In message <[log in to unmask]>, John
Collis <[log in to unmask]> writes
>If you centralise in order to try and do more with less it will be a
>disaster.
>If a certain degree of centralisation is accompanied by increased investment
>then care could be improved.
>
>> Are you trying to tell those of us in out of town DGH's that we provide
>> a poor service?
>
>Not at all. But I think our service might get worse if we try to spread
>ourselves even more thinly than at present.
>
>--
>Andrew
>_______________________________________________________
>Andrew Hobart FRCS FFAEM
>Birmingham
>
I think we can all agree that a nasty cut may not need to go to a major
unit. However, I did not refer to major units alone. There are towns
that are small, but have A/E departments because of their location. My
home town of Hereford is a good example.
What is a problem is where cutbacks have been such that no provision
exists. I know of a plan that had been mooted to remove one unit from a
town that serves a reasonable chunk of Herts and Essex. This area once
had three departments (excessive provision). The plan would reduce the
provision to zero in that area with all patients going to units elswhere
in the two counties. Under those circumstances, the workload on the
remaining departments would become intolerable.
Our correspondent from Loughborough illustrates the problem very well.
Why should people travel for many miles (discouraged by Govt motoring
policy) to get their acute health problems sorted?
I think we should be spread more thinly and that there should be more of
us to provide services where people need us.
Centralisation of care reflects more on the empire-building desires of
allegedly Great Men than it does for provision of service to the end-
user.
--
S A Hughes SpR Newham (urban) & Harlow (decidedly rustic)
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