The first example of consolidation of hospital services has now occurred with the reduction in the opening hours of Lagan Valley’s A+E department. This has produced some comment from the local council but possibly a more measured reaction than might have been expected. The Belfast Telegraph has a typically hysterical headline (not on line) about a bleeding woman sent away from A+E – later discovered to be a lady with a cut finger who was sent to the Royal for an X ray and stitches.
There might be an issue about supporting a minor injuries unit in Lisburn but the reality is that it is not possible to provide state of the art health care in the very large number of hospitals which Northern Ireland has. Consolidation has been proposed for years with suggestions of 5-6 acute units and the other hospitals providing out patients, rehab etc. This model was recently suggested by the BMA and is in part driven by the need to ensure adequate specialisation to deliver the best outcomes for patients. To quote the NI GP Committee chairman Dr Brian Dunn (from the News Letter):
Dr Dunn said while he understands communities may feel “a loss of pride” with the closure of a hospital, the need to provide patients with “modern medicine” in a unit that is not “plagued by staffing difficulties” outweighs those concerns.
He suggested cutting the number of acute care hospitals from 15 to “four, five or six”, which would offer “good specialist treatment”.
Those remaining would not be closed, but rather used for follow-up care.
Dr Dunn added: “You would be treated in acute hospitals then you would go off and are rehabilitated in your local hospital, which would be more convenient for the patient and their families – and it saves money.”
In addition the numbers of junior doctors in training and the need to provide them with adequate modern training and supervision is a major driver of change.
One thing which is particularly noteworthy is that Edwin Poots has allowed the first reconfiguration to occur to a hospital in his own constituency. Previously, rightly or wrongly, both Bairbre de Brún and Michael McGimpsey were unwilling to make any changes which reduced provision in their own constituencies. Poots, on the other hand seems willing to make the necessary decisions even if they are politically unpopular. If he carries on like this he may be able to radically improve the NI NHS which has amongst the worst waiting lists in the UK and in addition save money. If he can manage this he will be seen as a most effective minister and may in the future be seen as the man who helped modernise our health service.