Compton Review due next week

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The Compton Review into the future of the NHS here in Northern Ireland is due to report next week. There have been a series of articles about it recently: yesterday the BBC mentioned that Daisy Hill Hospital in Newry is likely to be downgraded whilst the Belfast Telegraph has suggested that the Mater in Belfast will lose consultant led maternity services but keep A&E.

Amid all the speculation, educated or otherwise, the News Letter’s Ben Lowry, a couple of weeks ago, had an impressive set of articles about the issue of acute hospitals. On the topic of A&E departments he quoted the local BMA chairman Paul Darragh:

There continues to be three A&E departments in Belfast within a few square miles, even after the City closed. We have to question if this is a good use of resources when trusts are struggling to recruit doctors to fill posts in each hospital.
Why not combine services to create centres of excellence that are fully staffed and offer the best treatment possible?

Lowry suggested that there will be six A&Es left: Altnagelvin, Royal, Ulster, Craigavon, Erne, and Antrim. The public tend to be very focused on keeping the local hospital and especially the local A&E but again this issue is tackled with the possibility that small local hospitals may not enhance the safety of local populations.

John Compton’s review is the latest in a long line of such documents all of which have recommended a radical reduction in the number of acute hospitals in Northern Ireland: typically to 6 or so. The problem has always been the political difficulties of closing the smaller hospitals including the loss of status for local communities, and the political pressures forced on the local politicians by outcries about closure. The fear that lives will be lost in the local community if a small hospital closes are strongly felt and passionately held; almost no matter what evidence to the contrary is presented. This time, however, it is possible that decisions will be made. To quote Mr. Compton (again from the News Letter):

“What is important is that we have decisions.”

The time to have that is now, he says.
“It is the right thing to do.”

The question is whether or not Edwin Poots will be willing to make the decisions the review recommends: from the comments he has made previously it does look as if he may be willing to do so. This may be the best chance to improve Northern Ireland’s healthcare in decades. If he can take these decisions and endure the political fire-storm which will almost inevitably be created Poots will achieve a genuinely impressive, important, long lasting and far reaching reform which will massively benefit the health of the Northern Ireland population. He will also in the medium term do his own political stock a great deal of good.

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  • quality

    “the possibility that small local hospitals may not enhance the safety of local populations.”

    This is where our parties have the opportunity to set the terms of discourse and best educate the public on the downgrading of hospitals. The north just isn’t big enough geographically speaking to warrant so many fully kitted-out hospitals.

    Of course they won’t, they prefer whipping people up into a frenzy.

    That said, it is terrible that people will be losing jobs (combined with high unemployment and a lack of jobs in the ‘private sector’ to go into) and of course I would be on the picket line if I was them.

    However, the NHS has to make decisions about whether it will provide a service to its people (and to my mind, all personal views on the man aside, Poots has been making some very encouraging noises about preventative health measures) or whether it wants to be a mass employer. Safety should of course come first, rather than simply taking a slash and burn approach.

    As someone who has worked in the health service on the pen-pushing side, I can say hand on heart I could have done the job of three people in my office. Administrative costs should be cut (and this is possible) to allow for better front line care.