I want to speak about the future of Whiteabbey Hospital, although Rev William McCrea has already dealt with some of the broad issues, because the hospital to which he referred falls under the same health and social services board as Whiteabbey Hospital.
One of the issues for many people in the North Belfast, Newtownabbey and south-east Antrim areas is that while more than 50,000 people signed a petition at the start of the year outlining their opposition to some of the board’s proposals, there does not seem to have been as much attention paid to that as to other hospitals. That is why I am taking the opportunity to raise this matter.
I want to appeal to the Minister. It has been assumed that the Assembly will have the final say on some of these issues, and I hope that that will be the case. However, that is not absolutely certain, and the message from the Assembly must be that the elected representative should take the decisions that will affect the provision of health care.
It should certainly not be made by the Minister in advance of a full debate and consideration of all the issues by the relevant Committees and the House itself.
It is easy to say this hospital is special, that it is a local hospital providing essential services. Everybody can make a case for a local hospital or a local school, so it is important to look at the issues as objectively as possible. I would therefore seek to measure the decision that has been taken by the Northern Health and Social Services Board against the criteria which it has adopted.
This is a reasonable approach and better than adopting criteria of our own choosing. There were five key criteria used by the Northern Health and Social Services Board in relation to the future of acute and emergency services and medical and surgical in-patient services in hospitals in its area. There were initially three options and option three has proved successful. All options involved severe downgrading of services available in the Mid-Ulster and Whiteabbey Hospitals. Accident and emergency services and medical and surgical in-patient services were to be removed under all options.
But let us turn to the five key criteria: ensuring high quality care, access to appropriate local services, efficient delivery of care to meet patients’ needs, equity of access to care and patient-centred care services. These are sensible, reasonable criteria. But how were they applied in the case of Whiteabbey Hospital? Now with high quality care, every hospital authority throughout the United Kingdom is looking at the question of centralisation. What is the best way to provide high-tech services, acute services and accident and emergency services?
I agree with what has been said by Mr Dodds. Whiteabbey Hospital’s catchment area straddles three Assembly constituencies: North Belfast, South Antrim and East Antrim. The recent decision by the board about services comes as a great surprise. There is disappointment and grave concern in Carrickfergus and Newtownabbey that the whole Assembly constituency of East Antrim will be left without adequate medical or emergency services.
May I interrupt on two counts. It is quite proper for Members to ask to intervene, but we are in danger of allowing Members to take the opportunity of their Colleagues speaking to speak by intervention. It is a little unfair to the Member who is speaking as well as to other Members.
It was intended that this sitting would end at 6.00 pm, but a short extension would enable Mr Dodds to finish his speech and Mr Wilson, the last Member on my list, to make his. Do Members agree to that course?
Members indicated assent.
The points that my Colleague made about Carrickfergus, Larne and Newtownabbey were well made, and the people in those areas will be grateful to hear that the Member made them on their behalf. I hope, Mr Initial Presiding Officer, that you took care that my time will not be reduced.
In relation to the point that I was making about high quality care and so on, this sort of process has been happening throughout the United Kingdom for some time.
Many people who are dealing with the Whiteabbey Hospital situation are annoyed because it seems that the decisions were taken some time ago. There has been much investment in the Causeway Hospital, and in the new Antrim Hospital and, as a result, there has been no investment in the Whiteabbey Hospital. There is a feeling that the process is under way and that there can be only one possible outcome.
There is a parallel with the Tower Block in Belfast. As soon as such a building is in place, many other decisions inevitably and consequentially flow from it and there are financial consequences. The guiding principles should be need and what best serves the communities in those areas. That is the approach that we should adopt to all these issues. I hope that the Assembly will have an opportunity to adopt that approach, and that we will not be presented with a fait accompli.
Another matter is that of ensuring access to appropriate local services. Rev McCrea has already dealt with some of the issues in relation to transport and so on. The Northern Health Board proposes that local services will be provided under option 3, but it makes no attempt to define the range of investigations, procedures and treatments that could be provided within key settings, such as minor casualty services. It deals with that in a broad-brush way, and many people will want to see detailed recommendations before they are prepared to give their assent.
The third criterion is to ensure effective delivery of care in keeping with patients’ needs. We know about travel time in relation to rural hospitals. It applies equally to Whiteabbey Hospital because its catchment area contains some of the largest and most deprived housing estates in Northern Ireland. Some people do not have access to a car or other transport, some depend on public transport, in which there are many deficiencies and difficulties.
The Ambulance Service has not been improved in line with proposals and suggested changes. It is essential that improvements to the Ambulance Service are made before there is any relocation or centralisation of accident and emergency services. There should be a review of the impact of any relocation or change in services to find out how people would get to hospitals.
Public transport should be looked at. The policy appraisal and fair treatment review reported that travelling time for more than 70% of people would be significantly increased, yet about 40% of all patients of Whiteabbey Hospital have no car or access to one. All issues must be considered before decisions are made.
Do patient centres and care services offer value for money? It is disturbing that we will be asked to approve more than £40 million to bring about changes. Nobody has been able to demonstrate to the Whiteabbey Hospital action committee or to me the economic advantages. I should like to know how much extra it will cost.
The final issue is implementation. The board’s document refers to consultation with local people, although it seems that the board is not listening to local people at all. It has brushed their concerns to one side. It also makes it clear that the local GPs will be consulted. I have spoken to some of the local doctors, and they say that their contribution will be essential if this alternative of a community-style hospital is to work. So far, they have not been consulted. Before anything more is done, they should be consulted.
I am concerned about the historical investment pattern that has led to major investment in Antrim and Coleraine. In saying that, I do not disparage those two fine hospitals. There should be necessary improvements to ambulance services and public transport, and the board should clarify to everybody’s satisfaction the advantages and disadvantages of transferring services to other hospitals.