Time to try something new with Purley’s £11m hospital

CROYDON COMMENTARY: Barely a year since major works were completed and it re-opened, Purley Hospital has switched to reduced hours because of… lack of use. DAVID CALLAM sees this as a missed opportunity for the over-stretched NHS

Croydon NHS must have money to burn.

Purley Hospital signLast year it spent £11 million on refurbishment at Purley Hospital. Now the opening hours have been slashed, apparently due to lack of use.

The refurbishment has been talked about for decades, demanded by the denizens of Purley, supported by their MP, Sir Richard Ottaway.

It beggars belief that in all the preparations nobody among the overpaid, overstaffed local, regional or national NHS management teams bothered to check the likely usage. In fact, it seems someone did, but there is now a dispute between the project manager’s figures and those being quoted officially.

You couldn’t make it up. If a private company didn’t research its market properly before making a substantial investment, it would soon go out of business.

Shortening Purley’s opening times to just six hours a day is such a wasted opportunity. Croydon’s only Accident and Emergency department is at Thornton Heath, in the north of the borough. The next one, travelling south, is beyond Redhill. In London’s most populous borough, there is surely a case for an A&E in the Purley area.

Where better than at Purley Hospital?

The present facility is neither an A&E nor an urgent care unit. It’s a minor injuries unit. Is that similar to a walk-in clinic, or what? And how do its capabilities compare with those of a GP surgery?

Jeremy Hunt and his chums in government complain that A&Es are inundated with people who don’t need to be there, and yet successive health ministers continue to confuse the issue by introducing different degrees of treatment with different opening hours and different levels of expertise.

They expect us to know which one to use and when. Can they really be surprised if, in an emergency – real or imagined – we call 999 or head for the nearest A&E?

Health professionals tell us we need to reduce drastically the number of hospitals nationwide because they are unsustainably expensive. The present geographical spread results from decades before the NHS, when founding a hospital depended on the patronage of a local Lord or Lady Bountiful to cover building and running costs.

I’m told it costs 10 times as much to see a doctor in a hospital out-patient clinic as it does at a GP surgery. I assume an A&E visit would be cheaper if the unit was stand-alone, rather than attached to a district general hospital.

So do we need a standalone A&E, open 24/7, in every major population centre? From there we could transfer patients, once stabilised, to one of a smaller number of specialist hospitals, albeit further away. I would attach a GP practice to each A&E so a triage nurse could redirect patients who didn’t need emergency treatment, avoiding turning them away without help.

Purley would be an ideal place to test the model. I’m sure it would attract large numbers of people – in an area stretching from South Croydon to Coulsdon and from Woodmansterne to Kenley – if it was open all hours and properly advertised as such.

It would relieve the pressure on Croydon University Hospital on Mayday Road, and possibly on Redhill, too. And it would make proper value-for-money use of a recently refurbished medical facility.

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3 Responses to Time to try something new with Purley’s £11m hospital

  1. Nick Davies says:

    Might I suggest everyone looks at this explanation of how emergency care works:

    http://www.kingsfund.org.uk/projects/urgent-emergency-care/alternative-guide-urgent-and-emergency-care-system-england

    The problem with David’s suggestion is that he doesn’t say where the full range of diagnostic services and specialist medical teams that a general hospital has and an A&E department depends on are coming from. Without them what you’ll really get is a minor injuries/urgent care centre similar to the current facility.

  2. davidcallam says:

    Nick: thank you for the reference to the Kings Fund guide (above) which tells me how things are, but not how they might be.
    We cannot stay where we are: paying out ever-increasing sums of tax-payers’ money for a haphazard hospital network, largely determined by the whimsical generosity of Victorian philanthropists.
    Nor can we go on fire-fighting; battling a funding crisis every winter. That way chaos lies.
    Of course every A&E must have complete diagnostic back-up, but can that only be provided by having a district general hospital on site? Or are you saying simply that we shouldn’t change the service in any way?

  3. Nick Davies says:

    Well given that most people admitted to acute beds arrive there via A&E you might as well put them in the same place, along with the path labs, X-ray, MRI and all the rest of it that you need anyway. Add in the operating theatres and you’ve just built yourself a hospital.

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