Debate contribution: Bangor and Newtownards Minor Injury Units: Closure
Debate contribution by Mr Alex Easton on .
- MLA
- Mr Alex Easton
- Party at the time
- Independent
- Date
- 30 April 2024
- Type
- Debate contribution
- Business
- Adjournment
- Heading
- Bangor and Newtownards Minor Injury Units: Closure
- Assembly identifier
- Official Report component 4487751
Read the official Assembly record
Text
At the outset, I say to the Health Minister that I in no way blame him for the closure of the Bangor and Newtownards minor injury units. My comments are not directed or aimed at him in any way but are comments of frustration and annoyance about the closure of the two minor injury units. I hope that he understands that. I suspect that, had the Minister been in place, there might have been a different outcome. On 6 March 2023, the South Eastern Health and Social Care Trust launched a consultation to close the Ards and Bangor minor injury units. The Bangor minor injury unit had already been closed for some time due to COVID. I always said that it would never open again, despite reassurances at the time from the Health Minister that it would be reopened. How accurate my prediction was: the Bangor minor injury unit never reopened its doors. It was stripped of its equipment even before the consultation was finished. The South Eastern Trust launched its consultation with one public meeting in Newtownards, attendance at which was booked through a complicated system, which immediately put people off going. A further two Zoom meetings with restricted numbers were held. No meeting was held in Bangor, despite it having the larger population, nor was there one for residents living in the Ards peninsula, the furthest point away. On the evening of that one public meeting, the South Eastern Trust arranged a format that meant you had to hand in questions beforehand so that it could control what was asked and by whom. So much for a fair consultation. The South Eastern Trust proceeded to say what its plans were. Closure, with the announcement of a new minor injury unit at the Ulster Hospital site, was the only option. The consultation farce continued with the South Eastern Trust's failure to mention that the Ulster Hospital was not creating a new minor injury unit, because there already was a minor injury unit at that site. Ironically, few people knew about it. It was the world's best-kept secret. The next farce came when the new unit, which was not new, was moved into the old Ulster Hospital A&E unit, which was declared not fit for purpose by the South Eastern Trust itself. At the public meeting, the South Eastern Trust claimed that it was closing the units as a result of the Bengoa report. That is where I have a problem. Minister, your colleague and mine, Alan Chambers, pointed out in 'The County Down Spectator' on several occasions that the Bengoa report should not be used as a reason to close MIUs; in fact, the Bengoa report does not even mention MIUs. The consultation documents were the poorest example of their kind. It is difficult to see how any external consultee could have provided an informed response that might have affected the South Eastern Trust's decision-making process on the basis of the document. There are two main issues with the consultation documents. First, important information on the policy, background and evidence base that informed the South Eastern Trust's decision-making process was missing from the consultation document.
Secondly, insufficient assessment was done of the impact of the proposed changes on service users, including section 75 groups.
That is problematic, as the scale of the change is likely to generate different impacts across areas and population cohorts on their having access to minor injury services. The consultation did not provide evidence of the South Eastern Trust's preferred option: the replacement of the two minor injury units with an urgent and emergency care centre. That has not even got off first base and was a red herring. It could be years before it happens, if ever. The Department of Health's 2022 review of urgent and emergency care services unambiguously states:
"Urgent Care Centres do not replace existing Minor Injury Units."
It is clear that the review was conducted on that assumption. The accompanying equality impact assessment (EQIA) was also flawed. First, it was prepared using outdated statistical information from the 2011 census. That data was superseded by results from the 2021 census, which were published between September and December 2022. The trust did not use that updated information. In addition, the disability measures used in the equality impact assessment did not accurately reflect the number of individuals with a disability in the relevant geographical areas. That was because it used a measure based on households rather than on individuals. The equality impact assessment also did not measure the different impacts of the proposals on section 75 groups. It merely listed the number of individuals falling into each category in two broad geographical areas. In fact, by the South Eastern Trust's own admission, it openly discriminated against those who are disabled in the consultation on the closure of the minor injury units. The consultation approach to the Bangor minor injury unit was problematic. The location was shut temporarily owing to the COVID-19 pandemic, without there having been a public consultation, yet the subsequent consultation document was produced on the basis that that closure was permanent. That meant that the consultation focused primarily on the proposals to close Ards minor injury unit, with minimal reference made to the facility in Bangor. That seemed inappropriate, especially as the South Eastern Trust's preferred option would have had a greater impact on residents of Bangor, owing to the greater distances to travel, poorer-quality roads and weaker public transport links to the Ulster Hospital site. From a freedom of information request, we know that the South Eastern Trust did not even bother to contact Translink about improving public transport to the Ulster Hospital site. The consultation also contains a number of concerning elements, suggesting a lack of understanding of the area and the issues involved. First, the South Eastern Trust consistently used a map in the consultation that does not accurately represent the area. The map shown in the consultation included the entire Newry, Mourne and Down District Council area, which has nothing to do with the South Eastern Trust area. We therefore know that the consultation and the equality impact assessment were a farce and a foregone conclusion. Let us look at the impact on the Ulster Hospital site. We know, from a freedom of information request, that the new A&E building is smaller than the old one, has fewer beds and is too small overall. Well done to the person who thought that one up and designed it. We know that there was no new minor injury unit on the Ulster Hospital site, as there was one already there. We know that some new, additional car parking spaces were provided. Anyone going up to the Ulster Hospital, however, has to wait for a space and is often met with queues. That means frustrated patients and visitors waiting for long periods. I took my wife up there this morning because she had previously fallen and broken her hip and had an outpatient appointment. We had to wait 45 minutes to get a car parking space, so that is more evidence. We know that, as a result of the closure, only seven members of nursing staff from the Ards and Bangor sites transferred. The rest left, so we have lost valuable staff. What do we know about the patients who were attending the Ards and Bangor minor injury units annually? We know that up to 13,000 patients a year were attending the Bangor minor injury unit. Some 10,200 patients a year were attending the Ards minor injury unit. Those stats were provided in answers to Assembly questions. Either they have not gone to the Ulster Hospital minor injury unit because they cannot stand the thought of going there and spending hours waiting or they have tried to go to their GP. GPs are not seeing patients as they did pre-COVID, however, and people do not want to queue on the phone for hours just to wait on a call from their GP. Then, of course, some people have gone to the Ulster, adding to the waiting times, backlogs and car parking issues and putting more pressure on the Ulster Hospital site, which is not equipped to cope. It is no coincidence that the Ulster has frequently declared an emergency as a result of A&E being too busy due to the number of people attending. According to the response to a question for written answer, there were zero savings to the South Eastern Trust budget from the closure, so the question is this: why close the MIUs when, between them, they kept 22,000 people away from the Ulster Hospital site? If there were no savings, why did they do it? We then come to the Alliance Party, which gave the South Eastern Trust political cover to close the Bangor and Ards minor injury units. Its political reps said:
"Minor injury units are not good enough and should go".
I quote two Alliance councillors, who said that the units had not been "of any use". If they were of no use, why did 22,000 people use the two minor injury units at their height? Over 20,000 people signed a public petition opposed to the closure of the units. That was ignored, even though, in the public consultation, 80% opposed the closure. That was also ignored. What is the point of a public consultation if the public's responses will just be ignored? The closures have achieved nothing but the creation of a bigger crisis at the Ulster Hospital site, with longer parking waiting times, overworked staff and frustration for the public. Minister, I thank you for hearing my frustrations and those of the public who, until now, have not had their voices heard. I hope that you will rethink the closure of the MIUs, because the staff did a wonderful job and took a lot of pressure off the Ulster Hospital site.
1,650 words. Text as published by the Northern Ireland Assembly.
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