Shropshire Star comment: Now is the time to pull together over A&E crisis
After all that, they are closing it anyway.
For the past few years Shropshire has agonised over Future Fit, the process which will determine the shape of future health care in the county.
At the heart of the anguished debate is great controversy over the central proposal which would see one of Shropshire's two accident and emergency units closed.
That would be a strategic decision, underpinned by a worked-out framework of urgent care centres, in a carefully considered blueprint for the future.
Today the strategic looks like being trumped by the tactical. The A&E in the crosshairs for closure under Future Fit is that at Telford's Princess Royal Hospital. The outcry from Telford has been great. There has been a lively public consultation to allow Salopians to have their say.
READ MORE:
We still do not know the outcome of that process. But as it has dragged on, it has become increasingly apparent that things might develop in such a way to leave behind Future Fit, with a nexus of factors dictating that an urgent decision is taken.
And now that seems to be coming to pass with a recommendation being considered today temporarily to close the A&E department at the PRH between 8pm and 8am, which could take effect as soon as next month.
This is not part of a long term plan, but a reaction to a shortage of skilled staff.
The Shrewsbury and Telford Hospital NHS Trust has come under the microscope over concerns of patient safety, particularly in the area of maternity services in which the reputation of Shropshire's baby care has taken a serious dent in the wake of tragic cases which have attracted headlines and investigations.
So the issue of patient safety, given as the reason for the overnight closure, has considerable force. How could anyone argue to keep an A&E open overnight if medical professionals are saying that doing so would put patients at risk?
Anyone who has been to Telford's A&E in the evening knows how busy it can be and how long waiting times can be. This is not a closure through lack of demand. It is heavily overworked, and the Plan B is going to involve Shropshire patients having to travel for treatment out-of-county, with Wolverhampton an obvious destination.
There are potential ripple effects of an overnight closure. Will maternity services at the PRH also be affected? Will they have to close overnight too on the grounds that there are no on-site consultants to deal with any emergencies that may arise? Will births be exported out of the county too?
At this time of crisis, you would like to see all local politicians and health professionals singing from the same song sheet, but they are emphatically not doing that and there is an underlying blame game.
There is not even a consensus over where the decision-making centre of gravity should be. Are these purely medical decisions to be determined entirely by the local health professionals and bosses? Or are these political decisions, to be decided by elected representatives, and the medical professionals have to fall in with those democratic decisions? Or should there be a blend of both approaches?
Blame the Government, and the Government will say the decisions should be made by the experts locally. On the ground locally they blame lack of money and resources – which are in the control of the Government.
While they all stand in their particular ideological segments of a circle, pointing fingers at each other, the situation has been deteriorating to the point we are at now.
While there are things out of the control of local politicians and health bosses, one thing is within their control – and that is the ability to work together. If they cannot even do something as basic as that, the prospects of an acceptable resolution do not look good.
