BMJ 1996;313:46 (6 July)

Letters

Strategic plans for vascular services have not been put into effect

EDITOR,--The media have recently focused on deaths resulting from the non-availability of intensive care. They see but the tip of the iceberg. The problem with paediatric intensive care beds, we are told, is "distribution rather than numbers."1 The problem with accident and emergency services, we are told by the Audit Commission, is that they need to be centralised.2 Advice such as this, however pertinent, is unlikely to be taken: the NHS is currently strangled by its own structure.

The need to rationalise those acute services that depend on round the clock availability of specialist staff and expensive resources becomes daily more obvious. The reorganisation of the NHS into independent trusts, the purchaser-provider split, and short term administrative contracts have placed road blocks in the way of strategic regional planning. Nowhere is this better shown than in the provision of vascular services.

In 1993 a report, Vascular Surgery Services, was prepared . . . [Full text of this article]


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