Car Parking Charges (West Lothian)
We have a final item of business today, which is the members' business debate on motion S1M-475, in the name of Bristow Muldoon, on car parking charges. [Interruption.] I remind members that this meeting of the Parliament is still in session and that we have business to transact. We are all happy to congratulate the new Lord Advocate, but I ask members who are not waiting for the debate to clear the chamber. That goes for the ministerial cabal as well.
Motion debated,
That the Parliament notes with concern the decision by West Lothian Healthcare NHS Trust to introduce car park charging at St John's Hospital in Livingston; recognises the financial burden this will put on users and the potential congestion problems this may cause to surrounding residential areas, and calls upon the Trust Board to suspend implementation until a full consultation with the West Lothian public, and a full discussion with West Lothian Council has taken place.
I want first to state clearly that, in raising the issue of proposed car parking charges, I intend no general criticism of West Lothian NHS Trust. Along with many other people in West Lothian, I campaigned for the establishment of an integrated national health service trust. I believed in the value of that approach in 1998, when the campaign took place, and I still believe that the integration of primary and acute services in West Lothian will offer great advantages to the whole West Lothian community. I also speak as someone with a personal interest in the well-being of the West Lothian health service and as a user of the health service—my two youngest sons were born at St John's Hospital at Howden in Livingston. As a former non- executive director of the previous West Lothian trust, I speak with specific knowledge of the issue.
Before I move on to discuss the issue, I welcome the support that I have been given by a neighbouring MSP, Mary Mulligan, by many other Labour members and by members from other parties, including Fiona Hyslop. I believe that Lord James Douglas-Hamilton also intends to express his support today.
Cross-party consensus on the issue of car parking charges is not new. It arose first a couple of years ago, when I was a member of the trust board. At that time, I joined the SNP councillor Peter Johnston and the former Conservative councillor and trust chair Isobel Brydie to oppose a proposal to introduce charges at St John's
Hospital. The political consensus on the issue extends beyond the Parliament, to West Lothian Council, where the Labour and SNP groups co-operated to agree a resolution in opposition to the proposals.
I believe that the trust board has gone wrong in respect of both the principle of the decision and the process by which it made it. The introduction of car parking charges should not be used as a back-door method of funding clinical services. That principle has been emphasised to trusts in Scotland by the Scottish Executive in its recent memo, which states that
"any decisions taken should not be driven by the desire to generate income."
The principle would appear to have been compromised by the option that has been taken by the trust board, which states clearly in its option paper
"that a net income estimated at approximately £200K could be realised" per annum.
When the options were being discussed on the trust board, one of the directors commented that the alternative in terms of cost to adopting the option recommended would be to close 18 surgical beds. That suggests that the trust's decision was motivated partly by the desire to raise income for the trust to fund clinical services. On at least two occasions, I have requested justification of the director's statement, but I have not yet received a direct answer to the questions that I have asked.
I do not believe for a minute that Lothian Health would allow the trust to reduce the number of surgical beds in the way that has been suggested; I suspect that the possibility was raised as a scare tactic to persuade some of the directors to vote to introduce charges. If the trust board genuinely believes that it requires increased funding, it should not try to disguise that issue by introducing car parking charges, but discuss it with Lothian Health. If it brought its concerns to my attention and convinced me that they were well founded, I would be happy to meet Lothian Health with the trust board.
I do not believe that there is a more general funding problem, as Lothian Health will receive an increase in the region of 4.9 per cent in its budget for the forthcoming year, which is well ahead of both general inflation and wage inflation in the NHS. That accords with the Executive's programme to invest in the national health service.
The proposal to introduce car parking charges has also been justified on the ground that charges already exist at major Edinburgh hospitals. I do not believe that that is a valid argument, as Livingston does not suffer from the same levels of congestion as the city of Edinburgh. I understand also that the headquarters staff of Lothian Health continue to enjoy free parking. It seems wrong that direct service providers and users should pay charges when the directors of Lothian Health do not.
One of the biggest mistakes in the decision- making process was the failure to consult adequately the people of West Lothian. When people campaigned for the establishment of the West Lothian trust, they expected to continue to be involved in key decisions that the trust faced. The Executive has also made it clear that it expects all quangos to be fully accountable to the people whom they are there to serve.
The trust board has failed to engage the people of West Lothian on the issue. The only justification that I have heard for the failure to consult is that
"the board did not need to consult since it was clear to all that the issue of car park charging would be very unpopular."
If any public body believes that the course of action on which it is about to embark will be unpopular, there is even more reason to hold a full consultation exercise.
The trust board failed to give local residents the opportunity to express their concerns about fly parking in residential streets. It did not give health service users the opportunity to express their views and, importantly, it did not give itself the opportunity to explore the alternative measures to deal with the parking problems that the local authority or other people might have proposed.
I wish to express my concern about the disproportionate effect that the introduction of charges will have on members of staff in the NHS and on members of the public on lower incomes. At this late stage I call on the NHS trust in West Lothian to suspend its plans to introduce car park charging, to comply fully with the circular from the management executive and to enter into a full and meaningful consultation with the community in West Lothian to identify alternative solutions.
Finally, although I hope that the trust will reconsider its position on the issue, I wish to restate that I have great faith in what the integrated trust in West Lothian can achieve. I will continue to support the trust and hope that we can soon put this matter behind us and return to the central issues of how we can work together to improve the health and life chances of the people of West Lothian.
Four members have asked to speak. All will be called if speeches are kept to about four minutes.
I, too, welcome this debate. This issue is of major public concern in West Lothian and, indeed, in west Edinburgh, and it has generated considerable heat. I think that we are having this debate because of the sense of ownership of St John's that the people of West Lothian have, as patients, visitors or members of staff. As Bristow Muldoon says, we place great importance in the unitary authority in West Lothian, and we should emphasise that all parties will work to champion that concept in the future.
We should recognise the role of St John's in the local community. I suffered because of the transport problems in West Lothian when I had to get to antenatal classes before the birth of my son at St John's, so I recognise those public transport difficulties. I pay tribute to the staff at St John's. In particular, the burns unit receives national acclaim. I know of many people who have to travel to visit people in the burns unit and are obviously there for a long time. We do not want to put a price on care. I am concerned that the proposals on car park charges will cause difficulties. I also pay tribute to the campaign that has been mounted locally, in particular by the SNP, but also by Unison. We cannot have low-paid workers paying for the privilege of work. I hope that the minister will address that major issue.
Although there are some points on which we will reach a consensus, I think that there are two issues on which Bristow Muldoon and I disagree. The first relates to underfunding. We should recognise that the trust board has admitted that its proposals were made on the basis of cost. In a letter that was sent to me on 2 February, the trust board said:
"The question of car parking was discussed by the Trust on two counts (a) to address the traffic flow and indiscriminate parking which is taking place and (b) to generate a revenue stream which will help address a budget deficit in the next financial year."
The other issue on which Bristow Muldoon and I disagree is the role of the Executive. I know that in recent days the Executive has sent out a letter saying that car parking charges should not be used as a revenue stream for hospital care. It might be helpful if the minister explained the status of that letter and instruction. We should recognise that the trust would not have to seek that revenue stream if there were not problems over funding. It is expected that the trust's deficit will rise from £300,000 this year to £3 million next year. We care about the NHS, about our workers in the NHS and about patients, who require the best treatment. Visits contribute to recovery.
We should consider alternative proposals. I hope that the Deputy Minister for Health and
Community Care will intervene to get everybody round the table. It is possible that for £60,000 an additional 50 parking places could be found at St John's. There is off-site parking 10 minutes away at Livingston football stadium. The point that Bristow made about consultation is absolutely right.
We should recognise the cross-party agreement on this issue. An amendment proposed at the trust board by the SNP council group leader, Peter Johnston, was seconded by the Labour council leader. There is strong feeling about the issue, as I hope the Deputy Minister for Health and Community Care will recognise. The issue is not peculiar to West Lothian, although people there feel particularly strongly about it. We must not put a price on care or on working in the NHS; we must not have car park charges at St John's.
I support much of what Bristow Muldoon and Fiona Hyslop have said, so I will not repeat it. On a number of occasions when I have been to St John's, it has been very difficult to park, so I know parking is an issue. However, the way in which it has been addressed has not been satisfactory.
Parking is particularly a problem for the community staff who use St John's. Although they regularly have to go into the hospital, they are also out and about in the community and have no option but to use cars. How will their needs be met? Will they be charged every time they come into the car park, will they be given an allowance to cover it or will they in effect be taxed for doing their job?
The problem affects all the staff, many of whom travel some distance to work. We all know that hospital staff work the kind of shifts that many of us would not put up with, starting early in the morning and finishing late at night. I would want them to use public transport, but I know that that is not yet an option and that they have no choice but to use their cars to get to work. Again, we are penalising staff who give their time and dedication to patients in West Lothian. That is unacceptable.
Link Transport, of which Fiona Hyslop probably knows, is a project in the Linlithgow area. Because of geographical difficulties and the limitations of public transport, the project was set up to offer transport to St John's for people who could not otherwise get there. The only recompense that the people who run the scheme get is their petrol costs. They give their time voluntarily. Again, I am concerned that the imposition of parking charges will penalise a valuable service to the community.
The community has not been consulted. The trust may have thought that there was going to be
opposition, but that is when it is most important to get out there and start talking. The trust should find out how the proposal could be changed so as not to affect as many people as the current plans will and to protect the most vulnerable—those who are on low wages. Consultation is essential; in West Lothian, it could have been productive. All is not lost, however. The trust should wait and not take the issue further, but discuss it with all those with an interest in ensuring that we have the best possible service for the people of West Lothian.
Bristow Muldoon is to be warmly congratulated on securing this debate, which raises matters of great concern. When I visited the hospital, there was tremendous congestion in the car park; the wheelchair users could not get past on the pavements because cars were parked there. It was difficult for disabled people to come by car, as all the disabled parking places had been taken. Clearly, something needs to be done.
The trust assured me that, if there were to be charges, any funds raised would not be used for core clinical services, but would be reinvested in car park improvements. However, any charging scheme could result in displaced congestion in local residential areas. If the trust decides to introduce charges, there should be some exemptions. The hospital must guarantee access by car for patients, many of whom are not registered disabled but may have short-term mobility problems related to their illness that make it impossible to travel by public transport.
I understand that, when the hospital opened, there were 750 car park spaces. Within three years, a further 150 had to be provided. With the Bangour unit and other initiatives, the demand for parking will steadily increase. I hope that the minister will bear in mind the particular needs of the hospital and will assist as much as he can in ensuring that it has all the necessary resources, as it is under considerable pressure.
I, too, congratulate Bristow Muldoon on raising this issue, not just because of what is happening at St John's, but because of the wider national implications. There is much ill feeling in many parts of England about the substantial charges that are made on a completely indiscriminate basis. It seems that we are now faced with a major problem that will only get worse.
As the acute services review progresses and there are major changes to modernise the service—changes that are entirely appropriate and must be driven through—there will be substantial increases in ambulatory care, which will lead in turn to greater congestion in hospitals such as St John's. The effect on staff of that congestion is extremely deleterious, as they are often unable to find car park spaces.
Mary Mulligan mentioned community staff. Having been a member of a community staff group, I want to emphasise that aspect of the problem. At our hospital, we managed to oppose the introduction of charges. I visited the hospital on a regular basis, but not as regularly as the midwives did, and I know that it is a major problem.
I ask the minister to consider establishing a committee to examine the transport strategy for Scottish hospitals. As I said, it will become a wider problem. Are there opportunities for staff to car- share and is it encouraged? Is any management effort put into supporting staff who are coming in for difficult shifts at night, when their safety and security are important? Any piecemeal solution, as often occurs, would be inappropriate.
Mary Mulligan mentioned volunteer drivers. The British Red Cross Society provides an excellent transportation service, demand for which can only increase. Since we have centralised paediatric cardiac surgery at Yorkhill in Glasgow, people have to travel there regularly. It seems unfair, and goes against my basic principles as a socialist, that we should be charging the people whose need is greatest, who go to the hospital most frequently with children or other relatives who are seriously ill. Those people suffer the most because of their illness. We must find a sensitive system that discriminates appropriately in relation to staff and to those who are using the service, so that we can manage things more effectively.
I do not deny that we have a problem or that we have no effective solutions, but I do not believe that a simple policy of introducing charging without adequate consultation is an appropriate way to progress.
The issue of charging for car parking in hospital grounds is one that generates a lot of attention. I recognise that it is doing so in West Lothian—although not only there, as Dr Simpson indicated. I am grateful for the opportunity to make one or two points in reply, and in particular to explain the policy that applies to car park charging by NHS trusts.
I will start by making a few general points. We all know that there are very few hospitals with sufficient space to cope with the demand for car parking within hospital grounds. Car park spaces,
therefore, are at a premium. People often arrive at hospital under stress. They are not helped by selfish motorists, some of whom may not even be in the hospital, who abuse the car park system. The inevitable results include double parking, parking on yellow lines, pavement parking, the use of disabled bays by non-disabled individuals and unsafe access to main entrances at peak times. Hazards are created for staff, patients, visitors and ambulance crews. Complaints and frustrations sometimes can lead to difficult, and even violent, situations.
Hospitals are encouraged to be crime conscious, but cars parked in hospital car parks are easy targets and are often broken into and vandalised. The introduction of additional security inevitably means increased costs for trusts. No one wants the funds for that security to be diverted from the funds for direct patient care. The decision to charge for car parking facilities is one that must be taken locally by trusts. In considering proposals to charge, trusts are best placed to address all the issues in the light of local circumstances and to take account of the needs of staff, patients and visitors.
Car park charging in hospitals is well precedented throughout the UK. In Scotland, a number of NHS trusts have already introduced schemes. Those schemes had the approval of the Scottish Executive health department, and took into account the ground rules that were drawn up. Indeed, as a couple of this evening's contributors indicated, trusts and health boards have recently been reminded of those ground rules. We expect them to be applied consistently when consideration is being given to implementing charging schemes.
I am happy to re-emphasise those ground rules for Fiona Hyslop. First, any decision to charge for parking must not be driven by a desire to generate income for patient care. Secondly, the trust board must be able to justify the proposals, for reasons such as the need to cover the cost of expanding parking facilities, to make existing facilities more secure or to better manage existing facilities. Thirdly, in considering proposals, trusts are asked to consider inviting tenders from commercial contractors, to ensure best value. Finally, and above all, staff, patients and visitors need to be consulted about the proposals. Trusts are trying to improve the situation for patients but, of course, during the consultation process, they need to set out clearly the reasons for the need to charge.
St John's West Lothian Healthcare NHS Trust has significant parking congestion problems on the St John's Hospital site. Mary Mulligan and James Douglas-Hamilton have confirmed that from personal experience. The trust feels that the level of complaints and the frustration caused by the current lack of car parking cannot be sustained. There are a number of reasons for that. The increasingly intensive use of St John's Hospital, the phased closure of Bangour Village Hospital and the increasing use of clinical services by residents from the west side of Edinburgh mean that the trust has to ensure that adequate parking facilities are available.
The trust has been considering several options, one of which is to increase the number of parking spaces from 900 to more than 1,100, and to double the number of parking spaces for the disabled to 70. However, we encourage other solutions and, as Bristow Muldoon made clear, there are other solutions that should be looked at.
In my constituency of Edinburgh Pentlands, West Lothian Council and Edinburgh City Council recently combined to secure a much-needed bus service from Currie and Balerno to St John's. In addition, I recently attended the opening of the new Pentland Medical Centre by the Minister for Health and Community Care, which includes facilities for consultants from St John's to come to their patients in the west of Edinburgh, rather than having their patients travel, and doing so by car— at least, before the bus service comes on stream.
Measures such as those, which can reduce car parking problems by reducing car use, are to be welcomed and encouraged. The trust has worked with West Lothian Council to draw up a revised timetable for public transport to ensure access from every town and village in West Lothian, so there are other options that need to be explored.
In relation to car parking and the potential for charging, we have sought and been given an assurance by West Lothian Healthcare NHS Trust that it took the decision to consider proposals for car park charging based on the urgent need to improve both the quantity and the quality of parking on the St John's site. I am further assured that any revenue accrued will be used to defray the cost of managing and maintaining the facility. The trust has taken no final decision about the way forward. It wishes to consult further and I expect it to do so. In particular, the trust will carry out a further traffic analysis survey and a survey of patients, visitors and staff.
I say to Mrs Mulligan that I expect the trust to get round the table with West Lothian Council and others who have an interest in this matter. Only then should a final decision be taken. I stress again that car park charging is a matter for local determination. I expect that West Lothian Healthcare NHS Trust will act with the interests of patients, staff and visitors at heart and will carefully take account of all the views expressed before reaching a final decision.
Meeting closed at 17:32.