Viewpoint: Why acute and emergency hospital services should be consolidated

A day after health secretary Jeremy Hunt announced the controversial downgrading of the A&E in Lewisham, south-east London, Conservative GP MP Dr Phillip Lee explains why acute and emergency hospital services should be consolidated in his Berkshire constituency.

Dr Phillip Lee: ‘Clearly, it will never be politically easy to sell the consolidation of hospital services as being in the best interests of constituents.’
Dr Phillip Lee: ‘Clearly, it will never be politically easy to sell the consolidation of hospital services as being in the best interests of constituents.’

There is no doubt that my training and work as a GP have helped me enormously in my role as an MP. My experience outside of politics has also provided me with a rare insight into the challenges and demands that are facing healthcare services across the country, particularly in the Thames Valley, where I have worked in around 50 GP practices and five hospitals. This clinical experience has lead me to the conclusion that managing future healthcare demand is one of the real challenges for my political generation.

With rising costs of an ageing and increasingly obese population and the continual increase in demand for better health services, along with the rising costs of new medical technologies and drugs, it is no surprise to those of us who work in the ‘front line’ of healthcare that the manner in which we deliver and receive healthcare requires much debate and consequent reform. Clearly, the way in which we configure future healthcare services in this country must be based upon clinical need and demographics. It certainly requires a commitment to concentrate upon achieving the very best clinical outcomes.

The Health and Social Care Bill aimed to increase clinical excellence, continuity of care and assist modernisation. Its implementation also seeks to drive efficiency and productivity through more streamlined service models and through investment in technology, hopefully leading to a reduction in waiting times and more rapid patient access to diagnosis and treatment. However, it simply is no longer an option to keep pumping more money into the NHS indefinitely. Difficult decisions have to be made now on how healthcare is funded and provided in the future. Therefore, I believe that we should shift pump policy development away from healthcare supply towards dealing with demand-side challenges, such as maintaining and improving clinical outcomes under the weight of increasing patient expectations.

I know from my own work in my constituency, where I am proposing a new regional acute hospital to replace some of the district services, that decisions on clinical outcomes outweigh difficult changes. I am calling for a consolidation of acute and emergency hospital services at a more accessible, motorway location so that it can realistically serve a larger patient population. A so-called 'hub and spoke-model' of care, with a centralised acute hospital from which a series of ‘arterial routes’ to community hospitals emanate, would lead to better health outcomes for all.  Clearly, it will never be politically easy to sell the consolidation of hospital services as being in the best interests of constituents. In my opinion, however, it is inevitable that such a consolidation of acute services will need to happen and so, the sooner that it is achieved the better off we will all be. By acting now, this generation of politicians could put in place a healthcare service that both empowers the individual and modernises the hospital and community clinic infrastructure, thereby reflect the real changes in medical practice that we all know have occurred. Politicians and medical professionals who share my view have a responsibility to persuade the public of the merits of this approach.

* Dr Phillip Lee is Conservative MP for Bracknell, Berkshire.

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