Campaigners calling for the reinstatement of the minor injuries unit in Armagh can take fresh hope from comments made by Health Minister Simon Hamilton in the Assembly.
It was last October that the Southern Health and Social Care Trust Board recommended the Tower Hill facility should be “permanently closed”.
That was a decision taken after a public consultation on the future of the unit, which ran from the end of May until mid-September last year.
The minor injuries never reopened after an earlier ‘temporary’ closure and October’s news meant that the facility was essentially dead in the water!
The recommendation to permanently close the unit was based – according to the Trust Board – on persistent low usage of the unit – averaging 3.4 patient contacts per hour – in the two years before it was temporarily closed.
The Trust, in making the decision, said it had been closely monitoring the impact of the closure which had shown that, although there is an increased attendance at South Tyrone MIU in Dungannon, there had been “little impact on the Emergency Departments at Craigavon Area and Daisy Hill Hospitals”.
The Trust Board recommended to the Health and Social Care Board that the unit would “permanently close”.
That was for consideration then for the Health and Social Care Board.
But the emphasis is on ‘consideration’ and reassurance had been given that “there will be no move to implement the plan until such times as Ministerial approval has been given”.
And the Minister has yet to make that decision.
It is also seems unlikely that it is a decision which will be taken before the May Assembly elections.
In fact, while the Health Minister Simon Hamilton accepts that evidence existed of low use figures, he addressed the issue in the Assembly, and, in relation to the closure, said: “A final decision has not been taken to make that permanent.”
The Minister’s comment came after he was questioned by Newry and Armagh Ulster Unionist MLA Danny Kennedy, who had asked Mr Hamilton “why he is unable to outline the savings made by the temporary contingency measures announced by each health and social care trust” in October 2014.
The Minister responded: “In response to the significant financial challenges facing my Department in the 2014-15 financial year, the health and social care trusts prepared a range of contingency proposals to help them meet their statutory obligation to deliver financial break-even in that year.
“The measures proposed by trusts were wide-ranging and reflected the measures that could achieve financial savings in the latter part of 2014-15.
“My Department monitored the achievement of the overall break-even position rather than tracking the achievement of each individual contingency plan proposal.
“It is important to emphasise that overall financial break-even was achieved in 2014-15, and the trusts’ contingency proposals played a key role in delivering that outcome.”
Mr Kennedy pressed further, saying Minister Hamilton had conceded that “the motivating factor behind those decisions was to save costs, with, unfortunately, patients and service users being overlooked and ignored”.
The local Assemblyman continued: “Those decisions were spun as being temporary, but of course many have become permanent. Can the Minister explain how decisions such as the closure of the minor injuries unit in Armagh correspond with and complement departmental policies such as Choose Well and seek to keep people out of emergency departments?”
Mr Hamilton said the Newry and Armagh representative would recall in 2014/15 the situation in “respect of public finances at that time”, because of the “issues surrounding welfare reform and not progressing that, and the fines that were starting to impact on what was not my Department then but is my Department now, and what was previously his Department”.
Turning to decisions in relation to the Armagh minor injuries unit, he said that it had been it “a temporary closure”.
And he added: “A final decision has not been taken to make that permanent.
“My understanding from the trust — and these are all decisions that are taken by the trusts, not by the Department, in order to live within their budget in the financial year — was based on many pieces of evidence, but not least the fact that the number of people attending that minor injuries unit in Armagh was only four per hour on average.
“Some of that resource has been moved to Craigavon to assist the situation there with the emergency department.
“In respect of the overall position about whether it is the best way to make efficiencies, I am on the record since becoming Minister as saying that, when you have a situation where you are making efficiencies or savings on the basis of budgetary pressures, it will sometimes — even though the decisions are probably in the best interests of the community that we seek to serve — give the impression of not being strategic or long-term.
“That is why I have tried to change the conversation around trying to take a long-term view about the need to reform our services, taking decisions that are in the best interests of the people and patients that our health and social care system is there to serve, and to give a clear understanding to people as to why a particular decision is being taken and why that will produce a better outcome for them, because, at the end of the day, the patient is the most important part of our system.”