Health and Community Care Committee, 06 Oct 1999

Meeting date: Wednesday, October 6, 1999

Official Report 172KB pdf

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Petition

Item 4 on our agenda—a petition from Stracathro hospital—will probably generate more discussion than the previous items. The committee may remember a representation by members of the Stracathro staff action committee in one of our meetings some weeks ago. As a result of that visit, the Stracathro staff have lodged a petition—the first to be placed before us in that way—through the Public Petitions Committee. I have a vested interest, as I sit on that committee.

The Public Petitions Committee will keep a watchful eye on what subject committees do with the petitions that are passed to them. The Parliament should ensure that when representations are made to it, they are given full and proper consideration, despite the tight timetables for our work load.

I am aware that a petition gives only one side of the story, but this one makes quite worrying reading. Some aspects have already been raised by the staff action committee, particularly communication problems between the health board and the work force at Stracathro. As the petition has in excess of 25,000 signatures on it, the committee should spend some time on an initial discussion about it before taking any action.

So far, only one petition has been dealt with formally by a subject committee, but it was decided that the matter was not within the competence of that committee and it turned it around. We are treading into new territory here. We will have a general discussion and then discuss how we can take the matter forward.

I am very worried about the Stracathro petition. I want to ensure that we are seen to respond to people's genuine and on-going concerns. I am concerned that there is a move towards locating all hospitals in major cities. Stracathro serves Angus and the Howe of the Mearns—it is almost a matter for the Rural Affairs Committee.

I am also concerned about the gradual running down of services. I visited Stracathro in the summer. As Kay Ullrich has said, the situation is death by a thousand cuts. Although I would like to think that the Rural Affairs Committee will take an interest, I suggest that we allocate some time to listen to representatives from Stracathro and Tayside University Hospitals NHS Trust. In this age of openness and accountability, those people should give us their views and explain any decisions that have been taken. That could happen after the acute services review, which is due quite soon.

One of the main points raised by the Stracathro group in the petition and in comments to the committee is that there is a continuing erosion of services, which should be halted until after the acute services review.

I realise that we have a tight timetable, but this is an important issue. The decisions that have been taken by the acute services trust in Dundee, which have been defended as being operational, have been interpreted by the staff as a prelude to hospital closure or permanent withdrawal of services. As the patients group said, the decisions appear to pre-empt the acute services review, which is being headed by Professor Jung.

With my colleague Roseanna Cunningham—we are both local MSPs—I attended a meeting at Perth City Hall to hear a presentation on the acute services review. Usually, such meetings are attended by 20 or 30 interested people; on this occasion, almost 1,200 attended. The concerns about the possible withdrawal of services that have been expressed at Stracathro are also being expressed by the people of Perth, Kinross and Milnathort. The acute services trust has done itself a grave disservice by taking a decision on operational and financial grounds—which I fully appreciate—to close or partially close those units, albeit without withdrawing specific services. That was politically naive. The trust has given the impression of pre-empting the acute services review and that has done it no good service.

The committee can play an important role in getting the debate back on a rational basis. We must call both the Tayside University Hospitals NHS Trust and Tayside Health Board to account for their approaches to the issues at Stracathro and the acute services review. We must create an atmosphere that will allow rational debate.

We should have an investigation into the matter and a presentation from the parties involved. As we know, many nurses and staff from Stracathro visited the Parliament recently. There are 25,000 signatures on the petition—the entire population of Angus is only about 111,000—which represents the majority of the adult population of the area. I have never seen such a high ratio of signatures on any of the many petitions in which I have been involved. That really is vox populi and we must heed it.

When one reads the evidence, it appears that the health board is extremely concerned because there is a £10 million deficit and closing a hospital seems the easy way out. As it is the only district general hospital in the whole of Angus, I think that we have to ask some searching questions. Furthermore, I note that Beattie Media does the publicity for Tayside Health Board.

Ah, now that is a road that I do not want to go down. Let us keep the meeting friendly.

I just want to reiterate what every other member has said. This petition is worthy of the committee's action. If a health service is to work properly and serve the community, the morale of health service workers must be in good shape. It is obvious that the people at Stracathro are working under very strained circumstances and there is much concern about that. The committee should call both the people who have presented the petition and representatives from the trust and the health board.

I agree with the general points that have been made. Perhaps we should emphasise procedural points such as whether the health board and the trust have been consulting fully and pre-empting the results of the acute services review. It is right that we hold health boards and trusts to account, but I would like to flag up a slight reservation. We do not want to give the impression that we are against the reorganisation of services. Saying that the status quo is acceptable is not a tenable position—although I am speaking generally, as I do not know about the specific case. I do not think that we are giving such an impression, but I want to put that down as a marker.

It is clear that we need a health services review and that, in some cases, difficult decisions about reorganisation need to be taken. Although I support what has been said, we have to emphasise procedural points and to hold the health board and trust to account for the way in which they are going about this.

Based on the representations that have been made to the committee and on committee members' comments, I suggest that we call members of the staff action group and representatives of the acute services trust and from Tayside Health Board. The points that have been raised touch on issues of staff morale and how staff are treated in the health service in Scotland. Malcolm has made a good point about procedural issues. Although that issue demands the committee's attention, it also flags up procedural problems and the committee can help people by pointing them in the right direction and allowing them to learn lessons. If we are to undertake strategic reviews of services in the health service, it is only common sense to wait for the outcome of those reviews rather than for people to prejudge them.

On the other hand, as I would not like to think that this committee would prejudge anything, the health board and acute services trust will have an opportunity to tell us their version of what is happening at Stracathro. I thank the committee for giving the matter proper consideration.

One problem is that we have a very tight schedule of meetings in order to discuss Arbuthnott and the recess also looming—thankfully. Realistically speaking, it will probably be November before we can timetable in the matter; however, if the committee is happy to let me organise that as soon as possible, I can work with the clerks and bring the matter back to the table.

I find that acceptable. However, the only thing that concerns me is that I am not absolutely sure of the acute services review; I think that it will come out in December or January. Furthermore, the atmosphere that has been created by the events at Stracathro will harm Tayside Health Board's prospects of undertaking the acute services review in a rational way. We could allocate not even a whole meeting, but an hour or an hour and a quarter to deal with the matter.

We could provide a good service, most importantly for the staff and patients of Stracathro, but also for the trust and health board, which will be in grave difficulties if the Perth situation reflects the general attitude in Tayside.

I will take on board Richard's comments and come back to committee members as soon as possible with a date to get this actioned. Our work load and housekeeping matters such as access to rooms may affect our ability to do this.

You did not mention the Brechin and district patients association.

I did not—you are absolutely right.

It is an outside body.

May I throw another suggestion into the air? The editor of the local newspaper has done a remarkable job with that petition. It might be useful to receive a written statement from the editor on how difficult it has been to get information. A local editor can give more of an overview than there has been in previous cases. The secrecy surrounding this concerns me considerably.

I agree that it might be useful to have a statement. We do not want a cast of thousands appearing. It is sufficient to have the action group, the trust and the health board.

Dorothy, do you think that we should get a statement from the Brechin and district patients association?

No. I suggest that we speak to a representative of that association. I suggested that, to save time, we get a written statement from the local paper. We do not want to add a vast number of witnesses, but I think that that will give a useful overview.

Is that patients group the only one involved?

It is the major one of which I am aware. I realise that we do not want to get tributaries of the main river. The patients association was formed in 1991 to counter a perceived threat to Brechin infirmary.

There is also the health council. We must narrow our consideration down to the main players.

Can members leave it with me to get a written statement from a group that I feel best represents the views of patients generally? We can do some investigation behind the scenes to find out who that group might be.

I have a letter from the Brechin and district patients association. It says that the association is

"supported by people from all walks of life and their commitment to Stracathro is the unifying agent."

The association is an "apolitical organisation" supporting the work of the hospital.

We will take that on board. I will investigate this so that a representative of the patients comes to speak to us.