A&E unit closure dilemma for Andrew Lansley

Two weeks ago NHS Nottinghamshire County PCT voted to downgrade the A&E to no longer take medical or emergency admissions. Blue light cases – heart attacks, strokes, serious accidents – will go instead to Nottingham, Lincoln or Kingsmill.This has inevitably caused an outcry.

The local Conservative MP Patrick Mercer has accused the PCT of failing to consult properly and of failing to give the local population proper choice, as promised by Mr Lansley.In response to a call by Mr Mercer, the Department of Health dispatched Health Minister Simon Burns to Newark today “for a listening exercise”. Mr Mercer said the minister’s visit sent a “powerful message”.

While Mr Burns told Channel 4 News outside the hospital: “Gone are the days when ministers and bureaucrats sitting at desks in Whitehall many miles from Newark dictate and issue orders as to what should or shouldn’t be happening to the local health economy. Those decisions, rightly, must be made by local people and local communities.”

But this will put Mr Lansley in a difficult position. Last week he went to Chase Farm Hospital in North London, and called a halt to the planned A&E closure there. He said: “Here at Chase Farm we will not have a top-down bureaucratic process.” Instead, he said, “we will talk to the local authority and representatives of the public and GPs locally”.

The Newark PCT would argue they have already done that. They also say that there are good clinical reasons for downgrading the unit to a 24 hour minor injuries unit, not least that there is no intensive care unit on site and that every year 1,600 patients have to be moved elsewhere.

They also say they were approached by local clinicians asking for this, that it is doctor-led and for the safety of the patients.Mr Lansley does have the final say but now faces either interfering in a locally-made decision or of reneging on an election promise.