Expect A&E units in every town

No-one denies that hospital casualty departments are in desperate need of reform. They are a national embarrassment. They are grim, angry places where bewildered citizens sit for hours, often in pain and shock, waiting to be treated.

In fact, about the only thing they have in their favour is that they are local.

Now, apparently in a dream world of his own creation, Tony Blair declares that “the best is yet to come” in the NHS and calls for “centres of excellence” to replace existing A&E units.

The result, if it goes ahead, will be fewer A&E units spread thinly across Britain.

Mr Blair has become convinced that only a new generation of super-A&E units can provide proper life-saving care for heart attack and stroke victims.

He may be right - but only on condition that the victim happens to have the attack a convenient distance from one of these new centres.

The best A&E unit in the world, stuffed full of the finest specialist surgeons, is no use at all if it takes the ambulance an hour or more to get there.

And in any case, the vast majority of people seeking A&E help are not at death’s door.

They are the bruised and bloodied victims of household accidents or street violence. Most of them need nothing more than a few stitches or a bandage.

These are procedures once carried out by family doctors and cottage hospitals. They have been handed over to A&E units which cope as best they can.

But if these local units were swept away and replaced with a few national super-units, what would become of the mugging victim, the Sunday-league footballer or the DIY fan who has taken a tumble off a ladder?

Every large town and city should have a properly funded 24-hour A&E unit capable of dealing, in a reasonable time, with everything from major heart attacks and road injuries to a sprained wrist.

That is the reform we expect, Mr Blair. That is what we pay taxes for.

England down, but not yet out

Once again, as so many times before, an England cricket team snatches defeat from the jaws of victory.

All is not yet lost.

The opening hours of the Second Test showed England is still a force to be reckoned with.

Our mistake was in underestimating Australia’s determination and strength in depth. They simply refused to countenance a defeat or even a draw.

History suggests that England now two Tests down, have little hope of retaining the Ashes.

But history counts for nothing if we can only muster the same sort of spirit as the Australians showed today.