WHEN progress cannot be made then we can be forgiven for looking to the past for background causes of today’s healthcare problems.

“Ludlow Town Council is concerned that the diminution of facilities at Ludlow hospital and elsewhere is not matched by a planned increase in community services. Any shortfall in the provision of continuing care for the elderly from the levels currently provided will lead to an increasing workload on community nurses which will be difficult to meet with the present staffing levels.”

So wrote D S Pauli, Ludlow town clerk, on October 12, 1988 in the report 'Shropshire Hospitals – A Crisis'.

The report was in response to the health authority proposal to close 10 cottage hospitals and reduce bed numbers significantly in other hospitals in the county – a net loss of 367 beds.

Ludlow, which had 91 beds, was reduced to 75, later adjusted to 72.

The report went on to predict that waiting lists will be of unacceptable length, bed-blocking will be inevitable, elderly people will occupy expensive acute beds rather than community hospital beds and the increasing pattern of early discharges will put an intolerable strain on community services.

“Community care will break down completely.”

Since 1988, Ludlow hospital has seen further reductions to 45 beds in 2006, to 40 beds by 2013, then 24 beds in 2015 – and still there is talk of Shropshire having too many hospital beds – despite an increasing population and ever higher proportion of elderly residents.

Thirty years on and Shropshire’s health economy is still grossly underfunded compared with other areas and so the slash and burn reductions continue.

Rural healthcare deprivation is now widespread across Shropshire.

However, the various NHS bureaucracies continue to flourish – so that’s OK then.