Editor's Viewpoint: Quick cuts have unhealthy effects
It is hardly the most auspicious time at which to close the accident and emergency unit at Belfast City Hospital. The shut-down - which is described as temporary - comes on November 1.
Did it not occur to anyone that the Halloween period is traditionally a busy time in A&E? Although, given that the unit catered for 42,000 patients last year, every day and night is busy in this frontline sector of healthcare.
There is certainly validity in Health Minister, Edwin Poots' rationale for closing the unit, since there is neither the staffing nor funding in these straitened times to facilitate three major A&E units - the others at the Royal and Mater hospitals - within a short distance of each other in central Belfast. However the public will want assurance that the new configuration of services - the City's patients will now be seen at the Royal, Mater and Ulster hospitals - can cope with the huge increase in patients coming to their doors.
The Ulster Hospital says its has put some measures in places including opening extra wards and increasing staff but that will have a knock-on effect on its other work including planned surgery which will be restricted for a period. It already is the busiest A&E unit in the province with 75,000 patients a year and expects that number to increase by 12,000. The Royal and Mater, on those figures, will have to cope with an extra 30,000 which is certainly a logistical, never mind medical, challenge.
The Health Service cannot be immune from the swingeing public expenditure cuts, but the minister and his officials must not fall into the trap of making piecemeal adjustments to services in the hope of riding out particular storms. They must ensure that all changes are part of a strategic framework of reconfiguration which will deliver effective as well as efficient healthcare. The public, for its part, should only visit A&E when it is the only option. Out-of-hours GP services and minor injury units in hospitals like Bangor and Ards can often be equally effective ports of call.