Intended for healthcare professionals


Reconfiguration of surgical, emergency, and trauma services in the United Kingdom

BMJ 2004; 328 doi: (Published 22 January 2004) Cite this as: BMJ 2004;328:178
  1. Andy Black, health services consultant (
  1. Durrow, PO Box 22, Machynlleth SY20 8WQ

    Centralisation of services is politically impossible

    To find the royal colleges proposing that acute inpatient care in the United Kingdom should be provided in fewer, larger, better equipped, and better staffed hospitals is not unusual. What would be unusual would be to find a government two years out from a general election rushing to implement such advice. The Senate of Surgery of Great Britain (comprising the four surgical royal colleges, the dental faculties, and 10 surgical specialty associations) has published a policy paper that seeks to speak with a single voice for the surgical community ( This policy paper signals a wish for a debate on this controversial topic and a wish to participate.

    These surgeons want a lot—and not for the first time, and not just the surgeons. The senate suggested something similar in 1997, but it did not happen.2 The Royal College of Physicians wants to phase out acute emergency admissions from isolated smaller units and transfer the work to properly equipped and staffed larger units.3 The arguments …

    View Full Text

    Log in

    Log in through your institution


    * For online subscription