HCI (Clydebank)
The next item of business is a statement by Malcolm Chisholm on the Health Care International hospital at Clydebank. [Interruption.] Order. Please let us have silence. The minister will take questions at the end of the statement and therefore there should be no interventions during it.
Since 1999, the Executive has worked in partnership with national health service staff to improve health and health services for all the people of Scotland, ending the internal market, supporting front-line staff, and increasing investment after years of neglect. Over the next five years, we will increase investment in health and health services by a further 50 per cent.
Our task now is to make best use of those extra resources to speed up the reform of the NHS in Scotland and to turn it into a modern, patient-focused service that achieves world-class standards of care. The drive to tackle waiting and reduce delays has been top of our priorities. Nothing is more important to the patient, and nothing impacts more on their experience of the health service.
We have made progress in equipping the NHS to reduce waiting. Extra doctors and nurses have been recruited, and next year capital investment in buildings and equipment will be double that invested in 1997. Seven out of our eight new hospital developments—the largest building programme in the history of NHS Scotland—are open in full or in part. In January, I announced the creation of the first-ever national waiting times unit. The new unit is at the heart of the health department and was created to bring added focus and central co-ordination to our drive to tackle waiting. The unit's task is to identify spare capacity in the public and private sectors that could be used more effectively to tackle unacceptably long waiting times. As a result, in the past year we have reduced by more than 10,000 the number of patients across Scotland who are waiting for in-patient treatment, concentrating on those who have waited longest. The number of patients who waited more than six months for in-patient treatment has been reduced by 6 per cent in the past year.
We have made real progress, but that progress has been neither universal nor as fast as either the public or we would like. Too many patients are still waiting too long for treatment. Maximum waiting times, especially for priority conditions such as heart disease and cancer, must be cut, not just in some but in all parts of the country.
Today, I can announce a proposal for one of the most significant new developments in the recent history of the NHS in Scotland. That development will boost the capacity of the NHS to tackle long waiting times; step up the reform and redesign of services; strengthen the NHS work force with additional experienced staff; and bring another world-class health care facility into the NHS family.
Earlier this year, we were approached by the Abu Dhabi Investment Company, which owns the private HCI hospital. Despite the hospital's world-class facilities, the original intention for the hospital has not been commercially realised and its current owners do not wish to continue the business. Quite simply, without a change of ownership and direction, the hospital would face closure. Clearly the loss of the facility would be a major blow to the economy in Clydebank and surrounding areas. It would also put the jobs of many health care professionals in jeopardy and it could remove a valuable source of additional capacity for the NHS.
I can announce to Parliament today that we have entered into detailed negotiations to purchase the entire HCI hospital facility for the national health service in Scotland. That pragmatic decision has been taken to step up investment and reform, to support patient care and to protect Scottish jobs. It is not an attack on the private sector. As we have consistently stated, the private sector has been, and will continue to be, a partner of the NHS in delivering patient care. Our decision to buy the hospital is about saving services for Scotland and opening up new opportunities for the development of patient care in the NHS.
We propose to transform the HCI facility into Scotland's national waiting times centre. We plan to use its world-class facilities to help drive down waiting times, not just for one part of the country but for all parts of the country, particularly targeting those waiting longest for treatment. An early initiative will involve HCI working closely with cardiac centres across Scotland to ensure that cardiac surgery waiting times continue to show significant reductions. The centre will also focus its resources on reducing maximum waiting times for hip-and-knee replacement, cataract surgery, general surgery, plastic surgery and diagnostics.
As well as the additional activity in elective surgery, we will use the diagnostic capacity available within the facility to complement local action plans to reduce waiting times—for example, through the use of the extensive endoscopy and investigative facilities. Last year, HCI carried out some 2,500 procedures for patients. It is our intention to double that figure to 5,000 within the first year of operation for the NHS. Working alongside and complementing existing NHS services, the centre will help us to sustain Scotland's performance at the head of the UK league table for waiting times.
Of course, acquiring such a high-quality asset comes at a price. I can confirm today that, subject to the finalisation of details, we will acquire the whole of the facility, including a fully functioning, 52-bed acute elective facility; six functioning operating theatres; magnetic resonance imaging and computed tomography scanning; an on-site hotel for patients and relatives, and space for expansion.
Today I can confirm to Parliament that we have agreed a price of £37.5 million for the land, building and its equipment, subject to the completion of the necessary due diligence. The cost of building a 60,000 sq m hospital, including equipment, at today's prices would be four or five times as much as the agreed price. We have tested the financial case for the investment and it represents exceptional value for money for the NHS.
In addition to acquiring world-class facilities, we want to retain the services of the highly skilled staff who work within the HCI facility, including around 10 consultant doctors and over 100 nurses. I want to send a strong message to those staff today that we want them to join—in many cases to rejoin—the NHS family.
I want to take the opportunity to make it absolutely clear that we see the proposed purchase of the HCI facility in a national rather than a west of Scotland context. The purchase of the HCI facility for the NHS will not be a factor in Greater Glasgow's review of acute health services for the city. Similarly, it will be for those running the NHS in Argyll and Clyde, in partnership with local people, to decide the best structure for the delivery of acute health services in their future plans.
On completion of a deal, it is our intention to create a special health board to ensure proper management of and accountability for the facility. Interim management arrangements and a project management team will also be put in place, as soon as a deal is completed, to oversee the transformation from a private hospital to a national NHS resource.
Our vision for the long-term development of the HCI facility does not end there. The purchase of the HCI facility gives us the potential for developments in a range of other areas in addition to reducing waiting times. For example, the spare capacity within the facility will be an invaluable additional safety net for the NHS in terms of planning and preparing for winter pressures. In addition, alongside the range of health organisations that already rent space within the facility, including NHS 24's west of Scotland call centre, we will explore the scope for other health projects to use the facility as a high-technology proving ground for innovative ways of working.
The need to reduce maximum waiting times, however, is the driving force of our national effort and the new centre at Clydebank will be in the vanguard of that effort. It will be an exemplar facility that the people of Scotland can be proud of. The facility will also require a new name, in keeping with its new role as a truly national asset. Before a final name is chosen, we will seek the input of staff and the public during the coming weeks.
This is a hugely important development for the NHS and for patients in Scotland. I am convinced that it will be warmly welcomed, not just in Clydebank and the surrounding area because of the obvious economic benefits, but right across the country and throughout the chamber. This is a good deal for the NHS, for the taxpayer and for all the members of the health care team at HCI whose jobs were under threat. This is a deal that will help to keep us at the forefront of waiting times performance in the UK. Above all, it is a great deal for patients and for Scotland.
I thank the minister for his statement.
As the minister knows, the SNP has consistently argued for more beds in the national health service and I am glad that, at last, the minister appears to be coming round to our way of thinking. However, the minister's statement is an almost farcical attempt to provide a solution to a problem that is entirely of the Government's making.
Is it not the case that the need to purchase 52 beds from the private sector at a cost of £37.5 million—that is a staggering three quarters of a million pounds for each bed—is proof positive that Labour's policy of deliberately closing 800 acute beds across Scotland over the past five years was misguided and deeply damaging to the NHS? Will the minister admit that the Labour Government's bed-cutting policy has caused the record rise in the length of time that patients are waiting for hospital treatment that was announced last month and that today's statement is little more than a panicked reaction from a Government that is running out of excuses for its abject failure to deliver speedier treatment for patients across Scotland?
Nicola Sturgeon should discuss beds with clinicians and front-line staff because I do not think that they share her analysis of the situation. Where numbers of beds have been cut—and acute beds have not been cut dramatically—it is as a result of changes in clinical practice, shifts to day surgery and the movement of long-stay patients into the community, which I hope Nicola Sturgeon supports. The key issue is to have the right beds in the right place—Nicola Sturgeon should reflect that we are not only buying beds, we are buying a hospital with all its equipment and facilities. She should also reflect that 52 will be the starting number of beds. There will be no break in treatment provision. We will double the number of patients who will receive care in the first year. The member knows full well that there is far more space in that hospital than the 52 beds to which she refers. Even those 52 beds, without the rest of the building, pass the economic evaluation test to which I referred.
There are a large number of requests to speak. There is no chance of granting them all, but the shorter the questions, the more can be asked.
It is interesting that the Minister for Health and Community Care says that there are 52 beds. There are also six operating theatres, MRI and CT scanners and an increase in the use of diagnostic equipment. As a member of the Health and Community Care Committee, I have heard much evidence this week and last from cancer patients and cancer centres. Why has the minister's ideological opposition to HCI prevented patients from using the facility for many years? The failure of admissions is a clear admission of the minister's failure. Patients in Scotland today face a longer wait for treatment and a longer wait to see a consultant; the waiting lists have increased and fewer patients are being treated. Nonetheless, we welcome the full use of that first-class health facility for patients throughout Scotland. It could have been in use for many years. We regret that patients in Scotland have had to suffer and languish on waiting lists because of the Executive's opposition to HCI, with a health minister more concerned with the health of the state rather than the state of our health.
First, why was the Clydebank facility considered to be at the margins of health care when it was privately owned, while it is considered to be at the centre of health care now that it is publicly owned? Perhaps today's announcement comes as a result of the ticking off that Malcolm Chisholm got from Alan Milburn at the weekend for his lack of vision.
Secondly, given the shortages of key NHS staff and the minister's plan to extend services and access to HCI, will the transfer of new staff not simply lead to shortages in existing NHS hospitals? Will today's statement result in the closure of other hospitals in greater Glasgow?
There were a lot of issues there. I will start by making it clear that there is no ideological opposition to the private sector. Indeed, since we took over at the end of November last year, in the first three months of this year, 2,000 operations were carried out there on the private sector. That gives the lie to that notion. This is not an ideological decision; it is a pragmatic one. We believe that what matters is what works. If we had not acted in this way, it is clear that HCI would not have been working—because it would have been closed.
The subject of waiting was central to Mary Scanlon's contribution. She said that waiting lists have increased, although all of Scotland knows that they came down to a record extent at the end of May. She said that the incidence of long waits for treatment was up, but the number is down over the past year. There is an issue about the median waiting time, which we will discuss during next week's debate.
We have taken a whole series of actions in order to increase staff capacity. In the first instance, it will be the existing staff who will work at the facility and, now that it is an NHS facility, we will be very careful about where any additional staff come from. The number of staff will grow up gradually, and the increase in the number of staff coming on stream will help to deal with that.
On cancer, I think that Mary Scanlon should, in the interests of balance, also report all the many positive comments that have been made to the Health and Community Care Committee during its last two meetings about both the investment in and implementation of the cancer strategy.
On behalf of the Liberal Democrats, I welcome what must be the health care bargain of the century.
I have two points to make. First, could the minister clarify that the Scottish Executive is not taking over any residual liabilities for redundancy payments or anything else of that sort related to the existing commitments of the HCI facility?
Secondly, to take up the point about staff, and against the background of the serious problem with the recruitment of nurses in greater Glasgow, not least for the Victoria infirmary, can the minister indicate what steps are being taken to find the additional staff—the nurses, consultants and doctors—who will be required not so much to continue the work at HCI Clydebank, but to double the number of operations to be carried out there, as the minister has indicated will happen in the next year? That is a very challenging target.
On the latter point, let me make it clear that the existing capacity can deal with the 5,000 operations to which I referred—in other words, the number of operations can be doubled with the existing staff. Beyond that, and in time, extra staff would be required.
A hundred nurses are working at the hospital already, and they can certainly cope with the 5,000 operations. Aside from that, we have an action plan for nurses, which has been widely welcomed and which is being implemented now. Members will know about the various actions being taken. I will not go through them all now, but I remind members of the return-to-practice courses and of the 250 extra nurses—over and above the additional number that has already been factored in—who are starting training this year. There is a lot of activity around the training of more nurses.
On Robert Brown's earlier point, we will not have residual liabilities, and I do not envisage there being very much of an issue of redundancy payments, given that staff will be coming to the facility.
As constituency member for Clydebank and Milngavie, I warmly welcome the announcement, which is a huge boost for Clydebank, not just for the 300 people who work at HCI at the minute, but for the substantially greater number of people who will come to work there in future. The announcement will have a significant impact on the speed of diagnosis and treatment throughout Scotland. The minister has had the courage to take over a ready-made facility and put it rapidly to use. That is an example of pragmatism in the best sense.
Would the minister agree that the SNP's sour-faced response to taking the HCI hospital into public ownership gives the lie to its claim to be in favour of public provision? This is a positive move as far as the people of Clydebank are concerned.
I have said to Nicola Sturgeon before that the people of Clydebank will not forget her attitude, or that of her party, and I shall remind her about it from now until May.
Order. This is not a debate. The member must ask a question.
Will the minister confirm that the potential capacity of the hospital is substantially more than 52 beds? The building is of a significant size and we must understand its potential. I thank the minister for listening to representations from me and from my colleague Tony Worthington. I am prepared to campaign for the hospital to be called "St Malcolm's".
I was going to say that I would begin with the last point, but I meant to refer to the penultimate point. The hospital is definitely an investment for the long term. As I made clear, the starting point will be 52 beds running at full capacity. There is a lot of scope to extend the capacity way beyond that in years to come.
I welcome Des McNulty's comments. I am sure that he is speaking for his constituents for whom the project started as an employment issue, which is an important dimension. The key issue is that it will, as Des McNulty said, affect the speed of diagnosis and treatment. I will leave the people of Scotland to make their own judgment about the SNP's response.
Now that a total of well over £140 million of public money has been spent on HCI over the past decade or so, can we have an assurance that today's announcement will not lead to a decrease in the money that is available for NHS projects in other areas, such as a new general hospital to serve the people of the Forth valley on the site of the old Royal Scottish National hospital, which is one of the options that the local health board is actively considering?
There are two important financial issues in that. Public assistance was provided in various forms, not to the sum that Dennis Canavan mentioned—
The sum came from a parliamentary answer in the House of Commons.
I do not want to go into the details of that. Let us accept that public money was provided, without disagreeing about the details of it.
The important point to make is that the company that received that money originally went into receivership within three months. People should understand that the Abu Dhabi Investment Company, the current owners, did not receive the public money to which Dennis Canavan referred.
I want to make it clear that buying the hospital will not be a call on the extra money from the budget, for the simple reason that that money does not come on stream until next April. I am sure that members realise that. I was berated last week for not spending that money before next April, but it will not come on stream before then. The cost will be met from end-year flexibility. It will not be a call on other services; other services will not be affected. Andy Kerr will make a detailed announcement about the use of EYF next week.
I welcome the minister's statement on the acquisition of HCI for the NHS. I understand from his statement that the existing capacity is 52 beds, but that overall capacity is substantially higher. Is it his intention to increase the capacity slowly and if so, over what time scale? Will he clarify how he will ensure that there will be minimal or no impact on local acute services provision, particularly with the movement of staff? The minister will be aware of my long-standing support for the Vale of Leven hospital, which is the neighbouring hospital to HCI. We need to be sure that the benefit of HCI is not counterbalanced by any negative effect on the Vale of Leven hospital.
On the first point, I envisage that the capacity will increase steadily rather than suddenly. In that sense there will not be any immediate effect on surrounding health care facilities. I envisage that the expansion will take place in tandem with the planned expansion of the medical work force. I understand Jackie Baillie's concerns about the situation in Argyll and Clyde NHS Board and, as I indicated, it is up to the local health system, in full consultation with local people, to make their proposals on that.
The minister has mentioned a number of times that there is space for expansion. He has given us a little detail, but will he give us more? What does he envisage as the final bed capacity at HCI? When will that be achieved? How will the hospital be staffed?
Things will happen gradually. I am not going to say that every bit of space in HCI will be used for beds. Of course, NHS 24 is already using the hospital for its very important new service. Clearly, there is potential for more elective surgery, in particular, to be done. I have also indicated the possibility of innovative health projects as part of our redesign work in the delivery of health care. Things will build up incrementally and members would not expect me to have a blueprint for exactly what will happen in every year over the next 10 years. That is not the way in which health planning and redesign happen. There has been a significant increase this year and there is potential for a great deal more.
Others have come up with ideas that I am quite sympathetic to—for example, if teams of clinicians come from other countries, HCI could be an ideal site for them to work. That possibility can certainly be explored. There has been an immediate gain and there will be many more exciting possibilities over the next few years.
I welcome the minister's announcement and I thank him for accepting a commonsense suggestion that reflects the needs and wishes of local people and for putting that suggestion into practice. I also welcome his reassurance that the money will come from end-year flexibility and will not impact on other health budgets. Will the minister take a similar approach to acute hospital needs south of the river and ensure that he takes the same commonsense approach to the needs of the population there when considering the future of the Victoria hospital in particular?
I congratulate Ken Macintosh on getting in a question about his local hospitals, about which he is rightly concerned and interested. I am sure that he will know that any proposals on the issue that he raises are matters in the first instance for Greater Glasgow Health Board. I know that it will reach its conclusions soon. Mr Macintosh would not expect me to pre-empt its recommendations this afternoon.
What a way to run a health service. A minister who opposed the building of HCI in the first place has moved to a car-boot sale panic buy to plug the gaps in the provision of his health policies. Will the minister answer three questions? Were there any other bidders for HCI and was it put out to tender? Will the Scottish Executive take on HCI's accrued debt of £82 million? How will the services of the present staff be used: will the minister pay them at their current rate, will they be forced into the NHS or will they be asked to leave?
Ben Wallace should know a little bit about commercial transactions—or perhaps not. If he reflects, he will realise that the question of whether there were any other bidders is one for the investment company and not for me. Obviously, that company will know whether there were other bidders or not.
We knew that the hospital was going to close. Everybody in Scotland should be clear that the hospital was going to close unless we tried to buy it. We will not have to deal with £82 million of debt: the money that we will have to pay is the money that I have indicated today.
The staff will transfer with their existing terms and conditions. Their conditions may improve because they will move to NHS terms and conditions. However, there will be no detriment in that change.
I welcome the minister's statement and I am pleased that he agrees with members on these benches that what matters is what works. He mentioned the need to boost capacity to reduce waiting times. Will he acknowledge the key role that same-day hospitals play in improving diagnostic speeds and treatment outcomes? Will he consider complementing today's statement by committing himself to making early progress on approval of the business case for the North Glasgow University Hospitals NHS Trust facility in my colleague Paul Martin's constituency, which serves the people of my constituency?
Brian Fitzpatrick's point illustrates what I was saying about changes in clinical practice and shifts to day surgery. Obviously he realises how an ambulatory care and diagnostic unit in north-east Glasgow could have a beneficial effect on diagnostic outcomes and the speed of treatment. I shall be considering that in the round when I receive the greater Glasgow proposals. I have a positive attitude to the proposal for an ACAD unit at Stobhill, because I know what benefit it would bring to local people.
Although we are well over time, I will take one more question.
Des McNulty raised the question of local jobs, but as the minister has answered further questions it is clear that those jobs are receding into the future. When can we expect the expansion in Clydebank? When that expansion takes place, will the minister ensure that recruitment is targeted in Clydebank?
That was the jobs question from a different angle, but it still requires an answer. Everyone will welcome the fact that in the first instance the jobs will be preserved. If I were not standing here making this announcement, many people in Clydebank would be receiving redundancy notices very soon. That is the main point on jobs. I also hold out the prospect of an increase in the number of jobs in due course. That is good news for Clydebank today and good news for Clydebank tomorrow.
Meeting suspended until 14:30.
On resuming—