If a member of my family had a heart attack today I would want them seen in a casualty department as soon as possible. However, not in any old casualty department. I would want him or her to be reviewed by a cardiologist who had 24 hour access to angiography facilities. The reality in today’s NHS is that, that level of care is not available to the majority of Britons. This is despite the massive increase in NHS funding which has taken place over the last seven years. How can this be?
Today, the Prime Minister announced plans to provide more units with the appropriate cardiological facilities. However, to do this he also indicated that casualty department numbers will have to go down. And that’s the political rub. Try selling to the average voter the idea that closing his local casualty department will benefit his health. Not an easy sell and certainly electorally disastrous. And that is why I am suspicious that departmental closures will most likely follow a particular political pattern.
I am in favour of properly staffed A&E departments. I would support the creation of these departments outlined by the Prime Minister if they were introduced with a fleet of helicopters. In heart terms, time is muscle. The length of time from onset of chest pain to diagnosis and administration of appropriate therapy determines morbidity and mortality, i.e. getting stuck in traffic could kill you. If the Labour government is proposing the closure of casualty departments, the money must be there to fund helicopter provision.
This announcement is yet another example of why health-care delivery in this country should be depoliticised and localised. It is impossible for any political party, of whatever colour, to make the changes to the health service consistent with the clinical demands of 21st Century health-care. Furthermore, local people want locally-based services. Health policy should be about breaking up monopolies, passing more responsibility to communities and individuals, and removing politicians from the week-to-week management of the service. This announcement is yet another example of why the present NHS will never be what we all want it to be.
