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.
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