Report to the People
31st May 2004
The Place Might Change, but the Challenge
Stays the Same
It
is remarkable to see, as David Cairns and I did on our recent visit there, how
regeneration has transformed the Leith waterfront.
It
has gone from an area of rejection, to a very attractive commercial and
residential sector. In place of its
old shipyard, for example, stands the Ocean Terminal shopping complex.
Elsewhere, derelict warehouses have been replaced by new flats, retail
outlets, leisure facilities and offices – bringing jobs, money and growth.
At
the risk of stating the blindingly obvious, there are significant differences
between Inverclyde and Leith – not least the big, rich city they have up the
hill. But the prerequisites for
change are the same.
As
a first step, dilapidated ex-industrial sites need to be made attractive to a
developer. And that means clearing
and decontaminating them. This is
something we have already done in Inverclyde, meaning we start from a slightly
higher base than they did in Edinburgh.
Leith,
however, is not the only community which differs from ours but must meet the
same challenges – as I found out when I exchanged the sparkling glass
modernity of north Edinburgh for the green rolling landscape of the Borders.
I
was down with colleagues from the Health Committee to meet with clinicians,
health service managers and the public to discuss the vexed issue of NHS
centralisation.
The
Borders has cottage hospitals earmarked for closure; local consultants deciding
they want to work in Edinburgh, with its greater scope for lucrative private
work; and other medical staff keen to decamp to foundation hospitals in England.
Everywhere
we went it was the same story: the combination of the European Working Time
Directive and Royal College Guidelines, it was claimed, was making the delivery
of local healthcare impossible. I
even spoke to one manager who told me that, even if he could find extra clinical
staff, arbitrary rules would block their employment.
This
is a scenario being played out all over the country – from the maternity
crisis in Wick, to the whole Glasgow review fiasco, to our own continuing
uncertainty over acute services.
Indeed,
only last week, as Lothian NHS endorsed plans to force patients from Livingston
to go to Edinburgh for emergency surgery, we read about a junior doctor earning
so much in overtime payments, he had to take an £18,000 pay cut to become a
consultant!
That
the NHS is subject to intense external pressures is not in doubt, but is
centralisation the only way to address them?
What other options are open?
And
why are the decision makers determined not to ask these questions?
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