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Save the NHS: Shut your local hospital

Oliver Wright

NHS 300x218 Save the NHS: Shut your local hospitalTrick question: You are involved in a serious road accident which has resulted in a life threatening brain injury. Do you want to be taken to the nearest hospital?

Answer: Not necessarily.

Second trick question: You have suffered from a stroke or a heart attack or your daughter is suffering from flu like symptoms which you’re worried might be meningitis. Do you want an ambulance to take you to the nearest A&E?

Answer: Probably not.

So now the serious question: Why are politicians and the public so opposed to shutting underperforming small hospitals and A&E units when they eat up the bulk of NHS resources, are based on an outdated model of patient care, and are almost certainly doing more harm than good?

Answer: Politicians are looking after their own skins and we don’t know enough about the facts.

The need to reconfigure (as the jargon describes it) hospital services is not new.

While Professor Chris Ham’s intervention (as reported in today’s Independent) is welcome, it is not – as he would admit – the first time it has been raised.

Back in 2006 Tony Blair gave a speech calling for hospital reorganisation and closures.

“The best reason for all this change is the best reason there possibly can be: better care for the patient,” he said.

Mr Blair cited two reports which both concluded that specialist care in large centres was better than in local units.

Professor Roger Boyle, national director for heart disease and strokes, said specialist centres could save an estimated 500 heart attack victims, prevent 1,000 further coronaries and result in 1,000 more stroke victims avoiding death and disability each year.

A separate report by the Institute for Public Policy Research (IPPR) suggested that campaigns to save services at local hospitals could cost as many as 1,000 unnecessary deaths a year.

The institute’s research found patients with heart attacks or severe injuries were more likely to survive if the ambulance took them past their local district general hospital to a more distant specialist centre.

The findings have been backed by international evidence showing people severely injured in accidents are more likely to survive if they are treated in specialist centres than in local hospitals, even if they are further away.

So why, five years later, has so little progress been made?

Well part of the reason is the current Health Secretary Andrew Lansley.

He made easy political capital in opposition by campaigning against hospital closures. He claimed that legitimate arguments that a minority of patients could be treated in a specialists centre were being used to justify a “financially-driven” process of closing down A&E and other centres.

He was wrong then and now in power has the difficult job of reversing this position.

But he needs to do so. The case for change is more pressing now than it was in 2006 – both clinically and financially.

You may take comfort from a local A&E or District General Hospital – but you really shouldn’t. Saving your local hospital, in some cases, may be costing lives.

Not only that but it is eating up money which could otherwise be spent on cancer drugs, getting operations done more quickly and funding new specialists units which can be truly world class.

Sounds like the basis for a good campaign: Save our NHS. Shut our local hospital. Any takers?


Picture:Getty Images

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  • tomfrom66

    “Why are politicians and the public so opposed to shutting underperforming small hospitals and A&E units”

    Probably because a lot of people don’t want to travel long journeys when they are at death’s door.

    Assuming a plethora of air ambulances – as yet dependent solely on public subscription, btw – then the proposal might make some sense.

    Not long ago there was a felt ‘need’ to shut either the A&E at Southport of the, er, ‘neighbouring’ one at Ormskirk. To save money you understand.

    Chelsea Clinton was part of the McKinsey ‘advisory’ team that came from the US of A to help make the decision.

    It’s doubtful if she travelled the inadequate A road between the two towns to find out what a silly idea it was.

  • david

    It’s been known for years that it is far better for overall health outcomes, to have large A&E departments with experienced specialists, rather than maintain all A&Es. But public opinion will completely block reform and politicians will always remember Wyre Forest. If ever there was a good argument against democracy, this is it; the only way round it is for the public to change the way they think. 

  • http://bit.ly/mlL66y Marc Clayton

    This will be very hard to pull through politically, indeed. Even though I agree with you, it’s hard to shut down something “positive”, such as a hospital or a school, even if it is performing less than expected. Hopefully, some MPs will take up the mantle and raise the issue. I’ve launched some Inspiratives on Neomma. http://bit.ly/mgIt6k Let’s see where they’ll go.


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