Sign of things to come?

North Wales is a good place to start assessing the current state of the NHS. It isn't often that you get three district general hospitals to supply the needs of a population as small as 675,000 people. That is the reality for people living in the North of the Principality. Given such comparitive luxury, you may be forgiven for expecting a Utopian vision of the NHS. You would be very disappointed.

It is revealed that ambulances turning up at Glan Clwyd hospital just outside Rhyl had to be turned away because the hospital couldn't take any more admissions. Instead, these ambulances were sent to the other two hospitals in Wrexham and Bangor, each being 33 miles away. I can only hope that there weren't any serious emergencies on board those ambulances because a delay of that order could easily be the difference between life and death.

All this comes in the aftermath of the decision to close community hospitals in Flint, Llangollen, Blaenau Ffestiniog and Prestatyn. As with other rural regions of the UK, the problem with a place like North Wales is its geography. We can change many thnings but distance isn't one of them. That is why North Wales has had such a robust distribution of smaller community hospitals. Campaigners correctly warned against their closure citing that patients would simply be relocated to the larger district general hospitals thus blocking bed space normally at hand for acute admission cases.

Nationally, the NHS pattern seems to be to build a massive central hospital and expect everyone to travel to it irrespective of the distances involved. This approach is riddled with flaws and moreso in a place like North Wales. Many of the population are reliant on a public transport sytem which is often more of a threat than a promise. Many live in rural communities miles from anywhere. The cost of fuel for those who do drive has inflicted yet another burden on already stretched resources. Big is not always beautiful and the standards of care in the smaller community hospitals is often much better because many of the staff are local and familiar to the patients.

This is simply a question of recognising the best setting for sections of our patient population. Up until the closure of the North Wales Hospital in Denbigh, most care of the elderly was looked after very well with the community hospitals picking up the pieces. Since the closure, the strain on the community hospitals has just become greater as our population continues its relentless feats of longevity. It therefore seems mad to close these vital units down because the district general hospitals will obviously bear the brunt. This is further proof of the folly of short sighted thinking. To ditch the vital resources which you already have is daft when the existing DGHs can't even cope with the numbers coming through the door as it stands.

In Llangollen, the folly has been taken to a new level. Following the closure of the community hospital which has served the town for 150 years, the powers that be announced plans to build a new one about 500 metres down the road. If I live to be 100, I will never understand the ratioanle for such an idiotic decision. This is madness followed by waste at a time when we are told there is no money. It's no wonder the NHS is struggling so much with decisions like these.