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Back to the UK scene, it also appears that those areas that are predominantly Tory/Conservative or Liberal Democrat in terms of their electorate and ruling political constituency fair badly when it comes to closures compared with those areas that are Labour strongholds. So that's fair enough, isn't it....
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I suspect there's more parity than that between the parties, it is more likely to be affected by regional factors....of course regional factors also tend to dictate who ends up in control of local government, so that might parrallel the impact.
The problem tends to be in the manner in which PCTs and local councils engage with each other. Good partnership working can go a long way, but requires Councils and their directorates to be able to play a strong overarching role in providing the vision for their region's health care. What makes this difficult is the tendency to merge PCT's which takes them into multi-Council partnership, and which leads to a parcelling out of services between the two (or more) PCTs. So, now whilst Halifax would once have had its own A&E, Maternity and other facilities, some facilities have now moved to Huddersfield. It sucks. I hate it. We now face the possible loss of the maternity section which would move to Huddersfield.
The system is fllawed. The whole PCT system is flawed.