Whitecoat, my initial concern was that you were mistaking Rose Johnson as someone with no ED experience/knowledge whereas she is in fact extremely qualified to put forward these recommendations.
In my area we already work with a system as recommended, what we lose in the 10-15 minutes extra travel time (maximum) we make up for in centralisation of experience, knowledge and facilities.

Newspapers in this country, and I’m sure in yours, love sensationalising everything. A downgrade becomes a ‘closure’ which then gives the papers something to write about and makes them look like champions of the people. A few years ago we closed an old 18th century hospital in my area which was frankly dangerous, but according to the papers we were going to cause all sorts of harm. it wasn’t until the senior doctors wrote and told the people the truth that the papers stopped.

Trauma: the air ambulance service (helicopters in England, Scotland also have planes for some of the most remote islands) for very urgent transport of major trauma cases and select other extremely time-critical patients cuts the travel time to pretty much any hospital in the entire COUNTRY down to a matter of 20-30 minutes. Such patients will be taken directly to the nearest trauma centre/burns unit etc as appropriate, and they’ll generally get there very quickly indeed.

I genuinely doubt that downgrading Redditch A&E to a minor injuries unit will have any catastrophic effect on people getting the care they need in good time.

Evidently we do. Sounds like the voters and taxpayers have spoken. If they don’t like the current state of affairs, there’s always another election around the corner.

The intent of this post wasn’t to compare the two systems. Then intent of the posts was to make people think about some of the potential undesirable consequences of cutting emergency medical services.

The article I cited stated that they were considering “getting rid of one of the county’s two accident and emergency departments – in Worcester and Redditch”. Those two cities are 20 miles apart according to MapQuest. Someone having a heart attack that has to drive an additional 20 miles or more just to get care is not a 3-5 minute difference in trip timing. More like 35 minutes difference in timing according to MapQuest – under ideal traffic conditions and assuming that there are rigs available.

Whether or not the systems are different, there are many conditions that are time-critical for treatment. Consider strokes, MIs, and major trauma just to name a few. I obviously don’t know the topography, traffic, and landmarks in England, but there are aspects of medicine which are universal. The “golden hour” doesn’t change with a patient’s country, health system, or EMS system.

Emergency care, both EMS and ER’s – I mean ED’s – need to be kept accessible to everyone. Not just people who can afford it, or people who live nearby; everyone. I know this creates problems with drug seekers and malingerers, but the alternative is a world where people with true emergencies can’t get good care. Imagine getting into a car crash and having the EMT’s check peoples’ insurance cards before treating them.

We’re also much, much more densely populated than most of the US. When A&E departments are downsized or closed, journey times are typically increased by 3-5 minutes for patients who’d otherwise have been taken to that hospital.

No comparison really.