Disabled people forced into workfare. Mandatory! Or lose Benefits.

If I have a life threatening emergency I want to be taken as quickly as possible to a leading specialist centre with the ambulance driving past any "community" hospitals with surgeons who dabble in the condition I am suffering from. The statistics say that this will give me the best chance of survival.

it will take longer to drive you to a "specialist" hospital, and you may die in the meantime.

the "statistics" are created by the tories who are planning this so of course they favour the plan. the reality is much worse.

You are right I may die in the meantime, but I am less likely to die in the hospital and that means I am less likely to die overall. I have no particular interest in where I die. I want the best chance of not dying and that comes from being taken to where the doctors with most experience of treating what I am suffering from are located.



Find me any statistician who doubts the figures, and I repeat where are the doctors with no personal interest who are opposing this?

see edited post.

so youre saying that doctors who oppose these reforms are biased?

I changed "biased" because I didn't want to give that impression. Clearly doctors who are masterminding this project and doctors who are going to be relocated both have a personal interest.

again, see the link that i posted.

medical staff are being fired because they disagree with these reforms.

I have read the link. There is no reference at all to these hospital in London




I would be very surprised if this were true, as one care barely fire doctors fro anything, but I cannot say whether it is is true or not.

I can however say categorically that it does not say that in the article to which you link.

they are part of the NHS reforms that are being talked about
are you being deliberately obtuse?

As I say, you can either take the position that from some date you choose, no changes to the NHS shall ever be permitted or the question is whether a particular change is a good thing or a bad thing. If you take the latter position, you cannot defend that position by quoting generalised attacks on NHS reform.

why would I lie about something like that?

https://www.change.org/p/peter-morris-reinstate-charlotte-monro-end-the-bullying-climate-in-the-nhs/u/8234890?tk=nGYMs6GW-FWGV1EAY8-4WDp84RACyWJJyj78ossYV2g&utm_source=petition_update&utm_medium=email&utm_campaign=petition_update_email

Charlotte Munro is an occupational therapist. The allegation that she had broken her contract by speaking out of turn seems to have been rejected in the disciplinary process. However, it looks as if in the process it was discovered (and of course I have no way of knowing whether this is true or not) that she had lied about previous convictions and was sacked for that reason. Undoubtedly the investigation into her speaking out will have led to the discovery of her convictions, but none the less the question is whether the convictions and the failure to disclose them justify the dismissal. Again, I don't know whether she failed to declare a 30 year old parking ticket or whether she made a habit of smothering babies.

However, all this is irrelevant in three respects. Firstly the issue in those proceedings is now nothing to do with her speaking out. Secondly, what she seemed to be speaking out about was loss of jobs not patient services and thirdly I asked for evidence that doctors were opposing this closure (and that includes doctors whom this trust can't either rightly or wrongly sack) and she is not a doctor.

Just on the case of this woman, trades unions seem to have a blind spot when other serious misconduct is discovered in a disciplinary process. This seems to happen frequently with London Transport. There cannot be an amnesty for serious misconduct where it is discovered when looking into something else.

http://www.ealingtoday.co.uk/shared/eaaeclosures001.htm
Many doctors have also joined the Save our NHS campaign, go to any protest and you will hear a number of speakers who are doctors opposing the reforms.

on the other hand, please do show me statistics that say closing A&Es will not compromise the safety of patients, because I sure as hell can't find them.

But with respect I not interested in generalised Tory bashing. Doctors are entitled to political views as much as anyone else. Where are the doctors who oppose this specific proposal?



This is the report of a left leaning think tank. The data is from page 30 onwards.

http://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&ved=0CC0QFjAC&url=http%3A%2F%2Fwww.ippr.org%2Fassets%2Fmedia%2Fimages%2Fmedia%2Ffiles%2Fpublication%2F2011%2F05%2Ffuture_hospital_1556.pdf&ei=Gs49VN7QEZSvaamDgrAG&usg=AFQjCNHJtPlc_05Mey0273vbmL6Qf4SvBw&cad=rja

This is the report of sceptics about this policy but ultimately the best they can come up with is an argument that if the policy is implemented a larger group of patients with one condition will live and a smaller group of patients with a different condition will die and is this fair to the smaller group? There doesn't seem to be much thought for the position of the greater number who will die through the status quo.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464671/#ref1

If I have a life threatening emergency I want to be taken as quickly as possible to a leading specialist centre with the ambulance driving past any "community" hospitals with surgeons who dabble in the condition I am suffering from. The statistics say that this will give me the best chance of survival.

and in the last link you posted: "Increased journey distance to hospital appears to be associated with increased risk of mortality. "

There is good evidence for some groups of emergency patients that care provided in specialist centres improves outcomes. Examples include primary angioplasty for acute myocardial infarction, and care for major trauma patients with multiple injuries.12 In these cases we can be reasonably confident that with appropriate pre‐hospital care and at distances typical in the UK, the benefits of specialist care, which is only available in certain centres, would outweigh any detriments resulting from the increased travel distances to the centres. However, there are also some groups of critically ill patients who need urgent but not specialist care. For example, patients in anaphylactic shock, choking, drowning, or having acute asthma attacks need urgent care that would be the same wherever it is provided. For these patients, there may be a detriment in having to travel increased distances

I posted that link because the writers were broadly hostile to concentration in specialist areas; but what they were forced to conclude was:-

If I have a life threatening emergency I want to be taken as quickly as possible to a leading specialist centre with the ambulance driving past any "community" hospitals with surgeons who dabble in the condition I am suffering from. The statistics say that this will give me the best chance of survival.

I think this conversation is degenerating, largely due to inaccurate and emotive generalisations by Sherlockfan, who suddenly changes the question under discussion - viz. - am I in favour of closing 5 A&E departments? (when we were in fact discussing the necessity of maintaining such services at specialist hospitals like the Hammersmith).

Again it's impossible to generalise without knowing the exact details of the hospitals concerned. To run such an general acute emergency service (rather than a minor injuries centre) you usually have to have a minimum number of consultant general surgeons and consultant emergency physicians. These are not present in every DGH and thus it would be best to designate emergency centres just as specialist centres are so designated for acute stroke and cardiac emergencies. Instead of all this emotive guff about 'closures' we should be concentrating on outcome measures - wisely pointed out by nulli tertius

You'll be seen quickly even with those closures.

No you wont.

In the not too distant past if you were involved in an accident or an emergency and needed to get to a hospital you'd be picked up by an ambulance and taken to the nearest hospital available. The ambulance drivers were little more than glorified taxi drivers who did very little work to stabilise patients.

In fact, it wasn't until a rather nasty train cash in the early 60s I believe when it was identified how utterly useless out ambulance drivers were and a move was taken to improve their training.


Now, we have paramedics who can offer significant skills sets that previously were only available inside a hospital where the patient is so although te distance may increase, the quality of care has improved dramatically.