Dr Paul Kerr, vice-president of the NI branch of the Royal College of Emergency Medicine, made the remarks to the News Letter on Sunday.
The Downpatrick-based Downe Hospital emergency facility has been closed during the Covid crisis.
Dr Kerr was speaking after a statement, issued by the Sinn Fein press office on behalf of “the five parties and the Down Community Health Committee”, at the weekend said: “It is essential for our community that all services are restored to the Downe Hospital at the earliest possible opportunity.
“South Down may be a rural community, but our community has rights. We are entitled to equality of access to healthcare.”
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Dr Kerr said Downe Hospital is a “minor injuries” service, and “its desirable in one way that that service be delivered locally – but in another way it can be delivered anywhere, and potentially could be delivered in a large health centre”.
He continued: “It always seems a loss to local people when something is taken away, in the way they perceive it.
“Now in medical terms, for major medical emergencies, cases have to travel to the larger centres anyway. We can’t manage patients with trauma, heart attack, strokes, etc, in small hospitals like the Downe.
“If we wound the clock back 20 years, what we saw was NI had 20 A&E departments, and that was obviously too many. And now we have 10. And that is possibly or arguably excessive, but it’s not that big a number.”
Smaller units can potentially help take the pressure off major A&E centres by handling lower-level emergencies at a local level, and that “might serve a very useful purpose”.
But he said the Bengoa report is clear that improving services “did not just mean retaining structures”.
Ultimately it is up to the South Eastern Trust to manage the Downe as it sees fit, and he has no “axe to grind” one way or the other.
He concluded: “It’s unfortunate when politicians push the idea that every unit should stay open, because sometimes that singular kind of logic does slow down progress in terms of reconfiguring services.”
Jim Wells, DUP MLA for South Down and health minister during 2014/15, believes that the aim had always been to axe Downe A&E, and the authorities were “using the cloak of coronavirus to hide their intentions”.
He said “in normal times there’d be several thousand people on the streets about this, but for obvious reasons there wasn’t – and therefore the trust had a golden opportunity to slip something through”.
The last time he voiced that view publicly, someone from the trust rang him “quite irate, to say this was nonsense – they were definitely committed to restoring the services as soon as the crisis is over”, he said.
NI’s A&E departments (all 24-hour unless stated):
• Royal Victoria Hospital
• Children’s Hospital (Royal site)
• Mater Hospital
• Ulster Hospital
• Lagan Valley Hospital (8am to 8pm, Monday to Friday)
• Downe Hospital (8am to 8pm, Monday to Friday)
• Antrim Area Hospital
• Causeway Hospital
• Craigavon Area Hospital
• Daisy Hill Hospital
• Altnagelvin Area Hospital
• South West Acute Hospital
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