Belfast Telegraph

Friday 18 April 2014

Why closing the City's A&E isn't healthy thinking

Belfast City Hospital

I spent Saturday night in A&E at the City Hospital. And it says everything about common perceptions of this most frontline of medical services that almost everyone I have mentioned this to since has reacted in much the same way.

A hand clasped to the throat, a gasp: "Jeepers! That must have been fun!"

The average A-amp;E during peak partying hours on Saturday night is generally seen as the medical version of Dodge City after sundown.

Was it wild? The honest answer is not very.

There were no mad, boaking lager louts, no obviously aggressive yobs. (Last time I was there, a smart-alecky drunk was keeping his captive audience 'entertained' with a loud rant, another patient was casually spewing up on the floor and a couple were sharing their marital breakdown with the rest of us.)

We arrived to a reception display warning of a two and a half hour wait. Twenty minutes later this had been upgraded to three and a half hours.

People chatted politely among themselves. But there comes a time in the utter, stultifying boredom of an A&E waiting room when you have nothing left to say.

The telly was on - but only showing a helpline number. Occasionally the screen would flicker and excitement would build. Was it about to come on?

Sadly, no. Back to staring at the signs advising proper hand hygiene and warning of a zero tolerance approach when it comes to abuse of staff. At one point - small rumpus - a shouting man could be heard just outside the waiting room. It turned out to be a cop accompanied by a female officer and their charge - a man whose forlorn refrain of "Lemme aloooaaaan!" echoed bleakly around the clinical area where he was receiving attention.

Through the crack in the door I got the odd fleeting glimpse of the female cop in her blue surgical gloves. Ominously for the patient, she was dangling handcuffs. Later, I spotted her fellow officer do a half-hearted little wheelie across the floor on his swivel chair. For them, presumably, waiting time in A&E is routine.

Hours later, when we left, the waiting room was still pretty full.

Yet this is a casualty unit that Stormont now sees as surplus.

Back in July, Health Minister Edwin Poots signalled that its days might be numbered. Since then we've been informed that the City unit will have to close "temporarily" due to a shortage of senior medical staff.

Campaigners say that, if it does close, it won't re-open. They argue that it is a vital service in the area.

Certainly it would seem to have no shortage of business. There are myriad bars and clubs in the immediate hinterland. Schools, major roads ...

And beyond the leafier avenues, large tracts of housing where residents may not always have the transport to take them across town to the Royal.

In rural areas where local hospital services have already been savagely cut, the idea of an extra 15 minutes to the nearest unit might seem like no big deal. But there it will undoubtedly mean hardship or at least difficulty for many in the City hinterland.

Campaigners insist it will endanger life. And it doesn't even seem to make that much economic sense. (Inevitably this is all about money.)

Surely the pressure on other A&Es (and the waiting times) will now simply multiply. All those people I saw on Saturday night will have to go somewhere.

The City unit is relatively new. Its staff are committed, pleasant and efficient. It is clean, it's well-equipped and it's doing a great job in an area where most people would say it provides a crucial service.

As the fracture doctor might say, Mr Poots, why mend what isn't broken?

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