Has St Cross got a future in Rugby?
- August 25, 2010
- Articles, Cuts, Health, St. Cross
- 3 Comments
By Rob McNally
Rugby is a growing town with a population of 62,000 and plans to expand rapidly in the future. However, strategically most of Warwickshire’s frontline hospital provisions are becoming centred in the West and South of the county. This new proposal to downgrade emergency care would leave Coventry as the sole provider of A and E care for most of the Eastern and Northern Warwickshire. In comparison to other towns in the area Rugby has to put up with what is becoming a limited and rapidly diminishing NHS service.
Warwickshire NHS seems intent on reducing St Cross’ capabilities to ‘rump’ status; each year provisions are transferred to Coventry. In downgrading the A and E service for the second time in 3 years, Rugby residents may well be cruelly exposed, forced to travel long distances, incurring undue stress and expense. We will be left with at best little more than an ‘on call’ GP service that ends at 10 pm and at worst a 24-hour nurse run clinic. It is important that people in Rugby realise that what is happening is part of a long-term plan by Warwickshire NHS to make St. Cross little more than an enlarged GP surgery. Economies of scale and efficiency savings seem paramount in their thinking. The consultation process seems to be based upon percentage figures and statistical data for comparative usage. It seems to ignore what is actually best for some of the most vulnerable members of our community.
It is heartening to hear that our local MP Mr Pawsey is aghast at this situation and is organising a public meeting at Benn Hall, 9/9/2010 at 7pm. We have a Coalition government that believes in giving GPs and patients more power and providing localised services, so it will be interesting to see whether we receive the support of the relevant minister in this process. It is important that we attend this meeting and make our concerns heard and take a full part in the public consultation period before 6th October.
Finally, it is crucial that politicians from the Con-Dem government are held to account for what they promised and are now failing to deliver. It seems to me that to phase out local services whilst promoting spurious ideas such as the ‘Big Society’ and local accountability smacks of hypocrisy. The people of Rugby deserve better than this duplicity and certainly don’t require further cuts to our front line services on top of what is being proposed to schools and jobs locally.
Send emails of support directly to:
consultations@warwickshire.nhs.uk
Or for more information on how the consultation works:
http://www.warwickshire.nhs.uk/CmsDocuments/d7643772-b4f8-4f38-8727-aeddbfc12a9d.pdf
What do you want to keep the Rugby A&E for? You don’t appear to advance any argument, although I do see derogatory remarks about some alternatives (nurse led services, enhanced GP services) without any effort to explain why these cannot supply the service that Rugby residents might need.
Rugby has a population of just 62,000 yet you feel it needs a full A&E service. Well how about giving Bedworth one? The thing is, concentration of resources is to the advantage only of those people near the resource. The whole strategy of NHS thinking is to bring services closer to the populations they serve, and this necessarily means moving more complex care away, and evening out the core work so it is generally more accessible.
Part of my job is looking at health care provision and planning it, although I don’t cover Rugby at all, but I can tell you that 98% of the work in a casualty unit does not need to be in a casualty and in my view should not be there. The same people who provide this work could do it in smaller units closer to where the populations are, so why not move them?
I find it amazing that every rationalisation of hospital based care seems to be challenged on the grounds of quality, yet nobody (including Mr McNally) ever cites any evidence on quality, it is just a tired old regurgitation of trite and ill-informed attacks on other workers in health care.
I do not see what is wrong with a nurse-led service. In casualty, 80% of work is done by nurses, and almost all casualties (including Rugby) use nurse triage to determine those people who should see a doctor instead. Of all those who are deemed to require a doctor, only 10% need a hospital doctor, and most of them don’t need one that quickly; if they did, then they wouldn’t lie on trolleys or sit in chairs for 4 hours – the statistics for Coventry show that only 17% of casualty admissions are admitted within an hour, but if you attended a GP surgery and waited even 20 minutes you would be annoyed.
We need to get away from this system of travelling some distance to A&E departments with things that could be treated nearer to home, only to wait hours to be seen and sent away again, while those who really do need urgent care have it compromised by the 98% sitting around with their sniffles and cut fingers. What we need is a system of urgent care near to where people live, that can handle the immediate needs of those in serious trouble BEFORE sending them bouncing across the Warwickshire countryside in the back of an ambulance to the nearest serious injuries unit, cardiac care unit, or whatever it is they need. But we can’t do that if we keep pouring money into little half-casualties just because enough people live close enough to it to kick up a fuss.
Now if you can produce some evidence to show that well run primary care services (nurses, GPs or both) offer a worse service for the 98% to whom it totally applies, or even the 2% who need hospital care, then go ahead and make the point, but don’t expect me to support a campaign to save Rugby A&E without some decent evidence that it is worth it!
Mr Holton, The ‘alternative’ we are in favour of is the retention of services. Your post seems to be based on the assumption that the plans from UHCW might include moving Urgent Care services out so that it is nearer to where people live. In actuality, the proposals would reduce the service in Rugby, either by taking the doctors out, reducing the hours of availability or both.
It would not mean more at Bedworth, or a proliferation of small units close to where people live, but the concentration of services in Coventry, which seems to be counter to what you think should happen.
As for keeping people out of A&E who don’t need to be there, this was being done in part by NHS Direct, which the government has now revealed will be replaced by cut-price call centres.
Finally, there is nothing in the above article that is intended to be derogatory to NHS staff. Having spoken to people working at St Cross, the staff there are concerned about the implications. A nurse-led service can definitely provide good quality care for many people, but not to the same level as a consultant-led one.
Ken
What an interesting response, I am glad you’ve joined the debate to give us the alternative view. A healthy debate needs disagreement. Just to clarify my key arguments:
1. Size – Bedworth has an A and E which is 3 miles away in Nuneaton and another in Walsgrave which is within 8 miles. Bedworth is also less than half the size of Rugby. So Rugby’s distance from Coventry, it’s strategic location and future growth plans are relevant. Therefore I fail to understand your point about Rugby not deserving an A and E department based on its size and location.
2. Distance – Rugby’s elderly and vulnerable residents will find these proposals incredibly unsettling, these changes will put their health at risk and may mean they have to incurr expensive transport costs. This will be compounded by the abolition of NHS direct which currently leads to fewer people attending casualty with minor complaints. Unfortunately, many people need the security of these services and will feel cut adrift by what is proposed.
3. Economics – I am sure having one supersize hospital in Coventry that serves the whole of Warwickshire may have economic benefits, the statistics for this look great!. However, is this the right thing for people and communities in the county? I know you require proof, however the individual testimony I am recieving would highlight that St. Cross is a great local success and a dearly loved institution. In addition, could this consultation not have waited until the health paper had passed parliament and had bedded in? Nobody is quite sure of the impact of changes to GP workload and the impact to the health care provided locally, this is poor timing by Warwickshire NHS.
4. Nurses and Doctors – I agree that high quality local urgent care is a key aim. I also agree that urgent care is best delivered in partnership with both nurses and doctors working together. I am in no way criticising nurses, however a nurse only service would be a downgrading of care. Many GPs in Rugby also rely on St Cross’ Urgent care service as their our of hours service. Will all GP’s in Rugby now be offering an out of hours service?
It seems to me that the future of the NHS is not as clear cut as you predict. The local trust may well produce huge volumes of figures proving how much money can be saved. How can this be precise fact? I don’t think anybody can truly or accurately gage the impact of the proposed changes. In this environment, we should put on hold this consultation until the impact of the white paper becomes clear.
Finally, I am not a local busy body ‘kicking up fuss’ as you put it. But a local organiser, who cares about the society we live in. Raw stats and financial measures are fantastic as tools for managers, plannners and economists. However on their own they are just cold figures on a sheet of paper. The elderly and other vulnerable people in Rugby will not appreciate this when they are boarding Taxi’s to Coventry at 3 in the morning, just to make your figures add up. People should take an interest in local issues and should also become involved in our campaign to save the services at St Cross. We must continue to fight these changes, as this Con-Dem government attacks the NHS and goes back on so many of it’s manifesto promises. Only the Labour party in Rugby can stand up to this attack and protect the frontline services that are now under fire.
Thanks
Rob McNally