This opening headline ran all through BBC Radio Wiltshire’s Breakfast Show on Friday (May 4): “Minor Injury Units in the most rural parts of Wiltshire should remain closed according to GPs in the east of the county.”
The contentious issue of the closure five years ago of the MIUs in Savernake (pictured) and Devizes hospitals was given a good airing in interview segments during Matthew Smith’s two-and-a-half-hour early morning programme.
The debate was re-ignited at Devizes MP Claire Perry’s health forums in Devizes and Marlborough last month and when she used an interview on BBC Wiltshire to attack the Primary Care Trust (PCT) which ordered the closures as “unelected quangocrats”.
Matthew Smith carried four interviews on the subject: Dr Richard Sandford-Hill from the Market Lavington surgery who is active in Wiltshire’s single Clinical Commissioning Group (CCG) which takes over from the PCT next April; Claire Perry MP; Val Compton from Marlborough who took her campaign against the Savernake closure to the High Court; and Professor Roger James who had twenty years as a consultant physician and ten years as a senior clinical manager before becoming an independent health consultant.
Dr Sandford-Hill told Matthew Smith that he had spoken to most local GPs and they all thought the decision to close the MIUs had been the right one – they had not been value for money. And reopening them now would be wrong: “I’ve spoken to colleagues of mine in both Marlborough and Devizes about reopening the MIUs – there’s not one GP I’ve spoken to who thinks that would be appropriate.”
Dr Sandford-Hill did agree there’s a need for people in the rural areas to have access to minor injury treatment: “Where that’s delivered and how that’s delivered I think should be discussed. I think we’ve gone about this in the wrong way really – bringing up the MIU again because I don’t think that’s going to happen.” But he said that the new CCGs would look at all the available models to see what would best fit and what could be afforded.
Claire Perry MP repeated her argument that it was not right for her constituents to have to travel so far for minor injuries treatment – the only other constituency without a MIU was, she said, in Norfolk. She told Matthew Smith she had figures from the PCT showing they spent £1.3million a year treating minor injuries outside the constituency and she believes treatment that was not at “very expensive hospitals” must be cheaper.
However, she appeared to be surrendering on her demand for a “bricks and mortar” solution to the problem – that is the reopening of MIUs at Savernake and Devizes: “It might be a service where different GPs agree within a certain area to have a minor injuries service staffed by nurses which is cheaper than doctors…There are many ways to crack this nut. Ultimately when you have a big spread-out constituency, I think it’s very unfair that we are one of only two constituencies in the country that doesn’t have an MIU. That’s why I want to keep really pushing on this and make sure we get the best possible service locally.”
In a final segment of the programme, Matthew Smith talked to Val Compton and Professor James.
While disputing the history surrounding the closure at Savernake, Val Compton agreed that replicating the unit there would not solve the problem: “There shouldn’t be a unit that’s exactly the same again. They should set up something new, a completely new service – it doesn’t necessarily have to be based in the middle of Savernake hospital.”
“GPs have absolutely got to get their heads together. How can we actually get minor injuries treated in the area where people live – and that is the crux of the whole matter?” People, she said, have to be treated in the same area – just as people with minor illnesses are.
Professor Roger James did not know all circumstances in Wiltshire, but thought ‘minor injury unit’ was now the wrong title and wrong service. He put forward what is called an “Ambulatory emergency care service – community based – coordinated maybe across the county.” His firm view was that it was up to GPs and the new CCGs they lead, to consult widely and design a new service to suit the communities they serve. And, of course, to suit the NHS budget.
So the debate seems to be changing – and when Dr Sandford-Hill says GPs agree that Savernake should not reopen as a MIU, those who have been supporting the reopening are coming round to the same point of view. The trick is to find a community service that fits.
Within minutes of her interview Val Compton was tweeting: “I pledge NOT to give up until patients in East Wiltshire can get their minor injuries treated in their own area without travelling to Swindon.” So it may all come down to what is meant by “area”.
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