Powys and Northern Ireland

A row seems to be developing regarding hospitals in Powys; the largest county in Wales. Powys is a very large rural county; much of its hospital provision is by small community hospitals. A recent report has been quite damning of the quality of care for patients admitted to these hospitals stating that they are inadequately staffed, cannot provide safe care and recommending that acute hospital care be transferred to local District General Hospitals. What on earth has this to do with Northern Ireland?

Actually a surprising amount:
The current model favoured by our Department of Health includes at least two hospitals which although offering slightly more services than the community hospitals and more out of hours consultant and junior doctor cover than the Powys hospitals are actually working to a similar system.

The new “Enhanced Local Hospitals” in Downpatrick and Omagh both have certain similarities to the Powys community hospital model.

Currently to maintain a hospital safely admitting acutely unwell patients it is recommended that one has on site acute medicine, acute surgery and anaesthetic cover as a minimum. As far as I can establish the new Downpatrick hospital only offers acute medicine yet it is proposed that it admit acutely unwell patients. The new Omagh hospital may not end up admitting acutely unwell patients but will have an “Urgent Treatment Centre” again without on site surgery and anaesthetics. Indeed Omagh council seems to be keen on increasing the numbers and complexity of the patients admitted to the new Omagh hospital.

As lamh dearg has noted here the problem is not the staff or the equipment; it is that the staff, no matter how competent, require a certain number of cases in order to keep up their skills and there will simply not be enough patients attending either of these hospitals to allow that to be possible.

In case anyone starts to complain that Downpatrick and Omagh are a long way away from the nearest other hospital: sit down with a map and see just how big Powys is and how far away these communities are from the nearest District General Hospital; yet their health care is best provided by acutely unwell patients travelling to these District General Hospitals.

With tedious predictability one local Assembly Member has already jumped on the save the hospitals bandwagon, much as they did prior to the last Welsh assembly elections; at the time halting Labour’s plans. In our case we could learn from these events and not have these two new hospitals but instead use the money to provide an adequate number of beds in the other hospitals so that these two hospitals can be closed and yet not reduce the total bed numbers. As in Powys I am sure that both the Tyrone County and Downe hospitals have provided excellent care for the last century; however, times have changed and with them health care has changed. Our politicians could show leadership, learn from the likes of Powys and talk seriously to the local populations about what would help to ensure optimal twenty first century health care. Sadly I have very little confidence that McGimpsey or for that matter any other local politicians will do this. As I have before said that is the Real Politick of Health and ironically it is the very people whose health care stands to be improved who will complain the loudest about the closure of these hospitals.

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