Tuesday, 22 May 2012

The realities of providing local health services

I found myself in a minority of one when I got embroiled in an online debate about local health provision last week.

The decision to close the local and replace it with the new facility five miles away was not popular with residents. A quick glance at the discussion will show you that most feel as though an inferior service is being provided at the new hospital, particularly in relation to A&E, and they are bemoaning the lack of a hospital in the town itself.

My perspective is somewhat different.  The old hospital was well past its best, a crumbling ruin compared to the new one. The new location is also much more accessible to people in the North of the Borough. Whereas the old hospital had a ‘9 to 5’ A&E,  the new one has an emergency centre that can deal with most minor accidents, with more serious cases being referred to nearby general hospitals. This was essentially what happened when the old hospital was still open, so there really isn’t any change from what went before.

Needless to say, my views were seized on. Other contributors to the debate would have you believe the new hospital isn’t a patch on what went before.  I was well and truly demonized.

We cannot have the penny and the bun, especially in these challenging economic times, and our healthcare commissioners are placed in an impossible position. The reality of the choice is this:  the people of the Borough can either have a second rate A&E service in the new hospital (which was the case when it was an ‘official’ A&E at the old one) or a better standard of service that they have to travel to. I’m not saying that the service at either of the other hospitals is perfect, far from it, but it would be considerably worse if A&E services were spread more thinly.

If people are worried about the length of time it would take to get to an A&E, the research shows that it is the ambulance response rate that matters more than the time it takes to travel to hospital. I feel that inconsistencies here are a more reasoned focus for health campaigners.

No matter where a hospital is located, someone will always be dissatisfied and too many people get fixated on the building itself rather than the quality of the service.  The public protests begin at the first whiff of a suggestion that a hospital may close (although interestingly not in my town, to any great extent) and the local politicians start to dance to their tune. At this juncture, we need more honesty from our politicians, but the desire to make political capital from the situation usually wins through. We cannot hope to provide a first rate service in every single community, town and city etc within the budget constraints. A whopping 40 percent of the Welsh budget already goes on health provision.

A reasonable service within a reasonable distance has to be a better option than a patchwork of inconsistent community hospitals offering varying standards of provision, whether it is A&E, Maternity, Cardiac or Pediatrics.

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