Royal Hospital for Sick Children Edinburgh (Fair Parking)
The final item of business is a members' business debate on motion S2M-5414, in the name of Mike Pringle, on fair parking for the Royal hospital for sick children in Edinburgh.
Motion debated,
That the Parliament welcomes the plan to build a new hospital for sick children alongside the Royal Infirmary of Edinburgh at Little France in south Edinburgh; notes that parking costs only 70p per hour and is free in the evening and at weekends near the current Royal Hospital for Sick Children site in Sciennes but that parking at the Royal Infirmary is almost £1.20 per hour, up to a maximum of £10 per day, and that this applies for 24 hours a day, 7 days a week, and believes that bus services to the Little France area should be improved from all parts of the city and that NHS Lothian should guarantee that parking at any new hospital will not cost any more than the current site and that the mistakes that were made in respect of fixing parking charges at the Royal Infirmary of Edinburgh are not made in planning the new sick children's hospital.
In lodging the motion, I wanted to highlight not only the issue of parking at the sick kids hospital but the charging situation at the Edinburgh royal infirmary, to whose site the sick kids is likely to be relocated. I am glad that the issue can be debated and I thank everyone who has signed my motion.
I welcome yesterday's news that the Edinburgh royal infirmary has decided to decrease its excessive charges from a whopping £10 a day to a slightly less whopping £7 a day from April—I am not sure why that cannot be done immediately. That still makes it the most expensive hospital in the country for parking, and, unlike charges for parking in most towns and cities, the charges apply 24 hours a day, 365 days a year.
I thank the Royal College of Nursing for its briefing paper ahead of today's debate. I certainly agree with the RCN's position—accepted at its annual conference in April—which calls for an end to parking charges in health care settings. As the RCN says, only some boards charge while the majority do not. No charging is the ideal, but I accept that in some circumstances some charges are needed to encourage the use of public transport, to deter commuters and to maintain the car park.
The contract for the Edinburgh royal infirmary was finalised by the current Government back in 1998, prior to devolution. I do not want to cover old ground, so I will simply say that something has gone seriously wrong when anyone agrees to a contract that permits a £10-a-day charge for hospital parking. It has taken four years of negotiations since the hospital opened to get Consort to reduce the charge by £3. I wonder what NHS Lothian has sacrificed to allow Consort to do that.
The £10-a-day charge caused outrage from its inception and, although there were discounts for long-term users, the high charges caused chaos in residential areas in my constituency near to the hospital. As public transport has improved, that problem has lessened, but I still receive—as I am sure other MSPs in Lothian do—regular complaints from constituents who have to pay the high charges when they have no choice but to travel by car to the hospital. Such complaints are primarily from those people who may be unable to travel by public transport because they are unwell, because they are not served by buses or because they are visiting or working at the hospital at night.
The other item of background to the debate is the decision to move the Royal hospital for sick children from its current cramped Victorian site in Sciennes to a new site adjacent to the ERI at Little France. The Royal hospital for sick children is one of the busiest in the United Kingdom. The hospital sees almost 90,000 patients a year, while the staff help nearly 250 children a day. That is a lot of people, many of whom need to park at the hospital.
The decision to relocate the hospital is a good one and I hope that the Executive will fully support it when the business case goes to it later this year. The hospital's reprovision board is working on its proposals for relocation, which afford an exciting opportunity. If any member has not seen the document that the board produced, I advise them that it makes a short but good read. Relocating the hospital to a site adjacent to the ERI will have many benefits, not least the ability to share specialist facilities and to cut down on ambulance journeys from accidents, perhaps where families—parents and children—are involved.
The hospital does a fantastic job at its current location. Many years ago, I had to take my seriously ill young son there when he had meningitis. The care that he received was excellent; I would say that the hospital probably saved his life. Last year, I was pleased to help to open the new drop-in centre for parents at the current site, and I know that the new hospital will be even better.
However, as with the royal infirmary, it must be acknowledged that the new site is not in central Edinburgh. That might be good news for some people, but we must ensure that the transport issues are addressed now. I hope that tonight's debate will highlight the matter. Bus services to Little France have improved, partly due to funding from the Scottish Executive—recently, I took Tavish Scott, the Minister for Transport and Telecommunications, to see the improvements. However, it is not enough to reduce parking charges and increase bus services after the hospital has opened. We need a modern sick children's hospital that is fit for the 21st century and we have a real opportunity to get it right.
With the decrease in parking charges, it will cost about £1 per hour to park at the Little France site, up to a maximum of £7 per day. That is slightly more than the current costs near the sick kids hospital in Sciennes, but the crucial difference is that, at the ERI, charges apply 24 hours a day, 365 days a year. On the streets round the current location, charges apply only from 8.30 in the morning until 5.30 in the evening and only on Mondays to Fridays.
First, the member said that we have an opportunity to get things right, but can we ever get them right if the project is tied to the private finance initiative and a public-private partnership?
Secondly, I apologise that I will not be able to stay for the whole debate, but the member has my 100 per cent support for his comments about parking.
I thank Margo MacDonald for that. I understand that there is a debate about PFI. I have never been an enthusiast for PFI projects. That is part of the debate that we will have from now on and I am sure that the reprovision people at the hospital will look at that.
Evening and weekend parking at the current site is free of charge. The charges at the ERI site have nothing to do with the management of demand at the car park or attempts to deter commuters from using it. They are simply about raising money. We cannot have such a regime at the new children's hospital. It would be wrong for parents who take their child to casualty in the middle of the night to be charged to park in an empty car park. I am pleased that guidance on parking at hospitals has been issued to the health boards. It will apply to the new sick kids hospital, but it is disappointing that it is not to be applied retrospectively at the ERI.
I hope that members will support my campaign to ensure that the parking disaster that was created at the ERI is not repeated at the sick kids hospital and that parking charges do not increase when the hospital relocates. Ultimately, parents should not be penalised for staying at the bedside of their ill children.
I thank Mike Pringle for bringing the matter to the chamber for debate. His motion focuses on parking charges, but he discussed a variety of matters in his wide-ranging speech. For example, he paid tribute to the service that we receive from the sick children's hospital and he mentioned the plan to resite it. He also mentioned the problems that have been created by siting the ERI at Little France and he mentioned the question of parking charges there.
Margo MacDonald is correct to say that pivotal among those issues is the PFI contract, which at the end of the day is the driver of the problems at the Little France site. That problem cannot be solved until the entire PFI scheme is reconsidered. As Mr Pringle correctly said, progress has been made and charges have been reduced, but the ignominy and the difficulties for staff, patients and visitors remain, even with the slightly reduced charges.
Mike Pringle is correct that the sick kids hospital is an institution. It is a small distance from where I live, so I am aware of the parking charges and difficulties that are caused as a result of its being within the resident-permit area. However, the charges are relatively modest. The institution has served well not just the south side of Edinburgh, but the whole city; indeed, given the expertise at the hospital, it has served all of Scotland well. We should pay tribute to the staff and to the volunteers, who have given a great deal of service in raising the additional funding that has been required. Obviously however, as with everything, times move on. The location is not exactly ideal and there are problems with the Victorian building, so a new site is almost certainly required. There are good arguments relating to centralisation of expertise and services for why the new site should be adjacent to the ERI and the medical school. However, if the hospital moves to Little France, problems will arise.
The problems with the ERI at Little France are twofold. The first, as Mike Pringle correctly mentioned, is transport; the second is parking charges. That goes back to the point that Margo MacDonald raised in her intervention that, if we were starting from scratch, we would probably not seek to locate the ERI at Little France because it is not only the hospital for the city of Edinburgh, but one of the two principal hospitals for the Lothians. We now have huge difficulties in the region because the two pivotal hospitals—St John's hospital at Howden in West Lothian and the ERI at Little France in Edinburgh—are in extremely difficult locations. Issues arise not only for people in West Lothian who need to access St John's, or for people in Edinburgh who need to access Little France, but for those who must go back and forward along the M8 and the other routes that connect east and west and elsewhere. The problems are created by the locations, but we are left with them.
Improvements have been made, such as the additional services that Lothian Buses has introduced, which the Executive partly funded and which have been beneficial. Doubtless, the park-and-ride site that is being created at Danderhall will lead to further improvements in that it will increase the through-flow of traffic, which will be of benefit. We must consider how we mix the two modes of transport. The subject is not part of the debate, but I broadly support the point that Mike Pringle has made previously about consideration of some form of guided busway to Little France. We must do something to break the logjam and ensure that there is a regular service.
To be frank, irrespective of what we do, the ignominy and the disaster of the parking charges at Little France will remain. However, we must not compound the difficulties as a result of a requirement to move the sick kids hospital from Sciennes to Little France. We cannot impose on users of that hospital the situation that those who go to the ERI—whether for work, visits or treatment—endure. We must ensure that the charges are capped and that the difficulties that those who use the ERI face are not also faced by those who use the sick kids hospital.
I congratulate Mike Pringle on bringing the debate to Parliament. An issue that arises is that this is not so much about specific transport links to the hospital as it is about situating the hospital within a transport system that works for the whole of Edinburgh. The first suggestion that springs to mind in that connection is not a guided busway, but the proposed tramline 3, which would connect the hospital to the whole of Edinburgh and out to the west, through links to other tramlines. That would be a sensible and good way of preventing many car journeys.
Another measure would be to persuade Lothian Buses to continue the move away from the present system, in which to get from parts of west Edinburgh to parts of south Edinburgh, people must come into the city and then catch another bus out. I need to take two buses, or sometimes three, to get from Morningside to Parliament. We clearly need a system with more links, and Lothian Buses should be persuaded to consider what more could be provided.
Only a small number of Edinburgh's buses are part of the new system that allows passengers to see the times of the buses. The next thing will be for the times to be linked; in other words, passengers on radial buses who get off will know that there will be a link within five or 10 minutes down to the ERI.
My next point is not exactly germane to the parking issue. Both the main hospitals have been mentioned, and Mike Pringle mentioned the new sick kids hospital. I would love to see the plans for it, and I hope that it will be designed to the highest environmental standards and will not be the environmental disaster that is the ERI. Far too many things are wrong with the ERI in terms of its environmental impact. We had a chance there, but we missed it; we will have another chance to build a hospital that is an icon of sustainability. We will have to give some thought to that.
If we get the transport links right, fewer people will want to park at the hospitals. However, I absolutely agree with Mike Pringle that people who park should not be punished for visiting sick children or members of their families. The charges should be reduced as much as possible; they should cover maintenance of the car parks and should not be making profits for a PFI group.
I congratulate Mike Pringle on his success in securing the debate and I welcome the plan to build a new hospital for sick children alongside the Edinburgh royal infirmary. The new hospital will be purpose built, which should allow it to offer multiple benefits to the many children who will need the very best of medical treatment. I understand that the new site will offer huge improvements for motorists in the availability of parking. So far so good, but the issue of fair parking charges is of great relevance and importance.
It is fair to say that when parents or patients have to visit a hospital, or take their children there, they do not welcome parking charges; their thoughts are totally focused on the circumstances and welfare of their child or children. However, of course I understand that car parks have associated costs—for security, maintenance and capital charges—and that car parking charges will be designed to discourage unauthorised users who simply want to park free for the day.
The debate raises a big moral issue for the majority of car park users who are visiting the hospital for medical treatment. The question is whether car parking charges across the board are absolutely necessary. If they are, how much do those charges, realistically and morally, need to be? I feel that concessions should be made for staff and patients who attend regularly, and for parents of children who are hospitalised for an extended time. I also feel that overnight and weekend parking should be seriously considered for concessions. Similarly, the circumstances of individuals must be considered. Children who have to attend the hospital regularly—for example, for dialysis or radiotherapy—and children who are hospitalised for several weeks or months should most definitely be taken into consideration for concessions or, even better, exemptions.
The main issue for NHS Lothian is surely to ensure that, when we are dealing with some of the most vulnerable and fragile members of our community, any charges for car parking have to be totally justified. Charges must not be simply a means of generating income.
At the forefront of the list of priorities must be the need to provide the best for the people of Edinburgh, the Lothians and Scotland. We should lead by example by putting the needs of child patients and their parents first. We owe them nothing less.
I add my congratulations to Mike Pringle on securing the debate. One year ago today, the Parliament held the stage 1 debate on my bill to abolish prescription charges—so I had better button up my coat. Today, we are debating the case for other charges for accessing the health service—car parking charges for visitors, patients and staff.
Members will accept that I believe in the principle that access to the health service should be universally free. I note that the helpful briefing that the Scottish Parliament information centre prepared for the debate highlights the fact that the decision on whether there should be car parking charges is left to the local health board, which is right. The briefing also says that it is clear in the Executive's guidance on car parking charges that charges should not be introduced as a means of generating income, which is also right. However, the Executive has compromised the clarity of its guidance by saying that charges are okay if they cover the cost of providing current or future parking facilities, or if they cover the cost of management of the parking facilities in order to discourage unauthorised users.
As Mike Pringle and other members said, a coach and horses is being driven through the Executive's guidance. Three quarters of hospitals in the country now charge for parking. The charges at the new Edinburgh royal infirmary were £10 per day but were recently reduced to £7. I live on the scheme that is adjacent to the hospital, so I know that many visitors, staff and patients park their cars in the adjacent schemes in the Inch and Moredun to avoid having to pay the daily charge. That causes difficulty for residents.
On a matter of factual information, does Mr Fox accept that there are parking charges at hospitals in only five of the 14 health boards in Scotland? I question his claim that there are charges at three quarters of hospitals.
I am happy to say that I got that figure from SPICe. Perhaps it refers to the whole of Britain. However, if there are charges in five boards, that is five boards too many.
A £10 daily charge is clearly a problem for residents in the local schemes who, like me, find it difficult to park their cars or even get their kids to school. The charge also acts as a disincentive to staff who want to work in the national health service. Staff are in work every day. My partner works at the new ERI, but she can walk to work rather than get the bus or use the car—Robin Harper will be happy about that. It is appalling to ask people in what is unfortunately a low-pay industry in this country to pay £10 a day out of their pitifully small income.
I understand that the minister was at the sick kids hospital today. I am sure that all members welcome the plans for a new hospital, as I do, and I have no problem with its being built at Little France, nearer to me and further from Mike Pringle and Kenny MacAskill—it seems that the hospital is moving to the left. However, it is not wise or in the best interests of patients in the Lothians for the new hospital to be a PFI project. The fact that the new Edinburgh royal infirmary is a PFI hospital has been an unmitigated disaster for patient care in the Lothians, without question. If time allowed, I would happily talk about Professor Allyson Pollock's recent report, which highlights the exorbitant costs of PFI and how hundreds of millions of pounds have been taken from NHS Lothian and given to shareholders in Balfour Beatty and other private companies.
I pay tribute to the staff at the sick kids hospital. My kids have been to the hospital a couple of times, unfortunately—that's kids for you—and they received superb treatment. I am sure that that is the case across the board.
I hope that the health board will consider the opportunity that the move to Little France presents to scrap charges altogether. The hospital is moving from a residential area in which there is pressure on parking to an area on the outskirts of town. The board could take a step in the right direction and ensure that no one who uses the sick kids hospital has to pay car parking charges.
I congratulate Mike Pringle on securing the debate. I will talk about the new children's hospital, as well as about parking at NHS Lothian's hospitals in general and at the proposed site for the new hospital.
The sick kids hospital has a place in the hearts of the people of Edinburgh, who have shown their affection, respect and gratitude over the years by giving the hospital financial support through appeals that have raised millions of pounds. For that reason, as well as because of difficulties that are faced at Edinburgh royal infirmary because its site and build have been procured through PFI, I do not feel comfortable supporting the construction of the new children's hospital through PFI—nor, I think, are most people in Edinburgh comfortable about it.
Parking and transport issues are fundamental aspects of proper health care planning. Those of us who took part in Colin Fox's recent debate on buses mentioned the need for good bus links to major hospitals. We must acknowledge that many patients, visitors and staff, many of whom work shifts, will still have to travel to hospital by car.
My constituents still have concerns about the siting of the new royal infirmary. Better bus services are now available, however, and some of them are supported by the Executive. Despite that, the location of the infirmary is not ideal for many people, as has been said.
I am very supportive of the proposals for tramline 3. I have always supported new trams for Edinburgh on the basis that the current plans are just the beginning. One of the most important things that we could do would be to extend the Edinburgh trams project to tramline 3, leading to the University of Edinburgh's buildings and to the royal infirmary.
A lack of car parking facilities can cause major problems for patients and local residents. That has certainly been the case around the Edinburgh royal infirmary, as Colin Fox and Mike Pringle said. The Western general hospital, in my constituency, is also affected. I am glad that NHS Lothian is taking the matter seriously there. There are additional spaces, and the health board is planning to build a tiered car park and to extend the assisted parking facilities at the Western's oncology department, which have proved to be such an innovative success. That will happen not only there; the board is considering taking the pilot beyond the Western to the royal infirmary.
If I may be slightly cheeky in mentioning this—although I believe I have the support of other members in doing so—one real present concern is to do with the shuttle bus service to the Western general hospital, which was promised to Parliament and to my constituents by TIE Ltd under the tram proposals. We should do all that we can to ensure that TIE honours that commitment, rather than simply diverting existing bus services. I know that other members have also been pursuing that matter.
I recently responded to NHS Lothian's consultation on child and young people's health. I support the health board's proposal to move the sick kids hospital from the existing buildings to the new site at Little France. The excellent care that has been provided at the hospital in the past has been possible despite the buildings that have housed it, rather than thanks to them.
I believe that the royal infirmary has suffered from a lack of flexibility, which is due to the contract-based approach that is inherent in PFI. One of the most startling examples of that is, of course, the car parking charges. Although yesterday's news that the health board will be cutting car parking charges at the royal infirmary is welcome, surely a maximum charge of £7 remains too high. It is essential that parents and families who go there to visit children, who have to stay for prolonged periods and who often have to travel significant distances—given the regional and national remit of the sick kids hospital—should not have to pay excessive parking charges. Many people could, and should, be exempted entirely. Although it might be argued that having car parking charges stops the car park at Little France becoming a commuter park-and-ride site during weekdays, that argument is not tenable when we consider charging parents who are sitting at a child's bedside overnight or during weekends.
I thank the RCN for its very helpful briefing. It is clear that no standard approach is being taken across Scotland. I know that Lothian NHS Board is trying to address that issue by bringing in standard charges for patients and visitors, and I welcome the salary-related car parking charges for staff. The board is to be commended for that, although I question whether it has got the amounts right. Nevertheless, it is a move in the right direction.
Let us learn from the mistakes of the ERI contract and provide a reasonable number of parking spaces for the sick kids hospital, which will ensure that parents and visitors can visit children without having to pay ridiculous parking charges. I support Mike Pringle's basic premise that it would be reasonable for car parking charges at the new site not to be more expensive for parents than they are at the hospital's present site nearer the city centre. I hope that the Executive will take those concerns on board when it considers the business case for the new sick kids hospital.
I, too, congratulate Mike Pringle on securing the debate and providing the opportunity to discuss this important issue. I acknowledge the work that NHS Lothian has done to date, planning for a new children's hospital at the Edinburgh royal infirmary site. That follows the opening of the new children's hospital on the royal infirmary site in Aberdeen, and it is in line with the plans for a new children's hospital at the Southern general hospital site in Glasgow. It is all part of the modernisation of children's services throughout Scotland.
NHS Lothian believes that the sick kids hospital should relocate from Sciennes to Little France because of the clinical benefits that could bring. Taking the hospital to the same site as the Royal infirmary and the University of Edinburgh's medical school is very much in line with "Delivering for Health", our blueprint for the future of the national health service in Scotland. An outline business case for that project is in preparation and I understand that the board plans to submit it to ministers for approval at the end of this year.
It is also NHS Lothian's intention to locate new multi-storey car parks at the Little France site. I understand that the children's hospital business case will detail what the car parking charges at the new site will be. I do not want to pre-empt the proper approval process, but I expect that they will be comparable to the local authority parking charges that are currently paid by users of the existing hospital.
Just before the summer recess, the Health Committee had a round-table discussion on hospital car park charging. Following that discussion, my officials carried out a survey of local NHS policy and practice since the Health Department guidance was issued in 2004.
A number of members have mentioned the terms in which the guidance applies. I should make it clear that the introduction of car park charging, or the revision of existing car parking arrangements, will be for local determination by the board responsible for the site in question. It is not for ministers to dictate in detail how boards manage those matters, but we have issued guidance so that they know, in general, what is expected of them, in the interests of patients.
The overarching principle that is laid out in our guidance is that the charges should reflect a reasonable balance between the availability of car parking spaces, the perceived needs of staff, patients, carers and visitors, the cost of car parking in the area and the cost of maintaining car park facilities. As I said to Colin Fox, at present, only five of the 14 NHS boards in Scotland levy car parking charges. As members would expect, they cover the main urban centres, where there is the greatest pressure on car parking and where there is a need to prevent unauthorised people from using parking spaces that should be available to those who have good reason to use them.
I am happy to acknowledge the minister's earlier intervention. The SPICe briefing does indeed say that three quarters of UK hospitals charge patients for parking.
Given what the minister has just said, am I right in thinking that the Executive takes no view on whether there should be charges and that it is happy to leave it to the five boards to make up their own minds about whether they will continue as they are?
I certainly do not share the view that Colin Fox expressed earlier, which was that there are no circumstances in which there should be car parking charges at any health service facility. That would not be practical for city centre hospitals or hospitals in sites that are attractive to commuters. There is a need to protect the interests of those who have good reason to park at a hospital. Where charging for parking can help to do that and follows the other principles that are laid down, it is legitimate for an NHS board to do so.
When I spoke, I said that I have sympathy for the view that charging can ensure that hospital car parks are not used by commuters. However, I also spoke about parking in the evenings and at weekends, when, in the city centres of most cities, people would not be paying to park their cars. Is the minister sympathetic to the view that there should not be 24-hour car parking charges?
I expect any scheme that is proposed for the new children's hospital to conform with the general principles that we have laid down, which state that the charges should take into account the other provision in the area that is available to visitors and other motorists.
My department monitors how car park income is spent, to ensure it meets the guidance we have laid down. Of course, boards should consider the transport infrastructure, the availability and cost of public car parking and other factors that will affect the supply and demand of parking at each hospital.
There is limited visitor car parking at the current children's hospital site in Edinburgh, but there is significant local authority provision. That is one factor that will have to be taken into account. As I have said, we expect the board also to take account of local authority parking charges when it considers relocating the hospital.
As has been mentioned, NHS Lothian has moved to establish two standard scales of car parking charges for the sites for which it has direct responsibility in and outwith the city.
As part of our response to the Health Committee, we have examined best practice in areas where car parking charges apply and the categories of patients who are, for example, exempted, provided with free exit vouchers or given access to a car park fob or season ticket. There are a number of different models. In response to the Health Committee, we intend to ensure that we revise the guidance so that the best practice of individual boards is made the best practice of all boards. That will meet a number of the concerns that have been mentioned this evening.
I expect boards to follow the guidance when they provide new facilities and revise existing charges. I also expect boards to work with public transport providers and their own contractors to ensure that hospital sites of all kinds are accessible to all who need access to them.
Meeting closed at 17:41.