Press Release
6th March 2003
NHS Cannot Survive in Vacuum
– McNeil
MSP for Greenock & Inverclyde,
Duncan McNeil, has called for the NHS to pay more attention to
how factors outwith its direct control – such as Working
Time Regulations and Royal College Guidelines – are
impacting on patient care. Failure to do so, he warns, will
inevitably lead to the sort of pressure to centralise services
which threatens the future of the Rankin Maternity Unit.
Speaking Scottish Parliamentary debate on the NHS, Mr McNeil said:
"We have guidelines from the Royal Colleges, European Working Time Directives and a reduction in junior doctors' hours [which] mean that, in the Argyll and Clyde NHS Board area alone, we need to recruit 25 consultants and even more junior doctors.
"That level of recruitment is necessary not to extend the service, but simply to maintain it. Those major challenges must be addressed."
Mr McNeil said that that the Royal College guidelines "address risk in very small areas." The effect of striving to reduce these specific risks, he said, is that "we constantly chase the impact on the other services, which pushes us towards more centralisation."
He continued:
"In practice, that has meant that, in Argyll and Clyde, we have witnessed the closure of the maternity unit at the Vale of Leven hospital, for the want of paediatric cover. That closure, which took place without consultation with the local community, has forced mothers and young babies to travel further for care. That has happened in spite of the massive amount of investment that we are injecting.
"Like many hospitals outside the cities, the Rankin maternity unit in my constituency has found it difficult to recruit appropriate staff numbers. It has to compete with university-led services in the cities. That is another example of the push towards centralisation that we must resist. Despite the fact that the number of consultants at the Rankin maternity unit has increased, there is once again a shortage of paediatric cover, which has threatened the unit and put it only days away from closure during the past year."
Mr McNeil’s call was backed by Scottish Nationalist MSP for North-East Scotland, Brian Adam.
"I do not often agree with Duncan McNeil," he told the Chamber, "but I agree with his analysis of the situation. Large parts of the additional funding are having to be taken up to address matters that are beyond the control of the NHS, and may even be beyond the control of the Executive. That highlights the fact that we cannot expect miracles overnight. Anyone who suggests otherwise is deceiving themselves, let alone the public."
Mr McNeil returned to this theme in the Chamber the following day, questioning Health Minister, Malcolm Chisholm on how the new Health White Paper, Partnership for Care, would "halt the march towards centralisation of services."
Welcoming those parts of the plan which aim to tackle bureaucracy and give patients a greater say, he said of Argyll and Clyde Health Board:
"The minister will be aware that … staffing difficulties are creating a pressure to centralise services, especially maternity services. How can the minister reassure my constituents that the reforms that he outlined in his statement will give patients a real say in the NHS and halt the march towards centralisation of services?"
The Minister replied:
"I am glad that Duncan McNeil welcomes our pledge to tackle bureaucracy to a greater extent. It is obvious that we have made great advances from the internal market bureaucracy that existed under the previous Administration. Argyll and Clyde NHS Board is a good example to give, because it has made the decision to go for single-system working. I know, having talked to several people in Argyll and Clyde, that the board's decision has been widely welcomed. Clinicians in particular welcome the fact that they are involved in discussing how the new forms of services will develop.
"Duncan McNeil made an important point
in relation to his concerns about centralisation of services. A
key message of the white paper is that, over time, more services
will be developed in primary care settings and community
settings. The fact is that upwards of 80% of health service
activity takes place in communities. However, some services must
be concentrated in specialist units. That is the hard issue that
arises in relation to acute service reviews; it is an issue in
Argyll and Clyde and in Glasgow. One of the white paper's points
is that we want to, and will, involve the public far more
effectively in discussions about reorganisations than we did in
the past."
ENDS
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