One urgent care centre for 220,000 people: does Rochdale not deserve a real hospital?

A borough of 220,000 people. One urgent care facility. No A&E, no maternity unit, no children's ward. Is that really adequate for Rochdale?

Rochdale Infirmary is open, and its staff do valuable work. The Whitehall Street site runs a 24/7 Urgent Care Centre, a short-stay Clinical Assessment Unit, day surgery, a rheumatology centre, x-ray, blood testing, antenatal clinics, an early pregnancy unit, outpatient clinics and an eye unit. But the NHS's own description is blunt: there is no A&E at Rochdale Infirmary. The Urgent Care Centre treats minor injury and illness. It is the fourth smallest hospital in the Northern Care Alliance.

That is what remains of a hospital that, within living memory, was a proper district general. The A&E department closed in 2011. The maternity unit went the same way, along with the children's ward and, over the past two decades, ward after ward of acute provision - each removal justified at the time as centralisation, each leaving Rochdale residents travelling further for care.

Today, a Rochdale resident with a genuine emergency is sent to Fairfield in Bury, the Royal Oldham, or North Manchester General. On a good day, that is a manageable journey. In an ambulance queue, at rush hour, or for a family without a car relying on two buses, it is anything but. Every expectant mother in the borough gives birth outside it.

Does distance cost lives? The honest answer is that nobody publishes a Rochdale-specific figure, and we will not invent one. No official body calculates the percentage of local deaths that could have been avoided if a full hospital were closer, and any number we quoted would be guesswork. What does exist is peer-reviewed national research. A study of over 10,000 life-threatening emergency cases, published in the Emergency Medicine Journal by University of Sheffield researchers, found that the risk of death rose as the journey to hospital lengthened - from 5.8% for patients living under 10km away to 8.8% for those more than 20km away, with each additional 10km associated with around a one percentage point increase in mortality. Distance to emergency care is not a neutral fact. It is a clinical risk factor.

That research does not prove any individual Rochdale death was avoidable. It does mean the burden of proof should sit with those who decided that a borough of 220,000 people - larger than many towns and cities with a full district general hospital - can safely be served by a minor injuries facility.

The underuse of the Infirmary compounds the frustration. The site exists. The buildings exist. A workforce exists. Yet its role has been steadily narrowed rather than rebuilt, even as the borough's population has grown and the hospitals absorbing Rochdale's emergencies report some of the longest waits in the country. If capacity across north-east Greater Manchester is the problem - and A&E waiting figures suggest it is - then an under-used hospital estate in the middle of a 220,000-person borough looks less like a rational configuration and more like an inherited decision nobody has had the courage to revisit.

We asked whether the borough's elected representatives have taken a public position on restoring acute services to the Infirmary. We could find no current on-record statements from the borough's MPs or councillors specifically committing to that goal, and rather than paraphrase old campaign material we have chosen to put the question directly: does Rochdale's political leadership believe the current provision is adequate for this borough - and if not, what are they doing about it? We will publish their answers in full.

Fifteen years on from losing its A&E, the question for Rochdale is no longer how the services went, but why a borough this size should not expect them back. A fully equipped hospital - with an emergency department, a maternity unit and the wards this town has lost - is not nostalgia. For 220,000 people, it is the level of provision most comparable boroughs would consider a baseline.

If you are seriously ill or injured, always call 999 or attend your nearest A&E. The Urgent Care Centre at Rochdale Infirmary remains open 24/7 for minor injuries and illness, and NHS 111 can advise on the right service.