Belfast City Hospital A&E Closure

In opposing our campaign not to move the Belfast City Hospital A&E department to the Royal Victoria Hospital a lot has been said about rural areas having to travel many miles to get to their nearest hospital and yet they cope.  Or do they??  How often will the Trusts admit that had the hospital been nearer, the patient could have been saved??  This sort of honesty is lacking in Trusts all over the UK, not just here.

 

When the Trusts began to make cuts, the first services that were removed were those from rural areas, and we believed them when they said it was the best decision, as after all they are the “experts”.  However, having seen these changes in place,  we have now seen that this does not work on many levels.  We do not have the best road system in this country and even the South have overtaken us in their quality of roads.  It has been quoted that many people travel a return journey of as much 100 miles or more to visit a hospital, whether it be for an emergency, an appointment or visiting a hospitalised relative or friend.  Because this is already happening in some areas does not make it right.  Indeed we would go further and say that it is wrong on many levels.  Firstly Northern Ireland per capita has 30% less cars than those on the mainland.  Our transport system, if compared with that of the mainland UK, is almost a part time service, as UK mainland transport system runs 24 hours a day, whereas ours runs until approx 11pm.  There is a higher concentration of population within the city as compared to the rural areas, again this does not mean that the rural areas should have less of a service, but the availability of services should be greater in a higher populated area.

 

We have the various departments who are pushing for investment in the province.  They are pushing for more visitors to the province.  Indeed many advertising campaigns are run, pushing the idea of Belfast as being the city to fly into to visit our many attractions.  We are struggling to cope with the residents of the city’s requirements for emergency health without adding to that the availability of a service for visitors.  One could be forgiven for thinking that the departments within Stormont do not actually speak to each and run off in their own direction instead of having a “joined up” service.

 

They are forever telling us that this works on the mainland and that works on the mainland, BUT this is not the mainland.  They do not have our history, and why should we be chasing a model that cannot be held up as being totally flawless??  What is wrong with being innovative and creating a system of our own, tailored to the needs or the people of this country??

The Elephant in the Room Belfast City A&E Closure

In so many interviews we are often asked, surely it would be better to have one  specialised A&E in Belfast as compared to three?  The simple answer to this would be “yes” …… however we cannot stop there, as Belfast cannot be compared to anywhere else on the mainland.  No other part of the mainland has the same history that we have.  Segregation is as strong to day as it has ever been and each area lays claim on their services and marks them as “their own”.  As obscure as it may seem, many people have a fear of entering areas that are “not their own”, they feel in a minority, they are not familiar with the area, they feel uneasy with emblems that mark each area’s individuality and to those who grew up during the troubles, were indoctrinated to stay within their own areas where they would feel safe.  I am not saying that this thinking is normal, far from it!!  However this is the reality of Belfast and many other parts of Northern Ireland.  Community groups and other forums down through the years, have received billions of funding from many sources including the EU, and they are trying extremely hard to break down these barriers and with total respect, they are very successful in what they do, but trouble can break out so easily, and frustratingly it is very often the case of 1 step forward and 2 steps back for these workers and their efforts.  There will always be an ever watchful suspicion of one group against the other.  There is a constant tally of who gets what, how many of each of the religions are arrested, how did they get the funding for that? and so it continues. To withdraw services in an area, is seen as an attack on the people in that area.  Sound ridiculous? Yes perhaps it does ….. but over 40 years of bloody history, abductions, shootings, murders, bombings leaves this legacy.  Belfast is a maze of little streets, where navigation is second nature to the local residents, but put a stranger who perhaps only lives a mile away, into this same area, and throw a bomb scare into the mix, and there becomes, confusion and fear.

 

The Belfast Trust, appear to be oblivious to all of this history.  They wish to push through a plan which years of effort from community groups and funding cannot achieve and send people into an area that they are not comfortable with.  Add to this fear and discomfort the worry of a friend or relative within the A&E, and it is a mix which can only be rivaled with a semtex mix!!

 

To the Health Minister and the members of the Trust, I invite you to go into the area and get down amongst the grass roots and listen to the people, the end users of the system …… the people who own this system.

Save the Belfast City Hospital A&E

We often are asked surely it is better to have one specialised A&E unit instead of 3 spread over a few miles. We would say yes this is true. We have already covered the area of segregation, but now we shall cover the past history of the trust in amalgmating services within the trust.

First of all we had the transfer of the Jubilee Maternity Hospital within the Belfast City Hospital to the Royal Victoria Hospital and the renaming of the Royal Jubilee Maternity. The residents fought this, but Barbara De Bruin steam rollered this through promising that the delivery of maternity services “would be all, singing all dancing” bringing together the best practices from both Maternity hospitals. Sadly this has not been the case. It must be pointed out that this does not reflect on the staff at all who do their very best of working within a flawed system.

Visit any ante natal clinic on any day within this unit and you will see the waiting rooms bulging with expectant mothers, and partners, and/or their families all fighting for seats. The staff’s job is to keep the system running efficiently and have very little time for the personal touch. Everyone is aware of the need to clear the day’s patients as quickly as possible, so emphasis in on the minimum time to be spent on each patient, so that all the patients can be seen. It has now become a unit of quantity versus quality.

Whilst bringing together the 2 units, into one unit, the capacity of beds available was cut. It is now often the case that an expectant Mother in the first stages of labour who arrives at the hospital is examined and assessed and if birth is not imminent within the next couple of hours, they are sent home with instructions of when to return. This is not because the staff do not care, it is because they simply do not have the beds to admit the mothers and take the time to reassure and monitor, instead the task is handed back to the mother, with support from partner and family. When all criteria have been met and the mother has been admitted, with a normal birth, it is common for a mother to give birth and be discharged back home within 4 hours. The follow up is done by a community midwife, who will carry out checks in her half hour visit for the folowing 5 days. The Midwives are charged with carrying out a certain number of clients in a day, and very often the little touches of showing the best way to bathe the baby, feeding techniques etc and addressed in a very short time with reliance put upon the Grandmother or other members of the family to advise, and whilst in the majority of cases, it might work, having children yourself does not qualify you as a child expert. We have accepted this, and got on with it, but it does not mean that we are happy with the service, but who can we vent our frustration at? Certainly not the midwives who do a sterling job, the people who we need to vent to, are our officials who keep their distance from the very patients that are forced to use this flawed system.

Recently we also saw the transfer of the Fracture Clinic in the Belfast City Hospital once again to the Royal Victoria Hospital, with the promise that it would be a specialised service in one central unit. However recent statistics have proved that this too has failed. Government targets require Fracture Services to operate on 95% of fracture patients within 48 hours of decision to operate yet the Royal Victoria Hospital’s average is 50% – almost half of the government target. So the amalgamation of the fracture departments has not delivered the specialised service in one unit as promised.

Bearing all this in mind, how can we believe them when they say that an emergency frontline service will be specialised in one central unit? Their history to date does not instil confidence, in their “trust me” policy, we are the officials who know best.