Sep 23 2011 by Lisa Boyle, Ayrshire Post (main ed)
A RETIRED doctor says health chiefs may be condemning the elderly to death if they push forward with plans to centralise orthopaedic services.
Former orthopaedic consultant Patrick McNally is adamant lives will be lost if the controversial proposal is made a reality.
He said patients with broken hips (fractured neck of femur) will have to wait longer to be operated on – hugely decreasing their chances of survival.
Dr McNally said: “We know that because of pressure on waiting lists, occasionally neck of femur patients surgery is postponed because of administrative, theatre and anaesthetic resources.
“Unless it’s possible to ensure that they will at least duplicate trauma theatre availability, I cannot see how you can draw any other conclusion other than people’s lives will be put at risk.”
Dr McNally says the only way to avoid patients suffering is to pour hundreds of thousands into orthopaedic trauma services.
He continued: “You will increase the rate of mortality if this is centralised without significant investment, and if we’re talking about saving money it’s simply not possible.”
Referring to a Scottish Government report which concluded that health chiefs manipulated their case to close Ayr’s A&E in 2005, he added: “I would like to see this clarified because we know about NHS Ayrshire and Arran’s history of misleading the public. There must be a searching analysis of what’s being proposed here.”
And Dr McNally went on to raise questions of logistics and practicality.
He said: “What is going to happen to patients who are admitted to Ayr Hospital at night and stay overnight? Is there going to be a perpetual ambulance shuttle service between the hospitals? A broken limbs bus?
“Are you asking ambulance staff to decide whether or not to take someone straight to Crosshouse incase they need an operation? You can’t lay that responsibility at the paramedics’ door.”
It’s feared the health service will be put under immense pressure to abide by national guidelines stating fractured hip patients should be operated on within 48 hours of the injury.
He explained: “Say for example you have an elderly lady in Dalmellington who falls at around 1pm and is found by her granddaughter on her return from school.
“The patient is then taken to Ayr hospital by ambulance and lies in casualty for an hour or so waiting to be x-rayed.
“It’s then decided she has to go to Crosshouse hospital for surgery. Is an ambulance to transport her going to be available straight away? Probably not so she could have to wait another couple of hours before she heads to Crosshouse. Then of course, she’s at the bottom of the queue to be processed there and eventually taken into a ward. So you could end up seeing patients lying in trolleys twice as long as they are now.
“And we know that the longer a patient lies on a trolley, the more they are at risk of developing bed sores, respiratory problems, deep vein thrombosis and the many other issues associated with elderly patients.”
Dr McNally concluded: “I have the greatest hesitation about these proposals, especially given the recent reemphasis of guidelines that fractured neck of femur patients should have surgery as quickly as possible.”