It's not just whole hospitals

doi:10.1136/bmj.39296.743391.3A

BMJ 2007;335:272 (11 August), doi:10.1136/bmj.39296.743391.3A

Letters

Insolvent hospitals

It's not just whole hospitals

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

Ham points out the importance of the choices the governmentmakes around failing hospitals.¹ Almost every proposed reconfigurationwill provoke local opposition from the people who live nextdoor to the hospital. But what should matter for serious decisionmakers is not the views of the IMBYs (everyone wants a hospital"in my back yard") but a rational standard of provision. Forexample, we might try to maintain general hospital levels ofservice in a certain travel time of the population (with perhapsa much less stringent limit for services that require substantialcritical mass).

But this sort of analysis is rarely seen in the context of reconfiguration.For England we recently found that if we set an acceptable accessstandard of 30 minutes' travel by road (actually quite a stringenttarget) we find that about 7% of the English population haveno provision (this is mostly the rural fringes), . . . [Full text of this article]

Stephen Black, management consultant

London SW1W 9SR

stephen.black@paconsulting.com