Judge backs Trust in A&E challenge

Judge backs Trust in A&E challenge

31 October 2012

A CASTLEWELLAN pensioner has failed in a High Court challenge to the closure of 24-hour accident and emergency services at the Downe Hospital.

John Duggan was seeking to judicially review the decision to stop night-time casualty care at the hospital. But a judge has rejected all arguments against the move, including claims that it was unreasonable and carried out without proper consultation.

Mr. Justice Treacy said in his view sufficient reasons in the public interest have been demonstrated to justify the course that has been adopted.

The accident and emergency unit was closed between 10pm and 8am from April 2011, less than two years after the new hospital opened in Downpatrick. GPs have since provided out-of-hours cover at the £64m Hospital.

Seventy five year-old Mr. Duggan, who regularly uses the hospital, brought the case with the backing of Down Council.

His lawyers claimed it was irrational to downgrade services so soon after the new hospital was built at huge public expense. They also alleged predetermination and apparent bias, unfairness, insufficient consultation and a lack of disclosure of an appraisal system used by the South Eastern Health and Social Care Trust.

The night-time closure was said to be necessary because of a shortage of middle-grade doctors. Counsel for the Department of Health insisted that the public was well informed of the reasons behind its preferred form of action.

It was argued that a full and proper process was carried out.

In his judgement Mr. Justice Treacy noted that problems with sustaining a 24-hour emergency service were apparent by 2007. The department was understaffed, with one consultant, one associate specialist and six middle grade doctors. A minimum of eight middle grade doctors was required.

He ruled that the public was made aware of the options under consideration, and the Trust’s preferred course. The judge found that resources or efficiency savings were not the reasons for change.

“On the contrary, the motivation for the new service was a UK-wide problem regarding the recruitment of middle grade doctors and the unsustainability of continual reliance upon locum doctors,” he said.

“I accept this was fully explained in the consultation paper and the consultation meetings.”

Arguments based on unreasonableness and a substantive legitimate expectation were also thrown out. “The reason for the change of service model is a change in the ability of the Trust to deliver the original service on a 24-hour basis in a safe and sustainable manner,” Mr Justice Treacy said.

“Emergency services will continue to be delivered from the new building. There is no question of facilities within the new building being redundant or unused. I reject the allegation of a waste of public monies.”