Travel to hospital. Accessibility of out-patient services in rural communities.

The medical and financial advantages of centralising health services contrast with the disadvantage that they are less accessible to patients, and this is specially felt in out-patient departments. In a study based on rural Northern Ireland Norma Reid and Chris Todd looked into how patients travelled to the OPD and how long it took them. It was the socially disadvantaged--the poor, the unemployed and the retired, who did not have a family car--who were most disadvantaged by the inaccessibility of the hospital and although they were quite numerous they were probably not enough to make a commercial bus service viable.