According to David Cameron, he and the Conservatives must save us all from the Hospital cuts taking place all over the country. It is true that reviews are taking place everywhere to examine how health services should look in the future and it is highly likely that those involved in making the decisions will not make friends in every area but is every review actually going to constitute a cut? Most towns in the UK appear to have some kind of hospital service along with smaller intermediate care and primary care services. Most of those hospitals have traditionally tried to deliver all services to local people on all sites, including accident and emergency, surgery, medicine and paediatrics. In the last 15 years the hospitals have become NHS Trusts and then have merged together so that each ‘trust’ may now have 2 or more hospitals, often providing identical services a few miles apart. This has made it difficult to develop services which are of sufficient size, able to deliver the kind of technology 21st century health care demands and to recruit and adequately train and supervise its staff. While the NHS deficits are often thought to be both recent and due to mismanagement by managers, they tend to date back years if not more than a decade, and during a time of almost continuous change.

In our area, where I both live and work, the three hospitals are now part of one trust. One hospital, badly built in the 60s is falling down and in other parts of the area there is no ready access to acute hospital facilities.  The people in the whole area deserve a better deal, but how many accident and emergency nurses can be provided and indeed need to be provided? About 2 years ago I spent an afternoon in our local A&E awaiting an xray on an ankle that was painful but turned out to be sprained. I was not the only person that day who could have been seen in a locally based minor injuries / urgent care centre freeing up the A&E department for those most seriously ill or injured.

There are plans now to have just one large accident / trauma centre and several smaller centres where people can go for less serious problems. There are plans to merge the maternity units (actually run as one department currently but on two sites). No less babies will be born, but a brand new unit will be built which is better able to cope with the way in which women can and should deliver their babies in 2007. Perhaps these moves will make changes, perhaps if you currently live next to the unit that will close and in future will need to travel 12 miles you will consider this a cut. But I am not sure we can assume it is. This is a political issue with a little p, I would actually prefer it if local people could give their views on the changes without David Cameron muscling in and making it into some kind of pre-election vote winner.