the proposed closure of maternity and accident and emergency services at Lewisham Hospital, as recommended by the special administrator of nearby South London Healthcare NHS Trust.

Healthcare expert Barry Francis of Pinsent Masons, the law firm behind Out-Law.com, told the Financial Times (subscription required) that the change tied in with the more market-driven NHS created by last year's Health and Social Care Act.

"The system is set up like a market and, if you accept that, the changes make perfect sense," he said. "The only alternative is to put more money into services that are not financially viable."

The debate comes the day after Sir Bruce Keogh, national medical director of NHS England, set out plans to develop seven-day services across the NHS by 2017. His report, which sets out the findings of a forum set up by NHS England earlier this year, sets out "significant variation in outcomes" for patients admitted to hospitals at weekends, including lower clinical cover and higher mortality and readmission rates. Keogh said that this could be implemented in a way that is "financially and clinically sustainable" if NHS providers found new ways of collaborative working.

The amendment would apply to NHS Trusts that have been placed into special administration, a procedure that was created in 2009 under the Unsustainable Providers Regime. It would allow a special administrator to make wider recommendations than those that would only affect the trust, and enable the Health Secretary and regulators to take decisions based on those recommendations.

Last year, South London Healthcare became the first NHS Trust to be placed into special administration. As recommended by Matthew Kershaw, the special administrator, the trust was dissolved on 1 October 2013 and its three hospitals absorbed into other trusts. Under the original proposals, nearby Lewisham Hospital would have lost some maternity and accident and emergency services, but the Court of Appeal confirmed in November that the Government was acting outside of its powers by ordering the closure.

Speaking in the House of Lords in October, Lord Howe said that the amendment would "put beyond doubt the Government's existing position that the remit of a trust special administrator is to make recommendations that may apply to services beyond the confines of the trust in administration".

"Where severe and prolonged problems exist, the administrator appointed must be able to propose a viable solution," he said. "It was always the Government's intention that the interpretation of the words 'in relation to' could include wider actions where necessary and consequential on primary recommendations about the trust in administration."

"NHS trusts, foundation trusts and other providers do not exist in isolation from each other. They are part of a complex, interdependent, local healthcare economy. Issues of clinical and financial sustainability nearly always cross organisational boundaries. Parliament must surely have intended originally that the legislation would enable an administrator to fix the problems that it was appointed to fix," he said.

The amendment did not "constitute a change of policy" and would not apply retrospectively, he said.