MAY I congratulate you on your coverage of the overnight closure of the MIU at Cirencester Hospital, and try to put a new point of view into the debate?

In my opinion, the problem comes from the fragmentation of NHS services which continues to worsen through this government’s policies.

Last year Mr Clifton-Brown refuted my allegation that his government was wrecking the NHS, does he not see that health care cannot be measured in monetary terms alone?

We have a position in the county of five bodies responsible for health services, the Clinical Commissioning Group whom administer the funding through the Gloucestershire Hospitals Trust, Gloucestershire Care Services, the 2gether Trust and South West Ambulance Trust also in addition various services are or could be provided by private companies.

All of these bodies face year-on-year cuts to their budgets, making decisions in isolation, but which impact upon each other.

In your latest edition you have an article regarding an old lady waiting hours for a response after a fall, but the ambulance service is under such extreme pressure that crews work an entire shift racing from one call to another, often not being able to take their full breaks.

Recruitment is very difficult and morale low, but they still do an excellent job under the circumstances.

The two main A&E departments run by GHNHST are failing to meet targets and an announcement  expected about this situation is likely soon.

I remind you that the Cheltenham General Hospital A&E already only fully operates between 8am and 8pm, putting more pressure on other hospitals and services, especially the ambulance trust.

The closure of the two 24-hour MIUs will only add to this pressure, and in the case of Cirencester, with its catchment area’s unique proximity to Swindon, will mean even more people showing up at that already busy and “creaking at the seams” A&E.

With regard to the amount of people using these MIUs,I know that other than the occasional quiet night Cirencester was often very busy with people turning up with all sorts of conditions.

Until about a year ago, Cirencester Hospital had a casualty doctor and other doctors including some local GPs maintained the night coverage, this was ended with an excellent doctor being lost to the service and no doctors on duty overnight.

When this became common knowledge patients started to go elsewhere.

It was after this move that the trust needed to increase the number of specialised nurses on duty and this problem was aggravated.

So with all these problems, to out of hours and emergency care in the county where do we go from here?

The present review should be postponed and the Clinical Commissioning Group should organise a round table conference including the trusts, representatives of the medical associations and societies, trade unions and patient representative groups and find a comprehensive solution to these ever-growing situations.

REG  BEAGLEY 
Chairman, Unite the Union, Gloucester area health sector branch