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Gale's View

20th November 2019

What goes around comes around.

It is twenty- one years since the “Tomorrow’s Healthcare “consultations in which the future distribution of hospital services throughout East Kent was subjected to scrutiny.  At that time the eminent Canterbury- based Consultant Surgeon, Mr. Richard Collins, said that the issues were “complex” and that the debate was not assisted by the intervention of “vested interests, including doctors and shroud- wavers.” In an adjournment debate in the House of Commons in I agreed that he was right and that “these are complex issues and they require careful and measured consideration, not the abuse of position and knowledge by people who, for their own interests rather than the interests of public health, in some cases seek to deliberately mislead”.

Back in 1998 I took a great deal of political criticism for supporting the closure of a four- cot neonatal intensive care unit at Canterbury and its replacement by a 12-cot unit at the William Harvey Hospital in Ashford. The healthcare case for the re- location was unassailable: a four-cot unit was too small to be viable and to attract consultants and trainee doctors: a large unit in Ashford would serve a much larger area, draw in top- flight specialists and have sufficient throughput to allow young doctors to learn their skills. At the time a consultant paediatrician said that “If Roger Gale gets his way, babies will die”. I listened to the expert opinion, took the considerable political heat and backed the move because it was the right thing to do in the interests of healthcare. As a result, there are, I am told, young people alive today who would not have made it through infancy if the Health Authority had not had the courage to take an unpopular decision.

We are faced, today, with a similar situation in relation to that which we had to confront all those years ago: do we support the creation of a Hyper Stroke Unit in Ashford or do we take the parochial view that we must maintain less effective Stroke services more locally?

Set aside the ludicrously ill- informed assertion that the QEQM hospital is “threatened with closure “and must be “saved” and consider the medical evidence upon which the present Health Authorities are basing their judgements. Where Hyper Units are established they deliver more successful outcomes, save more lives and contribute to greater prospects of full or good recovery than smaller units offering less diagnostic facilities and expertise. It is also the case that while Hyper Units offer the best immediate response to a stroke it is important that patients are then transferred back as close to home as possible because the TLC offered by family and friends hastens a return to good health. That is why it is proposed that far from “closing” the Stroke Unit at the QEQM hospital it should be transformed into a state- of-the -art Stroke Recovery Unit that will in turn support community and domiciliary care.

The next question is “why can’t we have both” to which the answer is straightforward. It is not practicable or possible to provide the best treatment for all conditions in all hospitals and it has always been accepted that individual hospitals would, therefore, offer specialist services to which others would refer. That is how the best consultants, the best support staff and the best equipment can be deployed to offer the best treatment to the largest number of people across the widest area.

And that is why I find myself once again not backing the ill- informed and populist views expressed by those who lack specialist knowledge and the ‘shroud- wavers’ that Dick Collins referred to all those years ago and supporting instead the politically less- attractive proposal that people who are truly expert know will save more lives.

In 1998 I said in the Commons that  “I hope that those of good will throughout Kent will shun those who are deliberately seeking to cause public strife and will concentrate on how we can best make the necessary reforms work".

I stand by those words and I believe that rather than seeking to “weaponise” the health service for party- political purposes we should throw our weight behind those who have the administrative courage to take tough but necessary decisions.

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