A Highland GP on life the universe and anything…

Ross Memorial Hospital, a proud past but what of the future?

Talking to my patients, it is clear that the majority of older people would wish to be cared for in our local hospital if at all possible. This is entirely understandable as the nurses there provide a caring and professional local service, with excellent aftercare following their discharge home. Unfortunately it is becoming harder and harder to make this happen.

Despite renovations to the building, the number of inpatient beds has been steadily cut, from the original eighteen down to thirteen, and recently to a new low of nine. A review of the Ross Memorial Hospital is currently under way with a public meeting being held on Wednesday 26th October at the Ross County Stadium. With the present difficult financial situation there is a real risk that these nine beds will be lost entirely. I believe this would be short-sighted as patients will then need to be cared for in the busy and specialised beds in Raigmore, at far greater cost.

The Ross Memorial Hospital is accustomed to adapting to the changing needs of the population. Built by public subscription in 1873, it had a key role in controlling Typhus and other “fever cases”, with a separate fever ward being opened in 1920. From 1946 to 1990 a much-loved Maternity Unit was housed in the building that is now home to the Rheumatology Unit.

Over the years the Casualty Unit has been upgraded and improved and is now also used as the centre for “Out of Hours” care to the local area. Specialists from Raigmore and New Craigs continue to see patients at the Outpatient Clinics, and the hospital is also the base for X-ray and Bone Densitometry Scanning as well as Physiotherapy, Occupational Therapy and Dentistry.

But the presence of these vital, locally-based services may not be enough to ensure the survival of its nine remaining inpatient beds. The present ward is considered to be outdated and failing to meet new strict standards with regard to infection control and fire safety. And worryingly, its closure would impact on the viability of the Casualty Unit, as medical and nursing staff is shared with the ward.

So where would the inpatients go? Apart from Raigmore, alternative beds might be sought in local Nursing Homes but availability is not guaranteed. Besides which, there is a real fear that devolving care in this way would lead to different levels and standards of care and an effective privatisation of care provision in the Highlands. Physiotherapy, Occupational Therapy and medical care would no longer be available on site for these patients, and the nursing expertise in undertaking this sort of work would be lost.

There is an alternative to closing the Ross Memorial inpatient ward. The Kerr Report of 2005[i] clearly states the need to invest in local community provision. Surely we have an opportunity here to reverse the continued emphasis on centralised, highly specialised services? Our ageing population is desperate for the sort of care provided in the Ross Memorial Hospital and if it was maintained and developed it can also be a hub for still more services such as Day Hospital Assessment, the provision of intravenous infusions and other Outpatient treatments. The alternative would be patients travelling to Raigmore or Invergordon and whilst that may be acceptable to younger people with access to cars, it is much more difficult to access by those relying on public transport.

Fortunately we no longer care for patients with Typhus, and surgical cases are excellently catered for in Raigmore. However people are living ever longer and as a direct result, patients are often seen with several ongoing health problems at once. Certainly, at times they need intensive and specialised care but far more often they need time spent on their assessment and care by staff with more “generalist” skills. I believe that is what is provided by the Ross Memorial Hospital and that it is worth investing in for the future. I hope that is the outcome of the present review and the consultation with the public on Wednesday 26th October. For anyone wanting to make your views known I’m sure Councillor Margaret Paterson, who is chairing the review, would be glad to hear from you.

Dr Miles Mack

8.10.2011

Notes
The Ross Memorial Hospital is a small community hospital in the town of Dingwall, 15 miles north of Inverness. Dingwall is the county town of Ross-shire.
This article was first published in the Ross-Shire Journal on Friday 14th October 2011
http://www.ross-shirejournal.co.uk
A recent document ( Achieving Sustainable Quality in Scotland’s Healthcare – A ’20_20′ Vision1 Sept 2011) appears to support the aspiration for providing day hospital and inpatient care in the community rather than resorting to Acute Hospital care such as is provided in Raigmore Hospital.


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Comments on: "An everyday story of threatend closure of a Community Hospital" (1)

  1. Good news in this weeks Ross-shire: –
    http://www.ross-shirejournal.co.uk/News/Future-for-Ross-hospital-looks-brighter-as-closure-threat-dismissed-16082012.htm
    I hope this is followed up by some longer term planning for the Hospital as part of local health system.

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