Report to the People
14th July 2003

Taking the Road to Centralisation is a Wrong Turning

Five minutes in the General Register Office with a calculator confirms two things about the Steering Group’s recommendation that all inpatient consultant-led maternity services be centralised at Paisley’s Royal Alexandria Hospital.

One, it could concentrate maternity services for up to quarter of the Scottish female population in two hospitals which are seven miles apart.  And two, it will force over 200,000 women over a 2,880 square mile area to travel to a single hospital for inpatient consultant-led services.

You don’t have to be a brain surgeon to work out that this is another attempt to centralise services in the NHS.

Taking the road to centralisation is a wrong turning.  It restricts access and limits choice.  In this case, it will mean that throughout Argyll and Clyde – from Tiree to Largs, Campbelltown to Greenock and everywhere else in between – expectant mothers who require consultant-led inpatient care will have to go to the RAH.

Nothing could change my view that this decision is wrong.  But it might be easier to accept if we were confident that all the arguments were given due consideration.

However, when we see how the consultation process was, despite representations, cut short, I’m not sure we can be.  The promised Citizens’ Juries, which would have allowed us to call and quiz witnesses over their plans, were scrapped.  The consultation period was interrupted by the festive season and an election campaign.  And, sadly, consultants did not even attend the public meetings and information events to argue their case for centralisation.

If consultation guidelines and frameworks cannot guarantee that decisions are taken correctly, it looks like it might be time to bring in legislative safeguards.  I am therefore backing two Private Member’s Bills which aim to make the system more accountable.

That, though, is for the longer term.  My immediate priority from now until they make their final decision on the 29th of this month is to try and convince the Health Board to reject this recommendation.  At the same time, I will be discussing the impact of this move on other health services, such as paediatrics, and will be seeking assurances that the continuity of care for women already in the system will not be affected.

If health authorities want to review how and where they deliver services, the appropriate weight must be given to the competing arguments.  The voices, not just of clinicians who, for whatever reason, seem determined to create a network of regional “super-hospitals”, but also those of the communities who rely on and who pay for those services, must be heard.

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