Down Community Health Committee members meet to discuss local health issues
At a meeting in Denvir’s Hotel on Wednesday 14th September 2022, members gathered to discuss some of the pressing health issues facing residents in the east Down area writes Jim Masson.
The discussion started off with chairman Eamonn McGrady citing a report in the Social Science and Medicine Journal which supported the idea that the smaller hospitals (under 400 beds) made a valuable contribution to health care challenging the myth of the centralisation of all services into centres of excellence mostly in urban areas.
Mr McGrady said: “The research conducted on English hospitals is valid here in our area. The report conclusion is that: ‘small hospitals, with fewer than 400 beds, are generally not associated with lower quality before or after controlling for hospital characteristics. The only exception is heart attack mortality, which is generally higher in small hospitals.’
“And the report clearly states that: ‘Low quality of services by small hospitals is a key argument to justify the closure of a small hospital, despite the accessibility costs that this implies… Closure of small hospitals will also have equity implications if patients have to travel long distances and have poorer access to care.’
“We will send this report to members of the Stormont Health Committee when it is formed and to relevant officials and politicians.”
Cllr Dermot Curran raised the question about the effect of centralisation and how it impacts on the Downe Hospital.
Mr McGrady explained that “60-70% of people go to the ED and have significant issues. In the old Downe Hospital, the general consultants managed to keep the system going. They were good for most conditions. The current Health Minister may not be in post much longer to consider these issues if the Assembly is not formed so we need to inform the relevant people.”
The discussion moved to the topic of consultants in the NHS health care setting. Mr McGrady said that in a letter from the South Eastern HSC Trust, it was clarified that consultants have job defined plans.
Cllr John Trainor felt, in addressing the problem of getting consultants to work in the Downe Hospital, that they were focussed on progressing and gaining experience in their own fields. He added: “But the main problem with the health service is the allocation of funding. Many MLA’s focus on parochial issues but the real problem is the level of funding that comes from London for our health service.”
Patrick Brown MLA expressed his concerns about centralisation and the role of consultants and asked if there was an argument against safe practice in health care being undermined.
Mr McGrady said that the stroke service was significant in that urban centres are well served but in rural districts, poor road infrastucture, lack of investment, longer waiting times in urban EDs, and an increasing rural population, were a key issues in getting equitable health care.
He added: “Our community has lost the expectation that an ambulance wil arrive in good time. Centralisation has just gone too far. It is very frustrating.
“One of the key points from the latest Department of Health Statistics on Emergency Care (2021/22) indicates that “During the last five years, the number of ED attendances (new and unplanned reviews) decreased by 71,204 (9%) from 794,154 in 2017/18 to 722,950 in 2021/22.”
The report also says that:
- gp referrals to EDs decrease from 17% in 2017/18 to 15% in 2021/22.
- the over 65s are 4 times more likely to attend an ED than someone under 15.
- there has been a 15% increase in seriously ill patients attend EDs in 2021.22 compare dto 2017/18.
- fewer patients have also been brought to Type 1 ED by ambulance in 2020/21 (127560) than in 2017/18 (137,018. )
(Type 1 ED – A consultant-led service with designated accommodation for the reception of emergency care patients, providing both emergency medicine and emergency surgical services 24 hours a day.)
Mr McGrady also presented information received from the South Eastern HSC Trust through a Freedom of Information request on people attending the Ulster ED not living within the Trust area.
“It is an inconvenient truth for the Trust that there were an amazing 37, 316 attendances to the ED at the Ulster Hospital for people outwith the Trust area. This puts pressure on the Trust services which prevents services being properly delivered elsewhere.
“Put simply, this means that there are around 700 attendances to the Ulster ED each week for people living outside the Trust area. Surely this resource could be used to keep the Downe A&E open 24/7?”.
Mr McGrady also said that the DCHC has sent a letter to Roisin Counlter, South Eastern HSC Trust Chief Executive asking if the hours for the Urgent Care Centre could be extended.
He said: “The response to the request for an 8am to 8pm service from the Chief Executive was that there was at present a shortage of medical staff but the Trust would make the effort to find the suitable qualified staff.” But there is as yet no indication of an increase in opening hours at the Urgent Care Centre at the Downe Hospital.
A discussion on the need for a MRI scanner at the Downe Hospital then followed.
There was also a discussion about the contribution of the Health Committee on Newry Mourne and Down District Council. Patrick Brown MLA, a former Rowallene Councillor said: “I think the councillors and even the MLAs support improving services at the Downe Hospital. However, council management needs to challenge the Trust more on key health issues.”
The last item discussed was the need to engage with younger people on issues of health care and Eamonn McGrady suggested running a few competitions through local schools to engage pupils and their families.
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If you would like to attend the open meetings of the Down Community Health Committee, you are welcome to attend to the October meeting. Date and time will be posted nearer the event.
