THERE is an important debate to be had about whether the UK's National Health Service local district hospitals with limited facilities but easy access should be phased out in favour of more distant centres of excellence. David Cameron's “bare-knuuckle fight” (why does he do this?) to maintain local services got off to a bad start yesterday when some of his facts about projected closures proved to be wrong. At the same time, however, he found unexpected help from a research report which showed that for some critical cases time spent in an ambulance adds to the risk of death; there is a direct correlation between the distance that emergency patients must travel to get treatment and increased risk of mortality. This research, although valuable, leaves a bigger question unanswered: how many people die in district hospitals because of the lack of top-level specialists and equipment that would be available at a larger hospital? Until we know the answer to that question the earlier research cannot be considered conclusive in this debate.

There are other arguments to be considered, of course. One is the inconvenience for families in visiting and caring for patients if they have to travel some distance to see them. The main concern about maintaining local facilities seems to be in respect of maternity services and emergency treatment for minor cases. If possible this debate should be conducted on medical facts not political point-scoring.


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