Most hospitals have experienced a 20 to 30 per cent increase in emergency admissions over the past year or so. The expected summer decrease in these admissions has not occurred. The reason for this is not apparent.
The instrumentation needed for laparoscopic (or any other form of hi-tech) surgery is expensive and delicate. Thus capital funds are needed to buy the intruments before the advantages can be realised, revenue required to buy disposable instruments, and further capital will be needed to replace outdated or worn-out equipment.
The number of patients that can benefit from shorter stay or day case surgery is limited to the relatively fit, and an increasingly aged population often living alone may further reduce the pool of suitable patients. Moreover, a proper after- care service needs to be set up in the community before the early discharge programme is begun.