When we did our engagement exercise, people rated services being close to home above safety. I can only assume this is because we as a community assume that if a service is there, it must be safe. And yet when I explain that it isn't, people want to fight to keep it open anyway.
Babies born in obstetric units where consultants are present on the ward all the time have a lower chance of sustaining birth injuries than those where the consultants are on call from home. Children in other European countries who travel further to more distant, large children's units have lower death rates than we do.
If parents had to sign a form saying they agreed to their child being admitted to a less safe service than the one at the hospital in the next town, would they sign? I wouldn't. And yet by our CCG sanctioning the continuation of a service we know to be less safe, we are in effect doing this on behalf of all of our patients.
There is no such thing as 100% safety. But surely if we can see a way of improving safety from 94% to 97%, that is worthwhile?
When things go wrong, I would rather my children were safe in a bigger, perhaps more impersonal environment, where experts are on hand.
We have listened to experts in the field whose job it is to understand what makes a service safe. They have all said we are doing the right thing.
And then we are left with a dilemma. We are accused of not listening to the public if we do not agree with them and instead do what we believe is the right thing to ensure the safety of our patients.
We can address transport and accessibility, we can improve community children's nursing so many services can be delivered at home. But if we cannot find a compromise on safety, will we always be accused of not listening to the concerns of those who campaign against us?
- Dr Pleydell is a GP and healthcare commissioning lead for Hambleton, Richmondshire and Whitby CCG, Yorkshire. She writes regularly for our sister website, insidecommissioning.co.uk.