Less than three weeks since the last health consultation, here we are again, following another huge public meeting, making the same basic points about the need for people in our rural area to have fair access to emergency and critical services.
The Western Health and Social Care Trust has been carrying out a consultation on its “Savings Plan” and the deadline for responses is tomorrow (Thursday 5th October). Please make sure that your voice is heard by emailing email@example.com
This is what I have said:
In response to the above consultation, my personal view is that the Trust should:
1. Extend the consultation deadline and publish its notes from the meeting on 2nd October
As the Trust has acknowledged, the arrangements made for the advertised public meeting on 28th September were grossly inadequate and led to that meeting’s being cancelled and rescheduled for the evening of Monday 2nd October. At that rescheduled meeting many vital and detailed points were made by Trust staff, service users and members of the public. In order for people to formulate full and informed responses to the consultation process they need access to the written records of the meeting, in a format which allows for clarification, amplification and rectification of any errors on the record. They also require a reasonable length of time to consider the issues raised, to seek further information where necessary, and to write their responses.
2. Decline to make any cuts during the present situation of political and financial uncertainty
We currently have no Health Minister, no Northern Ireland Executive and no functioning Assembly. What is more, there are huge uncertainties surrounding any distribution of funds in an October monitoring round, the considerable monies promised under the Conservative/DUP agreement and the latest reports that, on the contrary, further severe cuts will be made. In these extraordinary circumstances, there is strong justification for the Trust to decline to make any cuts within the timescale demanded by the Department. For the Trust to carry out its responsibilities to the people it is supposed to serve, it must demonstrate long-term planning, evidence-based decisions and wise medical and financial management. The making of hasty changes to meet arbitrary requirements shows none of these, and should be resisted. The meeting on Monday demonstrated that the public, to whom the Trust is primarily accountable, is firmly in favour of this position.
3. Ensure that any cuts impact only on those able to bear the burden
If the Trust considers itself unable to take the position set out in (2) above, it should explore cost-saving measures that would not affect the provision of services to the public or the wellbeing of frontline and junior staff. These should include the temporary or permanent restructuring of payments made under the Private Finance Initiative in relation to the South West Acute Hospital. It might also be appropriate to consider the levels of remuneration being provided to senior personnel within the Trust. The Trust’s obligations to its service users must be given priority over its financial arrangements with corporate entities, the extent of which arrangements were neither known of nor consented to by those service users. Similarly, those who take the decision to make arbitrary cuts must themselves be prepared to share their consequences.
4. Consider the full effects of any cuts imposed
Many of the measures proposed as ‘cost-saving’ have serious consequential effects both financially and, more importantly, upon the health and wellbeing of the service users and staff affected. For example, the withdrawal of the right to carry leave entitlement forward would result in considerable numbers of staff taking their holidays at the same time, leading to increased risks for patients and additional costs for extra cover. Meanwhile other members of staff would fail to take the leave to which they are entitled, with damaging effects upon their own health and morale. Further delays to elective surgery would inevitably result in the deterioration of the health of those on long waiting lists, causing them personal suffering and the need for more complex and expensive treatment and care. The reduction in the number of care packages for those in need would not remove that need, but leave it either unmet, with serious, possibly tragic consequences, or met by ‘bedblocking’ hospital care at a much greater financial cost to the Trust.
5. Secure the future of the South West Acute Hospital’s neonatal unit
Of all the proposals made by the Trust, that to ‘reform’ neonatal care at SWAH has rightly attracted the greatest concern and condemnation. As was so clearly explained by doctors and nurses at the public meeting, the proposal would be disastrous to the lives and futures of newborn babies and their families. The specialist neonatal transport team, based in Belfast, is already struggling to cope adequately with the demand for its services. With all the goodwill in the world, the physical constraints of time and space prevent an ambulance from being simultaneously in both Dublin and Enniskillen. It is impossible to predict when a baby will be born prematurely, when she or he will require emergency care immediately after birth or become seriously sick during those critical first hours and days. Mothers and newborn babies need to be close together in the first days and weeks, to nurture their bonds of love, to sustain their psychological health and to support the establishment of breastfeeding, Northern Ireland’s rates of which are already the lowest in Western Europe. For all these reasons it is vital that neonatal services are available close at hand. And as was warned, the closure of SWAH’s neonatal unit would ultimately lead to the closure of its maternity unit, with thousands of women having to travel unconscionable distances to give birth, at great cost to themselves, their families and their new babies. For the sake of all babies, and especially those in direct need of its lifesaving service, we must keep the neonatal unit at the South West Acute Hospital.
I am happy for you to contact me by email in relation to any aspect of this response.