And finally, my Downe wish list

And finally, my Downe wish list

26 February 2014

THE current cross-community, non-party political campaign to save accident and emergency provision at the Downe Hospital must succeed if we are to retain the hospital envisaged as meeting the needs of the community just five years ago when the Downe — the people’s hospital — was built.

The “temporary” change to A&E provision, which few in the community expect to be anything other than permanent, is a massive blow with serious short, medium and long term consequences.

Down District and its environs need the enhanced local hospital envisaged when the new Downe Hospital was planned and built. That enhanced local hospital was to contain a 24-hour, type two, accident and emergency unit and a coronary care unit.

The decision of the South Eastern Trust to choose to allocate resources to Belfast’s Ulster Hospital, rather than to the Downe and Lagan Valley hospitals, was a cruel blow to our local community delivered in Christmas week.

Defects in the training system and workforce planning for the extremely highly paid employees, which is what these emergency department doctors and consultants are, were not the responsibility of the people of the Downe and Lagan Valley catchment areas, yet we pay the price as the rural citizen is treated as second class, whilst yet more resources are pumped into Belfast.

Forty one per cent of the accident and emergency attendances at the Ulster Hospital last year were from residents of the Belfast Trust area. The appropriateness of the health trust boundaries thus comes under the political spotlight.

Eighteen years ago, a polyclinic was proposed for the people of Down and rejected as being simply inadequate. The spectre of the polyclinic it seems, is returning to haunt us as salami slicing of services and bed numbers continues to undermine the Downe.

The Downe may be a wonderful, convenient setting for GP surgeries but, if it was intended to locate these surgeries at the Downe, then there should have been a new build to facilitate them.

Health Minister Poots is undoubtedly committed to the future of the Downe and Lagan Valley hospitals, a future with 24-hour accident and emergency services. Surely, the Minister must be in a position to instruct public servants to deliver what he requires.

The almost weekly crises that seem to occur in hospital services across all of the country and these islands are a sad reflection on the cuts and reform and modernisation agenda that have been pursued for 30 years. Yet we still travel down the same road. Is that reasonable?

Taking the specific example of the Downe Hospital. Is it sensible to build a £65m hospital and then not be able to maintain essential services in it? This must surely raise many questions about planning and strategy.

When the people’s hospital was built and subsequently, we have continued to support all investment in the Downe that would help to sustain it as an enhanced local hospital for generations to come.

When we were forced two years ago to accept a reduction in our accident emergency services, we were told that the new GP supported service would be sustainable in the long term, an “exemplar” that others would wish to follow. Recent events have proven, as we had feared it would transpire, that this was not the case.

The most recent proposal to deliver a minor injuries unit, supported by GPs is not one that can deliver, in our opinion, a long-term sustainable solution to meet the needs of the community. Assurances to the contrary will fall on deaf ears.

There is absolutely no guarantee that a permanent GP out-of-hours base will be available at the Downe in the medium to long term.

The North Down nurse-led minor injuries unit had its working hours severely curtailed at the end of November due to staff shortages.

We do not consider, therefore, that convincing arguments can be advanced to support the development of such a facility at the Downe.

Perhaps it is the case that a fundamental restructuring of accident and emergency services is required for the Greater Belfast area, with one centre of excellence at the Royal dealing with chronic trauma and injuries and large minor injuries units at the Ulster Hospital, the Royal and City hospitals where nurse practitioners could deal with a great number of the cases that would then present at those hospitals.

That change would require, of course, a large investment in the ambulance service to enable it to develop its capacity.

Local hospitals like the Downe, Lagan Valley and Daisy Hill could then continue to offer 24-hour doctor-led, consultant supported accident and emergency, as is entirely appropriate.

The current situation, theoretically temporary, is not acceptable. The ultimate future of the Downe Hospital requires our community to fight for the defence of existing services and that it will most certainly do; 7200 Facebook “likes” and thousands of petition signatures are testament to that.

The Downe Hospital remains open for business and enjoys the confidence and support of a grateful local community all across South and East Down. We will never weaken in the resolve to defend it.

If any of us, as citizens, as taxpayers, are asked to travel elsewhere for treatment or diagnosis, we must ask why that is the case? We must ask if those services cannot be delivered locally. We must demand investment in services at our hospital.

Future generations are entitled to expect nothing less.