Doctors must debate hospital closures

doi:10.1136/bmj.333.7569.661

BMJ 2006;333:661 (23 September), doi:10.1136/bmj.333.7569.661

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Doctors must debate hospital closures

The first 150 words of the full text of this article appear below.

"Doctors back mass hospital closures" said the front page head-lineof the Observer on 17 September. To many doctors this will havecome as a surprise. This issue has never been the subject ofa full national debate in the profession. Over the past 15 yearsthere has been much talk of centralising services and many localcampaigns over individual threatened local hospitals but littlesystematic collection of evidence to inform decision making.Instead, the process has been driven largely by financial pressures,by the European Working Time Directive and its effects on juniordoctors' staffing, and various recommendations from the royalcolleges about the levels of staffing and activity that wouldallow posts to be accredited for training.

Inevitably these pressures have driven hospitals to amalgamateservices, at some cost to local accessibility. Equally inevitablysuch moves are deeply unpopular with patients, who may haveto travel . . . [Full text of this article]

Richard Lehman, general practitioner

Banbury, Oxfordshire Richard.Lehman@gp-K84059.nhs.uk