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It's time to halt downgrade of our casualty centres

It's time to halt downgrade of our casualty centres, says MP as he comes out in support of Mail campaign. This weekend the Mail On Sunday published Nick de Bois's opinion.

Root of the problem: Nick de Bois says the NHS is driving people to A&E departments when they do not need emergency treatment

It seems to have become an article of faith among most of the medical profession that some A&Es need to be downgraded and resources concentrated on fewer, larger centres of excellence.

Yet the public remains to be convinced –  and for good reason.

When ‘reconfiguration’ plans are published, they are often met with vocal opposition from those living  in the area.

These people are not irrationally objecting to change, they have real fears over what might happen to them in an emergency and suspect that changes are sometimes driven by financial – rather than purely clinical – reasons.

Indeed, in my constituency of Enfield North we have campaigned to prevent the downgrading of Chase Farm Hospital’s A&E unit to an Urgent Care Centre under plans drawn up in 2005.

Is it any wonder why? Following a catalogue of poor consultations and moving goalposts, it finally emerged that financial pressures, more than clinical arguments,  were driving the changes: two nearby hospitals were being squeezed by dreadful private finance initiatives (PFIs).

Last week the NHS Confederation and Academy of Royal Colleges released a report arguing that up to 20 hospitals would have to close to keep the NHS sustainable.

They believe the money saved should be reinvested in primary care, such as GPs’ surgeries, district nurses and social care, to stop so many people ending up in hospital in the first place.

But the medical profession needs to work much, much harder at explaining this to the public they serve.

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As it is, more than 30,000 people have written to The Mail on Sunday over the past year backing its commendable campaign to Stop the Casualty Closures.

With obvious pressure on A&E departments, people are baffled about why both the Government and Opposition want to downgrade local units.

Some half a million more people are attending A&E units than five years ago. Given such an increase it is inevitable, as we have recently seen, that some NHS trusts are not meeting their waiting time targets. 

Fighting to keep units open: Nick de Bois (left) with David Cameron (centre) in 2007 campaigning to keep his constituency's A&E department open

Stop the closures: Nick de Bois says the Government should stiop downgrading A&E units. He has fought to keep Enfield's Chase Farm Hospital open (pictured)

In fact, some trusts have gone as far as to warn that casualty departments could reach critical levels with another tough winter.

I do not subscribe to that theory, as I believe there are many talented and dedicated staff working hard to ensure that  A&E departments will not let patients down. 

Nonetheless, it is clear that urgent action is still required.

The increasing pressures being placed on some A&E departments can be linked to a number of factors, but many of them have one common thread: too many people are arriving at A&E departments when they do not need emergency treatment.

This isn’t the fault of patients. It’s because the NHS is inadvertently driving them there. 

Health Minister Dr Dan Poulter has acknowledged as much, saying: ‘We’ve got to start thinking about how we stop people who didn’t need to be in hospital arriving there.’

If thinking still remains to be done and solutions need to be found, surely it is only right that the downgrading of A&Es should halt until the alternatives are actually in place.

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