THERE is little prospect of a rethink over the closure of the accident and emergency department at the Queen Margaret Hospital despite 20,000 local people signing a petition to bring it back.

At the NHS Fife annual review last Tuesday, there was no encouragement for petition organiser Jim Philp from the board or Scotland’s cabinet secretary for health Alex Neil.

Mr Philp told the meeting, “I’ve been running a petition on behalf of the people of West Fife who feel they are being discriminated against.Do you think it’s fair to make the people of West Fife pay an extra cost to go and visit people in Kirkcaldy and to access A&E treatment. A&E treatment to most people is the most important part in the function of a hospital.” NHS Fife chair Allan Burns said, “A few years ago they looked at the best utilisation of the service to the whole of the community. Part of the challenge that we have is much of the demand for A&E can be met by minor injury units and we don’t use them as effectively.” NHS Fife medical director Brian Montgomery said, “A relatively small minority of patients actually need the facilities of the full accident and emergency department. One of the things that is of particular concern to me is that the minor injuries unit at this hospital is actually under-utilised.

“What we see is people choosing to go from Dunfermline to A&E at Kirkcaldy who could be more appropriately dealt with and more easily dealt with were they to come here.If you’ve got an A&E department you also need all the appropriate specialities standing behind that. You need medical experts, you need surgical experts, you need an intensive care unit you need imaging like CAT scanning and MRI scanning. Without those you don’t have an accident and emergency department so one of the things we have seen not just locally but nationally is the number of full scale accident and emergency departments has reduced in recent years so that the expertise can be concentrated.

“It makes more sense to consolidate two units into one. I understand that had the consolidation been on the Dunfermline site I would probably be facing a petition from people in Kirkcaldy. The reality is you cannot please everybody I’m afraid and by centralising the service on one site you inevitably will cause some inconvenience to people from other areas.

“My argument is that the inconvenience is more than offset by the gain in the treatment and outcomes that are available. It’s been shown that you get a much better result if you travel to the right unit.I’m talking not just about the UK here. If you look at Canada and Australia people will travel hundreds of miles to get to their nearest A&E department.” Mr Philp retorted, “We don’t live in Canada.” At this point Mr Burns said he would be happy to receive the petition and have a full discussion on the issue at board level. Asked if the petition was simply a waste of time, given the lack of political will to re-open the A&E, Mr Neil said, “A Labour minister took that decision many years ago and obviously the chair of the health board said he will listen and hear what people have to say but to re-establish an A&E department is not an easy thing to do, particularly when there’s a national shortage of A&E consultants. The centralisation was under the previous administration. As you know, we saved two A&E departments, one in Ayr, one in Monklands because Labour had plans to close them down but obviously there’s a difference between stopping a department from closing and creating a new one.”