Small cuts may be lethal

BEWARE Greeks bearing gifts. The East of England Strategic Health Authority may propose what look like small cuts in Hinchingbrooke Hospital s service to Huntingdonshire – but they may be lethal to local patient care. For example, a recent Department of H

BEWARE Greeks bearing gifts.

The East of England Strategic Health Authority may propose what look like small cuts in Hinchingbrooke Hospital's service to Huntingdonshire - but they may be lethal to local patient care.

For example, a recent Department of Health blueprint for the smaller hospital proposes a downgrade from intensive to high dependency care without the more advanced forms of life support.

An effective ICU is key to Hinchingbrooke's survival as an effective district hospital, senior consultant physician Colin Borland warned this week.


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Without an ICU, Hinchingbrooke would quickly become little more than a cottage hospital, with little incentive for the best physicians and surgeons to work there.

However, its catchment area - about 160,000 patients - is significantly lower than the 250,000 envisaged when district general hospitals were first designed in 1962.

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It has a round-the-clock A&E service, emergency general medicine, emergency surgery, emergency orthopaedics (bones and soft tissue), emergency paediatrics (specialist children's medicine), obstetrics and gynaecology and a full range of diagnostic back-up facilities.

"If the ICU were downgraded to HDU, it would be impossible to do emergency medicine, emergency surgery, or to support an A&E department safely," Dr Borland, who has worked at Hinchingbrooke since 1986, told The Hunts Post.

"The intensive care unit is the most expensive ward in any hospital, so it might seem a tempting target for cost-cutting."

But Dr Borland warned closing the ICU would be death for services at Hinchingbrooke by a single cut while losing other emergency capabilities would deliver the same, sorry outcome, only less quickly.

He added: "Putting unstable patients in ambulances to take them to other hospitals is fraught with hazards."

Dr Borland accepts that changes at Hinchingbrooke are inevitable but, taken sensibly with other organisations and GPs, he believes they could help shore up the hospital's future.

For example, treatment of a patient with lung cancer might involve a combination of surgery, chemotherapy and radiotherapy. Papworth Hospital has special expertise in lung surgery, Addenbrooke's is highly effective in radiotherapy, and Hinchingbrooke could provide the additional expertise needed for pain control and outpatient drug regime treatment nearer to a Huntingdonshire patient's home.

And the physician urges people not to be seduced by arguments that patients are automatically more likely to recover if they are treated at larger hospitals.

"I accept that the more often surgeons carry out certain complicated procedures, the more likely they are to be successful, but the results for common conditions are at least as good at Hinchingbrooke as at larger centres.

"There are two things at stake at Hinchingbrooke - clinical viability and financial viability.

"We cannot go on haemorrhaging £20million a year, but I think this financial crisis is a one-off.

"Whatever is proposed, there must be discussions with clinicians before decisions are taken.

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