The human cost of inaction.

Bearing in mind the dispute there has been (and remains) between Shrewsbury and Telford about the location of  'emergency' services in Shropshire, you'll be surprised to read about my deep concerns about the future for the Princess Royal Hospital in Telford. Of course my main interest is in services available to my constituents in Montgomeryshire, But I've had a close association with and interest in all of Shropshire for all of my adult life.

As we know, the Shropshire, and Telford and Wrekin Clinical Commissioning Groups met before Christmas to consider a new A&E/emergency structure for whole of Shropshire. It proposed an Emergency Centre at Shrewsbury and two Urgent Care Centres at Shrewsbury and Telford, which would deal with about 80% of those currently attending A&E. The plan had been developed by a group set up by both CCGs known as the Future Fit Programme Board. This Board had been working for almost 3 yrs and had cost at least £2million. But the proposals were rejected, casting many of us into a state of despair.

I immediately realised that this refusal to grasp the solution was very bad news for all of Shropshire and Mid Wales, but particularly bad news for The Princess Royal in Telford. Let me explain why to those who do not think so. We can all agree that the status quo is not sustainable  - unless some miracle tree that grows consultants who want to work in Shropshire is discovered. Unfortunately there is no such tree. Over the last 15 years there have been occasions when the A&E service has been barely clinically safe. It is currently 'on the edge'. I remember a previous Chief Executive telling me he should have closed the PRH overnight, because of insufficient consultant cover. Since then, we have had the Mid Staffs scandal. Today, he would have acted, not hoped for the best. With the increasing throughput we are seeing at A&E units, it cannot be long before a real 'clinically unsafe' crisis happens and the PRH is simply closed overnight. It's going to happen. No amount of political posturing will obscure the shock of this situation.

A lot of the debate is presented as a Shrewsbury and Mid Wales versus Telford and Wrekin. It is not. It's a debate about clinical outcomes, where the best outcome for patients across the region is not being taken forward, because of 'Political' considerations. And now I cannot see a way forward. The more I think about it, the more despairing I become. Many people are anticipating an early decision. We've been led to believe it could be a matter of weeks or months. I'm not so sure. The UK Govt is under huge pressure to agree capital investment across every part of England. In most places there is a case agreed locally. Are we really imagining that Govt will allocate capital spending to an area in local dispute, with no sign of resolution.  I feel we have run into a wall of stone cold realism. There will be a heavy price for inaction. And the main sufferers are going to be those who have stood in the way of progress with the Future Fit Programme Board recommendations.