Follow up to yesterday's post about location of 'serious' A & E services in Shropshire. I'm pleased that a bit of interest and concern has been activated. Its a complex issue that could not be included in a singe post. It would be an essay. Anyway, here's another take on it.
There are three time frames to consider. a) - 2010/11, b) 2012/13 and c) 2020+. Let's consider these in turn.
Firstly, there's the need to provide a clinically safe service in the immediate future. There are potential problems arising from a shortage of consultants. Two reasons for this. Firstly, there's the introduction of the Working Time Directive. And secondly, there's the trend for consultants today to be more 'specialised' than 'general'. More consultants are needed to provide the same level of service. The only way to deliver greater certainty of a clinically safe service is more consultants - which needs more money - from somewhere. I hope that every effort is being made to rejig finances to deliver on this.
The second time frame is connected to the first. Even if extra consultants are appointed, it will be no more than a 'sticking plaster' which puts a more radical resolution off for two or three years. There will need to be what we can call an 'interim' reorganisation around 2012/13. . The proposals about what this should constitute is what the current row is about. It will not be possible to deliver the full A & E service at both Telford and Shrewsbury. Serious emergencies will have to be concentrated on one site, and the currently proposed location is the Royal Shrewsbury Hospital - on grounds of carefully considered appropriateness and cost. To locate at Shrewsbury will cost less than £20 million, while to locate at Telford will cost getting on for £50 million.
The third time frame involves building a new acute services hospital, probably on a new site somewhere between the two towns. The cost of this development may well be £500 million,and even if a decision to proceed was taken now, it would take until 2020 until the project was delivered. Big decision! Big money!
Now back to what I want to happen. The opinion that I've been putting forward is that every effort should be made to retain full A & E services at Shrewsbury and Telford for as long as possible. When the decision to concentrate serious A & E services in one location has is made, it would be much more acceptable if a commitment to proceed with the new 2020 hospital were to be made at the same time. My fingers and legs are crossed that the short term problems can be sorted before Nov 2nd, and that the proposed consultation can be postponed for a couple of years.