Scepticism remains at the grassroots

EDITOR—I was surprised that McGinty thought that clinicians in Hereford were “satisfied with the result” of the plans for the private finance initiative.1 Few of the hospital doctors in Hereford whom I have talked to are confident that the new smaller hospital will have enough beds to cope with local demands, and general practitioners have consistently maintained through the local medical committee that they believe that the new hospital will be too small. The county already has an efficient network of general practitioners and community hospitals in the market towns, and there is little slack in the system.

Perhaps one reason why McCloskey and Deakin maintain that hospital admission rates have not risen in Hereford2 is because it is such a struggle to have a patient admitted. Indeed, the hospital was recently closed to admissions. Being told that my patient with pneumonia and status epilepticus was number four on the waiting list for admission gave me little confidence in the hospital's current ability to cope. I recently opted to manage a patient with a pulmonary embolus and a patient with a haematemesis and a haemoglobin concentration of 75 g/l at …