There was a debate on the radio this morning between a doctor brought in by the BBC to rubbish any thing the government does on behalf of the clinicians (Dr. Mark Porter, who chairs the consultants committee of the BMA) and a patients' advocate (Dr Mike Smith of the Patients Association).
At issue was whether the government should be closing hospitals or services in hospitals to improve clinical standards. One such service under threat of closure nearby is a paediatric cardiology unit, where there has been loud local support for the retention of the unit based in a South Coast town. It is one of eleven in the country and the government proposes to reduce the number to seven.
This is bad say the protesters. It is just government penny pinching and a closure would mean that little Jimmy would be further from home at a very traumatic time.
All very emotional stuff, but it seems to put Mum & Dad's inconvenience ahead of the youngsters chance of survival, because those willing to give this more than superficial consideration will remember the reports of excess deaths in the paediatric cardiology units at Bristol Royal Infirmary and the John Radcliffe Hospital in Oxford.
What has the bad performance at those hospitals got to do with another unit that has not had the same number of excess deaths? To put it frankly, the hospitals that failed probably did so because the surgical teams did not have enough experience, and that was a direct result of the fact that they didn't have enough "business" to maintain a suitably experienced workforce, and the same was likely to happen elsewhere. Some procedures were carried out less frequently than once a year in some units. I wouldn't send a pet rabbit to a vet for a procedure that he carried out less than once a year. Reducing the number of specialist centres increases the volume of specialist work in each centre and gives the staff more experience.
So, Mum & Dad, I am sorry about your little one, and it will be tough if you have to travel hundreds of miles a week to visit them, or if you have to stay in a hotel to be close by when they need you, but you have to understand, this probably really is for the best.