Socialist Worker

Healthcare in the community does not make up for closures

Issue No. 2308

Supporters of closures often argue that many patients currently going to A&E could be treated better elsewhere.

But all closures will make things worse.

Consultancy firm McKinsey advises NHS North West London on the need for A&E closures.

It argues that as many as 50 percent of A&E cases could be diverted towards community health services.

The College of Emergency Medicine described this claim as “fiction”.

A recent Department of Health study gave the figure as between 10 percent and 30 percent.

But a greater problem is that many of the services intended to pick up the slack left by A&E closures simply don't exist. And community health services themselves face 10 percent cuts over the next three years.

Most A&E workers will agree that many turn up who do not require emergency care. But they also point out that often vulnerable people come to A&E because it is the only way they are able to access the health service.


This includes people with mental health problems, migrant workers or refugees, older people and those with disabilities.

Many of these people sometimes have great difficulties getting an appointment elsewhere.

Norma Dudley works in community health in Walthamstow, east London.

She told Socialist Worker, “There are people who find it difficult to register with GPs, and it’s easier for them to access medical care at A&E.

“But these arguments are used to close and cut A&E services—when the service doesn’t end up being provided in the community.

“District nurses are being cut, and we don’t have the provision if they cut the A&Es with no plans to develop services in the community.”

Patients turning up to A&E when they struggle to access the non-emergency care they need is a feature of an underfunded and understaffed NHS.

Cuts will only make this worse.

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