‘THE idea that acute district general hospitals ( DGHs) can be run safely without acute surgical cover, a proper intensive care unit (ITU) and paediatrics, is very dangerous,’ consultant surgeon Anna Athow told News Line yesterday.
She added: ‘The DoH is determined to push ahead with the “reconfiguration” of up to 60 DGHs. In many cases, they plan to remove the accident and emergency (A&E) department, paediatrics and maternity, leaving a “cold site” for elective work only which can be privatised.
‘For other DGHs, the plan is to leave an A&E department, but to strip away acute surgery, ITU, and paediatrics. It is life threatening to do this.’
Athow was responding to a discussion document produced jointly by the British Association of Emergency Medicine (BAEM) and the College of Emergency Medicine (CEM) which warns that patients’ lives will be put at risk by the government’s planned A&E ‘reconfigurations’
The two professional bodies, who represent A&E doctors, warn against what they consider dangerous plans to downgrade district general hospitals which will result in casualty departments operating without vital hospital services such as intensive care, paediatrics and surgery.
Casualty department doctors fear they will face a harsh choice between carrying out operations for which they are not trained and simply leaving patients to die.
The joint document states: ‘Increasingly, doctors will be faced with an extremely ill or injured patient and have a stark choice of letting the patient deteriorate and die, or performing a procedure that is not part of their everyday practice.’
The emergency professionals’ document calls on the NHS to support doctors who find themselves facing prosecution if they make errors simply because they are put in a unsuitable situation where mistakes are more likely.
The paper has been produced in response to plans by the Department of Health to ‘reconfigure’ over 60 district general hospitals over the next few months.
Under the new system of acute hospital care, patients in need of urgent care would go to one of five types of centre, depending on how seriously ill they were.
District general hospitals are to be downgraded to become emergency hospitals offering A&E services, but without having supporting intensive care units, surgery or paediatric care.
The Royal College of Paediatrics and Child Health and the Royal College of Surgeons have warned that hospitals with an A&E but no surgery could struggle to keep enough specialist intensive care doctors and nurses on their books to support patients who suddenly fall critically ill.
BAEM president Martin Shalley, an A&E consultant at Heartlands Hospital, Birmingham, said his greatest fear was for parents who drove sick children to their local A&E, only to find that it lacked the skills and equipment of an expert in intensive care to deal with meningitis, for example.
Athow continued: ‘Providing consultant cover on a regional network cannot substitute for having junior doctors training in these specialties on site, to provide immediate care, with consultants in those teams, familiar with that hospital, available at short notice.
‘The professional organisation of the emergency specialties must be completely supported in opposing these schemes.
‘This means that the BMA must jettison it’s policy of half hearted resistance to DGH “reconfiguration” and start to fight it properly.
‘The whole trade union movement must be mobilised to defend DGHs as fully comprehensive units with surgery, ITU, paediatrics and properly supported A&Es.
‘We have to accelerate the building of Councils of Action to take direct action to ensure our DGHs are kept open.’
A UNISON spokeswoman responded saying: ‘You need to make sure you have facilities in place before going ahead with major changes in important services like A&E.
‘There has to be major trialling before going ahead; you can’t just go ahead with wholesale closures.
‘There have to be trials and at the end of the day, if it’s not appropriate, and it may even lead to people dying, it may mean the reforms should not go ahead.
‘The government needs to think again.
‘Most people want a local A&E with proper facilities close to home so that in an emergency they do not have to travel miles to another place, where delays could mean their lives being put at risk.’
• Second new story
BRITISH SAILORS AND SOLDIERS FACE PROSECUTION
British officials were yesterday still waiting to be granted access to, or to know where fifteen UK sailors and marines are being held by the Iranian government, two days after their capture.
Iranian Foreign Ministry spokesman Mohammed Ali Hosseini said in a statement that the British forces were engaged in ‘illegal and suspicious activities’ and face prosecution.
He said that ‘documents and evidence’ exist that show the British military personnel, who include one woman, had consciously entered into Iranian waters.
Iranian armed forces spokesman Gen Ali Reza Afshar told the Iranian media on Saturday that the fifteen British personnel were being interrogated, but were in good health.
The British embassy in Tehran said a meeting in the Iranian capital between Iranian government officials and the UK ambassador had not advanced the return of the arrested eight sailors and seven marines.
The British embassy said ambassador Geoffrey Adams asked to know the whereabouts of the personnel and for consular access, but this was not forthcoming.
The embassy said it had sought yesterday’s meeting to demand the release of the sailors.
However, Iranian TV said the Iranian foreign ministry had summoned the ambassador, to receive a protest about British actions.
Germany, which holds the EU presidency, on Saturday called for the immediate release of the Britons.
This was on the eve of the unanimous vote on the UN Security Council in favour of further sanctions against Iran for its refusal to suspend its nuclear enrichment programme.