The first post I ever did on slugger was on the number of hospitals in Northern Ireland. The latest news regarding the closure of the Mid Ulster’s A+E department along with Whiteabbey’s A+E and in patient cardiology are part of the gradual process of downgrading the smaller hospitals. This is seen as medically necessary as in the era of increasing medical specialisation it is no longer possible to have safe services in small hospitals without all the necessary specialities. Simply put so much more can now be done for people that doctors, nurses and others cannot be sufficiently competent at the whole range of treatments, procedures etc. It is not possible to have all the necessary specialities in a small hospital partly due to cost constraints but possibly more importantly because the specialist doctors, nurses, professions allied to medicine etc. would not get enough throughput of patients requiring their own specialist skills to maintain those skills. Hence, even if it were possible to provide all specialities in a small hospital those very specialities and specialists would rapidly become de skilled.
The simple fact is that apart from the “Gold Six” of the Royal, City, Ulster, Craigavon, Antrim and Altnagelvin, none of the other hospitals are completely safe in the longer term. Indeed many suspect the Belfast City Hospital’s A+E department will eventually be downgraded. The simple reality is that changes in hospital provision have gone on for years and rationalisation is long overdue. However, the fashion in which this has been done with the hospitals given two weeks to close and reorganise is scarcely believable. This will undoubtedly cause considerable problems especially in this case at Antrim Area Hospital. Clearly a longer run in time to this decision would have been more appropriate and had Antrim been provided with additional bed spaces prior to the closure of the Mid Ulster and Whiteabbey it would have been much more satisfactory.
The overall long term decision was actually made clear a number of years ago and of course local politicians all complained bitterly about it. In reality it is most unlikely that local politicians would have ever been willing to accept the gradual phased closure of the local hospitals even had it been done only when the larger hospital was prepared. Politicians of all parties find it much easier to pretend that every hospital and every service should be kept open no matter what and then when a decision is forced by external circumstances complain loudly about it. This decision looks hasty and inadequately prepared: however, when would local politicians ever have supported the closure or downgrading of a local hospital or service?