I did not intend to blog tonight but I came across a matter of importance for everyone, especially for us here in remote areas but it is a signal as to what could be around the corner for regions in the UK as a whole.

There is a proposal for neurological units in Scotland to be merged. It is likely that there would be one main centre of excellence expected to serve diverse and far flung communities, many of which have limited access to resources now.

What resources do exist locally are at a relatively low base and because of poor transport infrastructure, are expensive to reach. Compensation for trips further afield, and there are many required, does not cover anything like the true costs; it does not extend to the need for overnight stays and the expenses incurred. Families are split apart sometimes, for months on end while a parent, for example, stays nearby a sick child in hospital hundreds of miles away from home. The expense, physically and financially, for those that manage to stretch to the cost is enormous, and for those who cannot make arrangements or afford the costs involved, their children are not supported by family whilst undergoing treatments for serious conditions.

Our community physicians do not have ease of access to medical information that could be vital to care in the community, communications could be better and need to be. People are discharged from major hospitals that have the specialised departments that their conditions required, sometimes without appropriate follow-up care and they are left to chase whatever they need, or can get, or fester in the community. Much of the follow-up care required is only available on an outreach outpatients' clinic system where consultants from the regional hospital rotate visits bi or tri monthly. As the regional hospital does not have all the major departments, some areas, like neurology may have limited ongoing attention.

There are dialysis patients, many of whom are very elderly, who are expected to travel up to three times a week on a 240 miles round trip on a bus or train. (There is to be an expansion of local service as the current eight beds are in full use.)

Our area has just avoided having the local maternity unit downgraded to a midwife-led service. We are remote, with difficult roads to travel. We can be cut off in bad weather and the medical helicopter cannot be relied upon to be available if a dire need arises. There have been difficulties obtaining the services of an ambulance and a very serious, case personally known to me, suffered delayed ambulance transport as there were none to be had in the county. Another was found elsewhere to cover the 120 miles south. It had to travel northwards to collect the patient, but then there were problems obtaining the services of a midwife because the ambulance crew could not get her home! Mother and expected baby were in a very, very serious state, because of the delays, when they eventually arrived at their destination. An enquiry ensued. It has not, sad to say, improved the state of the ambulance service.

So, now, presumably as a cost-cutting exercise our already difficult access to services is to be made impossible by merging centres of excellence into one farther afield corral. By default, there will be a further rationing of services, accessing their use will be more of an obstacle course than it already is and, if I am not mistaken, it may encourage another Highland Clearance.

There is an on-line petition for retaining the Aberdeen Royal Infirmary Neurology services which can be accessed through the following link;
http://www.brainhelp.co.uk/

We really do need lots of support on this matter. Thank you.

See Purple Dragon as well, on this issue: http://purpledragon.blog.co.uk/