Mid-Ulster Hospital (Acute Services)

Part of the debate – in the Northern Ireland Assembly at 5:30 pm on 5th October 1998.

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Photo of William McCrea William McCrea DUP 5:30 pm, 5th October 1998

I should like to raise the retention of acute services at the Mid-Ulster Hospital. Some weeks ago, the Northern Health and Social Services Board decided to follow the Government’s line on the Golden Six acute hospitals. In the review, and in response to the Government’s request, the board decided to remove the acute services from the Mid-Ulster Hospital.

It was interesting to note that no sooner had the proposal been put by the chief executive of the board — an official of the board — than the meeting concluded. The proposal was accepted and a press release on behalf of the chairman and the chief executive was released immediately. It seems that the decision had been made before the meeting took place. This is not a proper way of dealing with the Health Service and the future health of our people.

On that occasion Mr Baker, an SDLP Councillor from Cookstown, and I made representations to the board. The members listened courteously but were quick to go ahead with their own proposals.

The present review ought to be stopped because its findings will in time prove to be nugatory. Given where the Golden Six hospitals are situated, the principle and the design of that policy is fundamentally flawed and out of date.

The review was commenced under the Tory Government and, when the Tories went out, the new Labour Government permitted it to continue. It may be that the decision about acute services will not be taken by the Labour Government. It may become a responsibility of the Assembly and of a Minister of Health in Northern Ireland. For that reason we should be looking for support for the Mid-Ulster Hospital from within the Assembly.

There are many headings, and one could consider why acute services should be retained as they are. Because of time constraints I can deal with only some of them. The first issue is accessibility. The time that is taken to reach skilled medical attention is critical in all emergencies, and it involves consideration not only of distance but of the condition of the roads and the route to be followed in getting patients to that point of assistance. It is generally accepted that the roads in the two council areas that are covered by the Mid-Ulster Hospital — Magherafelt and Cookstown — are some of the poorest in the Province. Journey times to the hospital, especially from the western half of the district, would increase significantly if acute services were to be placed in Antrim rather than in Magherafelt. The Automobile Association states that it would take 52 minutes to travel from Pomeroy to Antrim as opposed to 22 minutes to Magherafelt, and 50 minutes from Stewartstown to Antrim as opposed to 24 minutes to Magherafelt.

In 1994, the Northern Health and Social Services Board produced a report on the development of hospital services in its area. The report stated that an acceptable journey time was considered to be 40 minutes. The board’s ‘Customers’ Charter’ states that, in an emergency, an ambulance should arrive within 14 minutes in an urban area, 18 minutes in a rural area and 21 minutes in a remote area. Obviously, those times could not be complied with if the services were moved from the Mid-Ulster Hospital and placed in Antrim. The life expectancy of the person requiring immediate medical attention is put at risk.

The Northern Ireland Ambulance Service is currently undertaking a study into response times for calls if the rationalisation of acute services proceeds. Under a new system that is currently being piloted in Great Britain, the service will be expected to meet 75% of category A calls — immediate life-threatening calls — within eight minutes. This is highly unlikely to be the case if the Mid-Ulster Hospital loses its accident and emergency department.

There are travel delays in Toomebridge and although a new bypass is agreed and proposed, it will be several years before that is completed.

We have to consider equity. Cookstown and Magherafelt have fairly high levels of deprivation, and more difficult access to acute hospital services would result in the transfer of costs to those who are least able to pay, thereby reducing access to acute services. That also contradicts the Department’s guidelines. Its aims, which are set out in ‘Targeting Health and Social Needs’, are to reduce inequalities and to ensure that the changes do not increase variations in availability or access to health care. Reduction in services would cause job losses, resulting in a further negative impact on an already deprived area. The transfer of acute services can only increase inequalities and reduce accessibility. That contradicts in practice the Department’s statement that

"the effectiveness of targeted resources, programmes and services must be assessed to ensure that they are succeeding in reducing and not inadvertently perpetuating or increasing variation in health and social well-being or in the availability of or access to health and social care".

The Government have stated their vision for the Health Service. It is to provide

"a comprehensive Health Service, publicly funded, publicly operated, free at the point of use and available to all on the basis of need, not on the ability to pay".

If the policy dictated by the review were to be followed then the only safe place to be sick in this Province would be east of the Bann. Your chances of survival, west of the Bann — an area of the greatest deprivation and disadvantage — would be greatly diminished. The situation is totally unacceptable. All you have to do is look at a map of the Province to see that five of the six golden hospitals are going to be east of the Bann. That is not apportioning health services relevant to need or social deprivation.

On behalf of all the people of the mid-Ulster area, from whatever side of the political spectrum they come, I wish to make it clear that existing acute services at the Mid-Ulster Hospital ought to be retained. Failure to do so will result in an increase of inequality as regards access to acute services in the Cookstown and Magherafelt District Council areas. That is unacceptable. There will be longer response times in emergency situations with ambulances arriving outside the stated response times. Journey times will increase by 30 minutes, with some well above the acceptable journey time of 40 minutes, as stated by the Northern Health and Social Services Board. There is likely to be an increase in mortality rates on journeys to Antrim Hospital. There could be a possible reduction in self-referrals for acute hospital services, further reduction in the significant underprovision of services to the people living in the west of the Province and a negative economic impact on an already deprived area.

God forbid that what happened in Omagh had happened in Magherafelt, had the services been removed. I remember the fight to keep acute services in Omagh. There would have been a vast number of fatalities, and they would certainly have been significantly higher. I want to see our community getting the same acute services as the rest of the Province. In health terms that would be justice for all our people.