We, members of the University of the Third Age (U3A), write to express our concern at the continued erosion of Emergency General Surgery (EGS) in rural areas and to state our full support for the Save Our Acute Services (SOAS) Roadmap.
This is not just a health policy issue — it is about safeguarding the lives, dignity, and well-being of older people across rural communities. Many of us are in the later stages of life, living with complex health needs, and more likely to experience events such as falls, fractures, and other medical emergencies that require immediate surgical attention. The term “silver trauma” is increasingly used in emergency medicine to describe such injuries in older adults — and it is a growing concern.
Older people are more vulnerable to medical complications, slower recovery, and poorer outcomes when access to timely emergency care is delayed. Every extra mile to a hospital, every extra minute waiting for surgery, carries greater risk for our generation.
Long ambulance journeys, unfamiliar hospitals, and overstretched urban services are not the answer. We need services designed with ageing in mind — close to home, easy to access, and capable of delivering high-quality emergency care when seconds count.
The SOAS Roadmap recognises these realities. It offers a community-led, clinically informed pathway to restore and protect essential emergency services — including surgery — in a way that works for rural and older populations. It aligns with the Health Minister’s stated goals of developing alternative models of care that are safe, effective, and equitable.
We call on health decision-makers to:
Restore Emergency General Surgery in rural hospitals.
Designate rural hospitals as “Rural Area Hospitals”, with the resources and support required to serve ageing, geographically dispersed populations.
Recognise the specific emergency needs of older adults, including the rising incidence of silver trauma.
Engage meaningfully with older people, who are the largest users of acute hospital services and whose voices must be heard.
Older people should not be left behind. We are not a burden on the system — we are the very reason it exists. The restoration of local emergency surgery is not just a medical necessity — it is a matter of respect, equality, and basic human rights.
