Meeting date: Wednesday, October 24, 2018
Meeting of the Parliament 24 October 2018
Agenda: Portfolio Question Time, University Hospital Monklands, Ending Austerity, Poverty and Inequality, Business Motions, Parliamentary Bureau Motions, Decision Time, Deaths Abroad (Support for Families)
- Portfolio Question Time
- University Hospital Monklands
- Ending Austerity, Poverty and Inequality
- Business Motions
- Parliamentary Bureau Motions
- Decision Time
- Deaths Abroad (Support for Families)
University Hospital Monklands
The next item of business is a debate on motion S5M-14405, in the name of Richard Leonard, on keeping the Monklands hospital in Monklands.14:42
We are forced to bring this motion before Parliament because we fear that a great injustice might be served on the people of Lanarkshire. We bring the motion before Parliament because we believe that it is the job of Parliament and its elected members to speak up and stop a grave error, which would be felt for generations to come if we were to sit back and allow it to be made.
The decision to build a new state-of-the-art hospital for present and future needs, and to replace and not simply upgrade the existing Monklands university hospital, has been widely welcomed. However, the health board consultation, which closed last week, on what form the new hospital should take and, critically, where it is to be built has been roundly condemned.
The health board pleads that it has simply followed Scottish Government guidance. The guidance clearly states that
“the Scottish people and the staff of the NHS”
are “co-owners, in the NHS”, and that the health board has a duty to ensure that information that is presented to the public must be “balanced”. That is why we have brought the motion before Parliament today. The health board has undertaken a flawed process with flawed logic. It is true that the people of Lanarkshire have been informed, but they have been neither meaningfully engaged nor genuinely consulted. I will go further, and say that there has been nothing less than a cynical attempt to railroad through the board’s preferred option of closing the Monklands hospital and relocating its services to a new site in the village of Gartcosh in the teeth of widespread public opposition.
The public meetings were not meaningful consultations but one-sided presentations on the case for Gartcosh. People left those meetings angry and frustrated.
Before that, in June, there was an options appraisal process in which there was a desperate shortage of patient and public voices. The people who took part in the options appraisal have been described by NHS Lanarkshire as “delegates”. Here is my question to the health board: if they were delegates, who delegated them? Were they mandated in advance, and have they reported back on their decision?
According to the guidance they were supposed to be
“health service users, patients, staff, members of the public, carers, volunteers, and the voluntary organisations which represent them.”
However, the composition of the people involved in the options appraisal appears to have been dominated by NHS Lanarkshire employees—and senior ones at that. The surgeons and the consultants might have been consulted, but what about the porters? What about the domestics? What about the catering workers? What about the lowest-paid workers, many of them shift workers, most of whom live and work locally? What about the patients? What about the service users? What about the carers?
If the exercise is in line with Scottish Government guidance, is the guidance not so much waste paper? Is it not about time that the Scottish Government started laying down tougher rules that ensure that the democratic will of local communities be respected? On the other hand, if the exercise is not in line with the guidance, surely the time has come for the Government to intervene swiftly and directly.
As a member of Parliament for Central Scotland, I initiated an online petition in August. It called on the Scottish Government to step in to ensure that the new hospital is built on the site of the existing hospital. To date, the petition has gathered more than 5,000 signatures. The majority of the people want that option.
What was the health board’s response? It said that there are
“Significant challenges in delivering key adjacencies within identified expansion zone”.
The guidelines stipulate that everything is meant to be “easy to understand”! The board also says that there is
“Potential for complex way finding associated with building over different levels”
That is not transparent; that is opaque.
We are told time and time again that construction work on the current site would lead to the temporary loss of parking spaces. Of course, that is a consideration, but surely our commitment to public health, and the great legacy of Aneurin Bevan and the founding principles of our national health service demand that we look beyond short-term car parking difficulties. What about the long-term health benefits for the people of the Monklands and a health service that is accessible and free at the point of need?
At a public meeting that I attended in Airdrie town hall, the audience faced such a hard sell to close down the Airdrie town centre hospital and move it to the village of Gartcosh that, at one point, we were told that it takes less time to get from the Monklands to Gartcosh than it takes to get from the Monklands to the Monklands. Does the health board take the people to be that gullible?
If the newly built Queen Elizabeth university hospital in Glasgow can be built on the site of the Southern general hospital in Glasgow, why on earth can we not build the new Monklands hospital on the site of the old Monklands hospital? The health board accepts that that is possible and people want it to make that happen. The Maggie’s centre and the Lanarkshire Beatson are co-located on the existing site in Airdrie. Both are state of the art and fewer than five-years old, and both are good reasons to stay.
The town centre first principle, which is supposed to inform such decisions, has not been factored in by the health board—that is another good reason for the hospital to stay. The outline business case for the project will be considered by the board of NHS Lanarkshire at its meeting next month. Time is running out, but there is still time for the Scottish Government to intervene.
The Government’s own guidance says that the consultation process
“needs to demonstrate that the NHS listens, is supportive and genuinely takes account of views and suggestions.”
Let us hear today that the Government is prepared to step in to stop the closure before it is too late—before a great injustice is committed and a grave error is made—and instruct the board to keep the new Monklands hospital in the Monklands.
In the name of the people whom we are here to represent, I move,
That the Parliament believes that a replacement hospital for the current University Hospital Monklands should be built in Monklands.14:50
I welcome this debate on an important issue for the many people who use and value the services that are delivered by Monklands hospital. I recognise the strength of feeling in the local Airdrie community about the future access to and provision of hospital services. I want to make one point absolutely clear to members and to local people who use the highly valued services at Monklands hospital: no final decision has been taken by the NHS board on the preferred option for a new or refurbished Monklands hospital.
We recognise that the hospital is more than 40 years old. Although there has been, and continues to be, significant investment in the hospital to maintain high-quality patient care, the current facilities do not have the right layout to ensure an ideal model of care in line with best modern clinical practice. That is why the Government has been clear that we support NHS Lanarkshire in bringing forward the proposals to replace or refurbish Monklands hospital for the benefit of local people. We note that the plans will ensure that the new hospital will have state-of-the-art facilities and will provide a range of specialist services for patients across Lanarkshire, as well as continuing to be the local hospital for people who live in the Monklands catchment area.
It is also important to note that the new hospital will retain an accident and emergency department for the benefit of local people, along with its key support services. Any decision on the new hospital’s location must, as a priority, help to reduce the level of health inequalities in the Monklands area and across Lanarkshire.
With regard to the strategic context, the Monklands of the future will support the required clinical model to meet the objectives that are set out in the board’s healthcare strategy, “Achieving Excellence: A plan for person-centred, innovative healthcare to help Lanarkshire flourish”, which is consistent with the ambitions and aims of the Scottish Government as set out in the national delivery plan for health and social care.
Sustained investment in our health infrastructure is vital to ensuring that Scotland’s health service can continue to provide a high standard of care. In the Government’s forthcoming capital investment strategy, which will be brought to Parliament before the end of the financial year, we will set out the further steps that we will take.
I will offer members a brief update on NHS Lanarkshire’s progress with the important Monklands replacement or refurbishment project. In June, local stakeholders took part in an appraisal of the non-financial benefits of the following options: on-going maintenance of the current hospital in Airdrie; a refurbishment of the current hospital; a new build on the existing site; or a new build in Gartcosh or Glenmavis. In line with national guidance on informing and engaging with local people on potential changes to the healthcare services, NHS Lanarkshire conducted formal public consultations on the options between 15 July and 15 October. NHS Lanarkshire has assured us that it will carefully consider all the responses to the consultation and rigorously evaluate all the options before the board decides on a preferred option. The board’s consideration will be informed by a report on its public consultation from the independent Scottish health council.
Perhaps the minister can tell us why the board went out so vigorously promoting Gartcosh, which is not in the Monklands area, as a preferred option. Perhaps she can also tell us who the stakeholders were, because they were not the public.
I do not know whether Elaine Smith is aware of this, but there were public engagement events, including in my constituency.
In this instance, the role of the Scottish health council is to quality assure the board’s public consultation process, in line with the national guidance, “Informing, Engaging and Consulting People in Developing Health and Community Services”, which was issued in 2010. The health council’s report will be published in due course. It is incumbent on the board to demonstrate that it has properly dispensed its statutory duty under the National Health Service Reform (Scotland) Act 2004 to involve patients, carers and the wider community in developing the healthcare services that it provides for them. The board must be able to demonstrate that any decision on a preferred option has been meaningfully informed by the views of patients, carers, staff, elected representatives and other local stakeholders. The choice of location must also take full account of other factors, such as the views of staff, accessibility, transport links, travel times and the best return to the NHS in terms of patient care.
Ministers are aware that elected members and local people have raised concerns about the quality of the engagement and involvement activity that has been undertaken by NHS Lanarkshire. In particular, concerns have been expressed about the quality of information, the quality of the analysis that the board has undertaken and the robustness of the options appraisal process that led to Gartcosh being identified as the highest scoring option for the site of the new-build replacement hospital. I assure members that we have noted those concerns.
We are clear that it is critical that the board comes to a robust, evidence-based decision in such cases, in line with national guidance and practice—
Will the minister take an intervention?
The decision must also be meaningfully informed by the views of local stakeholders. We agree that all efforts must be made to advance work on this important development while meaningfully engaging with and ensuring the confidence of local people and their representatives.
Will the minister give way on that point?
The minister is closing.
That is why, on the completion of the formal consultation process, the Cabinet Secretary for Health and Sport asked the director general of health and social care to liaise with the chief executive of NHS Lanarkshire to discuss the need for the board to undertake further analysis and engagement with local stakeholders to explore the concerns that have been raised in more detail. That discussion will take place by the end of the week.
I have set out ministers’ clear expectations that NHS Lanarkshire’s choice of a preferred option for the location of the replacement for Monklands hospital must be based on robust evidence, must be in line with national guidance and best practice, and must be meaningfully informed by the views of local stakeholders.
I move amendment S5M-14405.1, to leave out from “believes” to end and insert:
“welcomes the development of plans to refurbish or replace University Hospital Monklands; notes that these plans will ensure that the new hospital will have state-of-the-art facilities and provide a range of specialist services for patients across Lanarkshire as well as allow it to continue to be the local hospital for the patients living in the Monklands’ catchment area; further notes that the new hospital will retain an A&E department along with associated specialist services; acknowledges that a public consultation has been undertaken regarding the possible sites for the new hospital; believes that any decision for the new hospital’s location must, as a priority, help to reduce the level of health inequalities in the Monklands area and across Lanarkshire, and further believes that the choice of location must take full account of the views of the patients who will be served by the new hospital, as well as other key factors, such as accessibility, transport links, travel times and providing the best return to the NHS in terms of patient care.”14:57
I am pleased to speak in today’s debate about what is a major issue for residents across Lanarkshire.
I was pleased to visit Monklands hospital in May this year to meet staff and management at the hospital. I was hugely impressed with the hard work, enthusiasm and dedication of all the NHS staff who work there. It was clear to me that the hospital enjoys widespread and deep-rooted community support, and we should all work to protect and build on that.
What struck me on that visit and has stayed with me since was the fact that a nurse I met had finished her shift but was staying on to be with her mother’s elderly friend who was expected to die that evening. For me, that showed how those who work in our NHS at Monklands put the community first. We do not often have the opportunity to highlight such love and care in Parliament, and it is important that we take any opportunity to do so.
As Richard Leonard said, the news that Monklands hospital is to be rebuilt or modernised is hugely welcome, but it is vital that the choice of location for that replacement building is backed by local people who will use the hospital’s facilities for decades to come.
Having spoken to a number of councillor colleagues in North Lanarkshire and members who represent the area, I fully recognise the significant public concerns about the highest-scoring option for the site that has emerged—Gartcosh—and the growing concerns about the consultation process that resulted in that option emerging as the likely preferred site. It is important to note that those serious concerns are being expressed by local elected representatives from across the political spectrum and, perhaps more important, by local residents in Lanarkshire. Many local people feel very strongly about the issue. Understandably, they want the new hospital building to be as locally accessible as possible, so they want it to be constructed in the Monklands area.
Many people believe that the Gartcosh site is too near Glasgow and that not enough has been done to consider the current Monklands site. Public transport links to Gartcosh from Airdrie and other nearby villages are very poor, and too much importance seems to have been attached to rail services to Gartcosh when a mere 4 per cent of people use the train to get to Monklands hospital. In addition, the consultation provided very little information about the Glenmavis option, even though that option has strengths and clearly has local support. It is the responsibility of NHS Lanarkshire to address the concerns of local people and their elected representatives.
The member will be aware that there was a completely cross-party campaign to prevent the A and E department from being downgraded and to keep it in the Monklands community. Does he agree that it would therefore be outrageous if the SNP Government were to sit back and allow the whole hospital to move out of the Monklands area?
What is key is that we can all accept that the hospital needs to be upgraded, and we can look forward to that happening and to all the services that have been retained there being transferred to the new site, whether that is in Monklands or involves a new preferred option.
It is clear that serious questions are now being asked about the consultation process, particularly with regard to the removal of potential other location options. Those issues must be addressed. However, we are talking about a major investment of perhaps £400 million to £600 million for a major new-build hospital that will serve the area for decades to come. It is vital, therefore, that the new hospital is developed on the best site that is available and that that choice enjoys as much support as possible from as many local people as possible.
I know from other decisions that have been taken in the past by other health boards, including the one that covers my area, that it is important to future proof the site. Having the potential for future NHS developments and investment is important, and developing a site that cannot provide that flexibility is not good for patients or the future sustainability of our NHS.
I hope that NHS Lanarkshire will listen closely to today’s debate, and I thank the Labour Party for bringing the motion to the chamber. It is important that the health board acknowledges and responds to all the concerns that have been expressed by members of all parties and decides whether it needs to pause and reconsider the consultation process to date. We need to get the location of the new Monklands right and, above all, make sure that the needs and the interests of all the people of Lanarkshire are put at the heart of that decision.15:01
It is important that we come to this debate and consider these proposals with an open mind. We cannot always allow the history of service changes in a particular place to shape our future decisions, although I appreciate that that is easier said than done. I also appreciate that colleagues across all parties have, at different points and in different ways, fought hard to maintain and protect Monklands hospital and the excellent, local healthcare that people there benefit from.
Looking at the information that is outlined in the consultation on these plans, I think that it is clear that a total rebuild is needed to provide the high-quality facilities that people deserve. It would be unthinkable for people to lose such quality of service.
I am extremely conscious that we spend a significant part of our time in Parliament scrutinising service change proposals and that, time and again, patients and residents are forced to point out that longer journey times are one of their main concerns. Getting to hospital by public transport can be painfully difficult. Even small relocations can cause communities real problems when they do not line up with decent transport routes. That process also speaks volumes about the generally inadequate state of a lot of public transport in Scotland, how slow it is to change to people’s needs and, frankly, how low our expectations are of what it should provide.
It is crucial that we get the sites of our hospitals right and that, as Miles Briggs pointed out, when new facilities are developed, they have the space and capacity that they need, with room to expand if necessary, and that they offer a good environment to patients, their families and the NHS staff who work in them. New public transport routes and other planning decisions should then fit around that.
It goes without saying that it would be unacceptable for any aspect of the current service at Monklands to be downgraded in any way whatsoever as part of that process, and I am glad that the Government’s amendment speaks directly to those concerns, reiterating its commitment to the hospital’s A and E department and specialist services.
Does the member agree that committing to an A and E department and then moving it out of Monklands is no commitment at all, from the point of view of the people of Monklands?
It is clear that people in that area and the wider area need access to a first-class A and E department. However, I would like further information about the plans for the existing hospital site, in a situation in which new facilities are built elsewhere. I ask the minister to address, in closing, how that site could be used to the best effect for the people in the local area.
It is important to note that any judgment that Parliament takes today on the service change would be formed without sight of a report on the public consultation, which ended just 10 days ago, as that report has not been published yet. Apparently, there have been more than 600 responses to the consultation. I would prefer to be able to take those views into consideration. We rightly criticise the Government, as we have criticised health boards in the past, when consultations have been flawed and people’s views and responses have not been given appropriate regard. We cannot ourselves rush past the consultation process that is in train. The board has not yet met to decide on a preferred option for the outline business case. That is not due to happen until next month.
I appreciate that my colleagues are acting out of genuine concern for people and patients in the area. However, I am also mindful of the fact that the longer timescales anticipated for rebuilding on the existing site would leave patients without a viable local service for longer—possibly many years longer—as well as putting more pressure on other hospitals that would have to absorb displaced demand during that time.
It is crucial that the best decision is made for the long-term future of the hospital. That can be achieved only with a clearer and more detailed view of the potential advantages of building on all sites, and by taking into proper account the views of patients and residents.
The Government’s amendment does not make any determination on the ultimate location for the new hospital, and it stresses that the views of patients, along with other factors such as travel, must be fully taken into account. For that reason, I am minded to support the Government’s amendment this evening.15:06
I am grateful to the Scottish Labour Party for bringing this motion before Parliament.
I do not know Monklands hospital well, and I have never used its services, but its reputation precedes it and it has been the subject of many heated debates, questions and campaigns in the Parliament. That is testament to the calibre of its excellent staff and to how well regarded it is by the communities it serves.
Above all, I understand the drivers for and the reasoning behind the Labour Party bringing this debate to the Parliament today and the depth of feeling that exists in the community about the location of the hospital. That resonates with me, given many of the campaigns in which I have been involved about health services in the areas that I represent, so I understand it very well. The hospital is a dynamic and well-regarded institution, which has substantial throughput. What really resonates with local people who have backed the campaign is not just the certainty that the hospital provides because of where it is but its heritage and its place in the local firmament.
The process so far, which we have heard a lot about this afternoon, speaks to a wider catalogue of decisions taken in major service redesign by territorial health boards and Scottish ministers, which are underpinned by theoretical arguments, spreadsheets and arguments about economies of scale that might well look good on paper but fundamentally fail to carry the support of—and indeed are wholly adrift from—the communities that the services in question serve. I remind Parliament about what happened with the redesign of cleft services, which saw Felicity Mehendale lost to the profession and diminished our offer to patients in that regard.
Hospitals will always evoke strong emotions locally. They are in many cases central to the fabric of the communities that they serve. That is because they do not exist in isolation; many local businesses and voluntary groups have very close ties to them and depend on their location for their own viability. They define public transport links and impact in many ways on the roads and traffic profile of the communities they serve.
Our support for the Labour motion would be harder if these communities were being pitted against one another—but they are not. In fact, many residents in Gartcosh have already voiced concerns about pressure on parking, traffic flow and other such issues. Some elected members have cited proximity to gas mains and all the rest of it as aspects of the unsuitability of the Gartcosh site.
As I said at the start of my speech, I do not use this hospital, so I am not familiar with it, but I have absolute solidarity with the community campaign that has sprung up around it, given its perseverance in the locale. The campaign speaks to the much wider problem that we have in Scotland with the delivery of our health services. The process for determining where we locate services and how we design and redesign them to meet the needs of the citizens whom we are all elected to serve is fundamentally flawed, because it is focused very much on what looks good on paper but does not necessarily work as well in practice for the communities that the services are there to serve.
I welcome the motion and assure Labour members of our support for it.
We move to the open debate. I ask for speeches of up to four minutes, as we are tight for time because there is a second debate this afternoon.15:10
More than a decade ago, I campaigned with colleagues from across the political spectrum to stop NHS Lanarkshire downgrading our local A and E department at Monklands general hospital. The first thing that I did when I was re-elected in 2007—straight after being sworn in—was to go out of the chamber and lodge motion S3M-0002, which called for a reversal of the decision to downgrade Monklands hospital. As it is fond of reminding us, the SNP Government then instructed NHS Lanarkshire to do just that. At that time, Nicola Sturgeon MSP, the health minister, concluded that the health board had not given sufficient weight to the concerns that were being expressed by local people.
Fast forward to the present, and Monklands hospital is now facing a much worse threat: the removal of the whole hospital from the Monklands area. I assure the First Minister that, yet again, sufficient weight has not been given to the concerns of local people. The so-called consultation closed a week last Monday, while the Parliament was on recess and during the school holidays. To make matters worse, an additional paper suddenly appeared with a week to go until the closing date.
The whole process has been flawed from the start, with NHS Lanarkshire heavily promoting its preferred option of building outwith Monklands, at Gartcosh. Even the option appraisal exercise was weighted in favour of Gartcosh and involved far more staff and professionals than patients or members of the public.
It was also very clear from the public presentation—not meeting—that I attended that the Gartcosh site was being heavily promoted, with the other sites, in particular the current location, being negatively portrayed. I say to the minister that these were not inclusive public meetings but public relations exercises that were designed to promote the Gartcosh option and undersell the other options. I am sorry, but no one in my community in Monklands will believe the minister that the decision has not already been taken. Of course, the minister can overturn that decision.
As we have heard, building has happened on the Monklands site in recent years. We have new theatres, the Beatson and Maggie’s centres and investment in the A and E department. The current site has many advantages: it is in a very central location; it is embedded within the Monklands community; and people can access it through well-established transport links, whether by car, bus or train. We also know that far more staff live closer to the current hospital, which is an important factor in terms of childcare and additional travel costs, as well as raising issues around providing services in bad weather, for example. We should commend the staff who walked to work during the heavy snow of last year—that will not be possible if the hospital is moved out of its central location.
Over the years, Monklands residents have lost acute medical services such as paediatrics, in-patient dermatology beds, gynaecology and orthopaedics. Living in the community, I have no doubt that the people of Monklands are deeply concerned about losing their local hospital provision in the heart of our community.
With the closing of the so-called consultation, it is time for Parliament to step in and show support for the people of Monklands. I understand that the contributions to the consultation are not being made public by the health board, so I put that on the record.
In last week’s Airdrie and Coatbridge Advertiser, Alex Neil MSP is quoted as saying:
“We must ensure that Gartcosh gets the kybosh.”
However, Fulton MacGregor has not publicly supported keeping the Monklands in the Monklands. Both of them can show their support today by voting against the Government’s anti-Monklands amendment and voting for Labour’s motion.
Let us be very clear: any MSP who supports the Government’s amendment, which talks of the “catchment area”, will give a green light to Monklands hospital being removed from Monklands. Of course, a newer, substantially upgraded hospital is needed, but I believe that it should be on the current site.
The Scottish Government will have the final say, or it can call the decision in. The Government is investing heavily in new provision, but its amendment is worrying. It does not support keeping the Monklands in the Monklands. Having previously stopped the removal of A and E services from Monklands, I call on the Government to step in and stop the removal of the whole hospital from Monklands. If members want that, too, they need to vote against the Government’s amendment and vote for Labour’s motion.15:14
I speak as the local MSP for the Airdrie and Shotts constituency, which includes Monklands hospital. Neil Gray, the MP for Airdrie and Shotts, and I have spearheaded the campaign against what I regard as a stupid decision by NHS Lanarkshire to make Gartcosh the preferred site for the new hospital.
Unfortunately, that sentiment is not universally agreed with. I will quote.
“I am delighted that Gartcosh has been short-listed for a proposed new build of Monklands Hospital. Gartcosh is a good choice”.
That is from Hugh Gaffney, the Labour MP for Coatbridge. The Labour Party needs to sort out its position: as usual, it is trying to face two ways at once. I speak as the local member and am facing only one way, which is this: no to Gartcosh, and no on a number of other points.
First, as a former health secretary, I say with the greatest respect for the people who work in the Monklands hospital that there were, at the options appraisal that has been referred to, 53 people, 34 of whom were senior employees of NHS Lanarkshire and only 16 of whom were patients. Five of those 16 came from South Lanarkshire; the other 11 were from North Lanarkshire. The health board could identify only one patient who lives in the Monklands catchment area: out of 255,000 patients living there, the health board identified only one to turn up at the scoring event. The board has then had the cheek to say that it has stuck to the process that was laid down by the Government. There is no way that the board has stuck by that process.
This is not just about participation; it is about the how the whole scoring system was rigged to get the answer that the senior people in the health board wanted, against the wishes of the majority of people in North Lanarkshire and the vast majority of people in my constituency. The information on which the board scored was inaccurate, misleading and unbalanced, and very often bordered on being deliberately economical with the truth. There is no way that the exercise could be described as fair and objective.
The top priority for the health board, according to its own document, is reducing health inequalities in Lanarkshire. If the hospital goes to Gartcosh, far from reducing them, inequalities will be made much worse.
That is why Neil Gray and I have submitted to NHS Lanarkshire a petition that has 6,000 signatures. It is unfortunate that NHS Lanarkshire acts as though it is deaf: it is not listening to the people. The people told the board previously that closure of the accident and emergency department was the wrong thing to do, and the people are telling it now that putting the new hospital in Gartcosh is the worst thing to do. I agree with the people, and the evidence agrees with the people.
It is time for an independent review of the process, the information and the decision to make Gartcosh the preferred site. That decision cannot be allowed to stand. It would be a betrayal of the people of the Monklands hospital area if Gartcosh were to become the site for the new hospital. Unlike Labour Party members, I can say that on behalf of all my party’s representatives for Airdrie and Shotts.15:18
Monklands, in Airdrie, was the first new hospital to be built in Scotland in the post world war two era. The hospital’s roots go back to 1887, when Sir John Wilson, a late 19th century businessman and local politician, bought the Airdrie House estate. He went on to bequeath that land to the people of Airdrie, and it became the site of the local maternity hospital and then Monklands hospital.
Over 40 years, there has been a significant increase in the number of people who live in the Monklands area, so it was not doubted that at some stage Monklands hospital would no longer be totally fit for purpose. It is fair to say that the hospital is currently less than fit for the modern day.
Emotions and feelings run high. Hospitals belong to communities—not only the patients who attend them, but the staff who work there and who dedicate their lives to looking after our sick people, so it is no small wonder that emotions in Monklands are running high about the potential closure and re-siting of the hospital.
I welcome today’s debate. Although I am led to believe that the health board has not yet fully made up its mind regarding the location of the new hospital, there is significant evidence and other factors that must now be taken into overall consideration in respect of the hospital’s future.
There is no dispute about whether there should be a new modern Monklands hospital. I do not agree with Richard Leonard and Elaine Smith that the problems will be solved simply by building on the current site of the hospital. Apart from the considerable time that will be required to dismantle the old hospital and rebuild a new one, operating an efficient hospital on the same site, which already lacks space, is simply not practical, in my view. I appreciate the passion surrounding the current location and why people think that it makes logical sense to take out the old and put in the new.
Forth Valley hospital in Falkirk had a similar experience. There was Falkirk royal hospital and there was Stirling royal hospital: a person was either a Falkirk bairn or a son of the rock, and discussions about what was the best site to replace the two hospitals went on for 25 years. The new Forth Valley royal hospital has now been there for about eight years.
Where I do agree with some participants in the debate is that Monklands is in Airdrie, so to start looking at a site in Gartcosh involves the potential move to a Glasgow postcode. There is an argument that Gartcosh is technically in Glasgow, not in North Lanarkshire, so that move would and could benefit the people of Glasgow but be a huge disadvantage to people who live in the Monklands area. Not only would travelling be problematic for a lot of elderly and infirm people in the area, but we would have to consider emergency ambulance transfer times and the additional travel time that the move would add to the already long hours that staff work.
Will Alison Harris take an intervention?
If Elaine Smith will let me finish, I will do so, but as the hospital is in my region I want to try and finish this point. I will give way at the end.
I am afraid that you cannot take an intervention, Ms Harris. You are in your last minute.
When I looked back to find out when the hospital was originally opened, I discovered the story of Sir John Wilson bequeathing land to the people of Airdrie for what would become the Monklands hospital as we know it. It was fitting to learn of a similar gesture, some 130 years later, from a local Airdrie businessman to sell for the princely sum of £1 land at a suitable location in Glenmavis with the potential to build a new Monklands hospital there. That huge gesture should be given serious thought. Glenmavis is a more central location. It is local and would keep the hospital within the heart of the community. That is a serious alternative and one that I urge the health board to consider. Now is the time to go back and have a significant rethink—not to take choice away from local people.
I call Neil Findlay, to be followed by Fulton MacGregor. You will have four minutes to speak, so if you take an intervention I am afraid that you will have to absorb it.15:23
Monklands hospital is not in my region, but I have had representations from constituents who work there or have been treated there. Like so many hospitals in Scotland, Monklands was built by a Labour Government to serve the health needs of growing communities—in that area, a growing industrial town—but the recent history of the hospital has been one of insecurity and indecision, which have left local voices marginalised by the health board.
That is a familiar tale indeed, and there are many reasons why that is the case, but today we have to concern ourselves with how we answer the question about where the new hospital will be located. People in the area have had to put up with repeated instability in recent years—not least when services have been taken away from the hospital, which has forced patients to travel further afield for treatment. That is a serious problem, especially for people who rely on public transport. It is a situation that is reflected in my area, where the same is happening at St John’s hospital, with families and children having to travel up to 30 miles because a service is not run on a 24/7 basis.
All too often, such decisions are made with there having been no prior consultation of the staff or the people who fund the NHS—the taxpayers, the patients and the people. At Monklands, we have seen dermatology, gynaecology and paediatrics services lost, and bed numbers being cut from 527 to 477, despite the population growing and getting older. At what point does the downgrading of a hospital end? When will the uncertainty over the future of the hospital be settled?
I hope we are all agreed that the community needs a new well-resourced hospital, and that its location must reflect the concerns and wishes of the local population. It is not the role of Government or of NHS boards to dictate to communities that have shown a clear and strong preference. I suggest that doing so goes against the very essence of the chief medical officer’s principle of realistic medicine.
A new hospital must continue to serve the people of the communities, and it should be built where the communities want it to be—at the site where it has always been.
The argument from Green Party members is bizarre. They are arguing for a hospital to be built on a greenfield site when it could be built on an existing brownfield site. That makes no sense to me whatever.
It is not a greenfield site.
It is not a greenfield site.
The site is out of town.
Let us call it an out-of-town site.
Will the member take an intervention?
I will not, at the moment.
We should also remember that Monklands hospital is the largest employer in an area of multiple deprivation, and provides an economic boost to a community that needs it. That is very important.
Richard Leonard has secured a petition with more than 5,000 signatures, and I am delighted that Alex Neil has done the same. It is good that people are making their points, which must be taken into account over and above the so-called local consultation. It is clear that people have a clear preference.
My Labour colleagues have been pressing on the issue for many years. It is of concern that we have spent so much time deliberating on such matters, rather than getting on with the job of creating an NHS that is fit for the 21st century—not just in Lanarkshire, but across the whole of Scotland.
Hospital instability has become a common problem in Scotland, as I know only too well from my area. That is absolutely unacceptable. People in Lanarkshire deserve certainty about their situation, just as people in West Lothian deserve certainty about theirs. Were the future of their hospitals to be secured, they could start to plan for the future and could feel confident that their services were being protected. That is why I will support the position that has been put forward by Richard Leonard.15:27
Thank you, Presiding Officer, for the opportunity to speak in the debate. As someone who grew up in the Coatbridge area, right next to Monklands hospital, it is a privilege to speak in a debate about a hospital that I know well and its future in serving my constituents and the wider area.
Because of the unique position of my constituency, I have taken extra time to listen to the differing views of people and communities within the constituency before expressing an outright opinion. I have attended the NHS public meetings, met constituents and stakeholders, held street surgeries and engaged in various forums to gather opinion. My consultation response was balanced and tried to reflect the issues.
Generally speaking, people from Coatbridge want the hospital to remain at the current site or nearby. People from the Chryston area, which encapsulates the various villages in the north of my constituency—an area that has been fighting for a health centre—are comfortable, in the main, with a move to Gartcosh, although there are exceptions.
However, the most important and wider issue that the consultation raised concerned health inequalities, which is why the Government amendment is so important. I add that it shows the Labour motion for what it is: shallow, simplistic and scaremongering.
Coatbridge and Airdrie, the two Monklands towns, have some of the most deprived areas in Scotland.
Will Fulton MacGregor take an intervention?
Between them they have nine areas in the most deprived 5 per cent across Scotland, according to Scottish index of multiple deprivation—SIMD—statistics.
Is the member allowed to take an intervention?
Would Monica Lennon listen to this? Four of those areas are in Coatbridge. If that is then increased—[Interruption.]
Just a wee minute, please, Mr MacGregor. I want to hear what Mr MacGregor has to say. You will have a chance in your summing-up speech, Ms Lennon.
If that is increased to the most deprived 10 per cent, the figure rises to a staggering 28 areas—14 in each town. The poverty and deprivation that resulted from deindustrialisation in the 1980s under Conservative Governments, and which are being perpetuated by current failed UK Government austerity policies, have brought with them a host of health inequalities, from high rates of heart disease and other long-term health conditions to significant drug and alcohol-related harm. Monklands has been known as “the sick man of Europe”—a term that will be familiar to many of us.
It may not be the intention, but removing a well-established hospital with an A and E department from an area that has such health inequalities and where fewer people have access to private cars, could be regarded as the elitists and decision makers dealing a hammer blow to those communities. That is not what I, or anybody here, came into politics to do. As the amendment outlines, the hospital needs to serve the Monklands area and to continue to be part of a plan to address those health inequalities, on which slow but sure progress is being made by the SNP Government. The board and engagement process have a duty to instil confidence that that will be the case.
However, as others have said, generally that has not been the case. Some aspects of the consultation were good, and the meetings were responsive and professional, but there was weighting of Gartcosh as the preferred location, and I was disappointed to hear that only one Monklands resident was involved in the scoring. There should have been more information on the other central Monklands sites—for example, at Gartsherrie. That site was rejected due to poor road access, but the roads there are the main ones that would get folk from Coatbridge to Gartcosh. How does that make sense?
Similarly, the current hospital site has many positives, such as its location and transport links. I would like more information on options on the land nearby and on building up the way, which seems to have been dismissed too easily. This is a major decision and I believe that it would be best to start again and consider all the options, including looking again at Gartcosh, while dealing with the concerns that have been raised.
I will finish with this. In 2007, it was the SNP that saved the Monklands A and E department from closure by Labour—the shameful proposed closure of an A and E department in one of Scotland’s most deprived areas. It is the SNP Government that has invested heavily in the site since then. It was this Government, under Shona Robison as Cabinet Secretary for Health and Sport, that agreed the funding for a new hospital to be built. It is local politicians including Alex Neil, Neil Gray, me and our councillor colleagues who are scrutinising the proposals of the board and holding it to account. Our candidate in the Coatbridge South ward by-election is standing on a strong platform to keep the Monklands central—[Interruption.]
People are not fooled by Labour’s scare stories any more. They know that the Monklands hospital is safe in the hands of the SNP.
Mr MacGregor, sit down! If you overrun your time, you cut other people out, no matter your passion.15:31
I was thinking that it was a very considered contribution from Fulton MacGregor, until the end.
This is an important debate for the people I represent in Central Scotland. For those of us who live in Lanarkshire, Monklands is one of our hospitals. I live in East Kilbride and Hairmyres is my local A and E, so when I fell off my bike a few years ago that is where I went, but Monklands is just as much my hospital as Hairmyres, because there are specialisms there—such as ear, nose and throat and radiotherapy—that are not available closer to home. It is Airdrie’s hospital, but it is Lanarkshire’s, too.
First, do we need a new hospital? No one is arguing that the current one fits the bill for the 21st century. The second question is, where should it be? When there is a proposal to build a new hospital, there will always be strong views on where it should be. It is vital that there is a robust, evidence-based process and that people’s views are taken into account. There has been a consultation, which is now closed, and the health board says that the process was in line with official Scottish Government guidance.
The board says that the process to select those taking part in the consultation was formally agreed with the Scottish health council. There have been 13 public meetings, attended by around 600 people, which is an average of 46 people per meeting. I can guarantee that any of us here could rustle up more than 46 people to a public meeting about something so important. That does not sound like very many people to me, and I have to wonder how well publicised those meetings were. The minister should take a very close look at the consultation process that has been followed, because we need to be absolutely certain that it was done in the correct way.
Thirty-seven sites were initially considered and various criteria were looked at. The sites had to be within North Lanarkshire, on an area of at least 40 acres, within the existing catchment area, with suitable road access and so on. Any new hospital could not be built in a location that would mean that Monklands patients would choose to go to another hospital, such as Wishaw or Forth Valley.
As we have heard, there are only three real options: building on the existing site—which I think is problematic and it would take 13 years; I do not think that people want to wait that long—or Gartcosh, or Glenmavis. Gartcosh is further away from the current site than Glenmavis is. It has a railway station but, if someone lives in Airdrie, they would have to travel into Glasgow and back out in order to get there—it takes about an hour.
Glenmavis does not have a station but there are a couple nearby, which shuttle buses could easily connect to. To me, it is more convenient. A new link road is planned and thousands of houses are to be built in the area. That is why local politicians, including Airdrie’s three Conservative councillors, support that site. I think that it is sensible, but we are in an on-going process—no decision has been made.
The health board will meet at the end of November to decide its favoured option, and it will then have to produce an outline business case. We have to be absolutely certain that the board follows due process. Enough serious concerns have been raised in the chamber today to require us to question whether that has been the case. We must get this decision right for the people of Monklands and the whole of Lanarkshire.15:36
I found it a wee bit of a challenge to prepare for this debate because I am not a resident in the area and I am not as familiar with the area as some others. However, I will speak in the debate because we had a similar experience in Dumfries and Galloway when the new site was being chosen for the brand-new, fantastic facility that has been built near Dumfries.
It is not very often that we are presented with a two-line motion for debate, so I was pleased to see a significantly more substantive, informative and positive amendment from the Government in the name of Clare Haughey.
The Scottish Government has been clear that it remains committed to robust, evidence-based policy making, as set out in the national clinical strategy, and I welcome plans to refurbish and replace the current Monklands university hospital.
Will the member take an intervention?
Yes, I will take an intervention—please make it quick, though.
Does the Government amendment leave the door open for the hospital to move out of Monklands?
I thank the member for allowing me to clarify that point. The motion does not leave any door open to allowing the alternative site.
I am aware that NHS Lanarkshire has a process of consultation under way. The board must consult, engage and listen to the patients, the outpatients and all the people and service users who will use the new state-of-the-art facility.
The Scottish Government, time and again, has committed to the thinking that people should receive treatment as close to home as possible to promote safe, effective and person-centred care. Indeed, in the Government amendment, that commitment is reaffirmed.
The consultation is on-going and the board will evaluate all options. It is yet to decide on a preferred option, which will then be sent to the Scottish Government for ministerial approval. Once the board has gone through that process and when it has sent its final proposal to the Government, the proposal will be subject to the national clinical strategy. That approach will ensure that all decisions are based on available evidence and that any decision is taken on the basis of proper and comprehensive public consultation.
I echo the words of others today regarding concerns about certain aspects of the consultation. On listening this afternoon, it seems that there may need to be a further review of the actual process, the scoring system and the engagement that NHS Lanarkshire has undertaken.
I ask the Government to consider whether the process might need further investigation. Local people need to be assured that this SNP Government will always focus on providing as many services as possible as locally as possible, and I am sure that ministers will take into account all available information before coming to any decision.
All are in agreement that the Monklands hospital needs to be upgraded. Speaking from experience, when I was working as a nurse in the old Dumfries and Galloway Royal infirmary, I used to find it difficult to move around in rooms that were too small to manoeuvre in. The equipment and supplies could not be accessed easily and we needed to carry out bedside care in a space that just did not work.
Upgrading the hospital or building a brand-new hospital will allow better, modern patient care to be achieved. I recognise the need for hospitals across Scotland to be upgraded and refurbished when necessary to meet the state-of-the-art needs of the 21st century. The constituency member for the area, Alex Neil, has been proactive in his campaign to replace the current building and I join him in expressing disappointment that the Labour Party has launched a separate petition on that matter. I support the best option for the future.
Thank you. You have made your position clear. Closing speeches are a tight four minutes. Mr Whittle will close for the Conservatives.15:40
I am pleased to close the debate on behalf of the Scottish Conservatives, and I thank Labour for bringing the debate to the chamber.
As we would have expected with the issues of health and the delivery of health services, the debate has been passionate, with MSPs—especially local members—quite rightly rallying to the cause of their constituents and, in some cases, putting partisan politics to the side. It would be remiss of me not to mention that there happens to be a local by-election tomorrow in the area. Members may call me an old sceptic, but perhaps politics is not as removed from this topic as it should be.
Such debates are often framed in the wrong way. We discuss bricks and mortar when we should be discussing the delivery of services. However, the debate highlights that it is crucial that bricks and mortar are established in the right place for the good of the whole community that they serve, ensuring that no part of the community is disadvantaged. Alison Harris pointed out that Glasgow could benefit from a Gartcosh option to the detriment of people in Monklands.
The debate has highlighted once again the NHS’s continued inability to engage in satisfactory public consultation processes. That issue has been brought to the Health and Sport Committee’s attention again and again, and we must address it. Change in the delivery of services is inevitable, and the process would be much less painful if proper protocols for open and transparent consultation were implemented from the outset, led by healthcare professionals and focusing on service delivery. In this instance, we have heard from across the chamber—from Miles Briggs, Elaine Smith and Neil Findlay, and in a passionate address from Alex Neil—about the process being misleading and economical with the truth. It is obvious that the consultation process about the site of the Monklands hospital replacement has been, at best, flawed. According to some members, there has been a significant conspiratorial element to the process. The outcome seems predetermined by a process that tries to lead to a specific conclusion.
That leads to consideration, or otherwise, of the practicalities of access to services. The Monklands situation is by no means unique. I fully accept that change is inevitable as services develop, but the study must be cognisant of transport infrastructure and how the move of a service may impact on those who rely on it. For example, a plan is under consideration in Ayrshire and Arran to change the way in which cancer treatments are delivered. The basic plan has merit and is worth considering as a potential solution, until we recognise that, in some cases, it would mean changes of hospital appointments from Ayr to Crosshouse and a journey by public transport in excess of three hours for some patients to get treatment, with the same journey on return. Therefore, I am glad that infrastructure has been raised in the debate, because in considering and evaluating how we may better deliver services, a core principle in that decision should be how those in need would access the service. We also need to be cognisant of the people who deliver the services and their travel to work. The delivery of a public service—especially one as critical as the NHS—should have service users as the key element of decisions.
The question that has to be asked in the first place is, in the two decades during which health has been devolved to this Parliament, how has Monklands been allowed to deteriorate to such a poor state that it has to be replaced?
Thank you for keeping to your time. I call Clare Haughey to close for the Government—a tight four minutes, please, minister.15:44
I assure members that ministers have noted the concerns that have been raised. I reiterate ministers’ clear expectations that, in such cases, NHS boards must come to a robust, evidence-based decision that is in line with national guidance and best practice and that is meaningfully informed by the views of local stakeholders. We agree that all efforts must be made to move forward work on this important development while meaningfully engaging with and ensuring the confidence of local people and their representatives.
Will the minister take an intervention?
I do not have time.
I have already explained that that is the reason why ministers have asked the director general for health and social care and the chief executive of NHS Lanarkshire to discuss the need for the board to undertake further engagement and consultation with affected communities on the proposed options for replacing or refurbishing Monklands hospital.
On a wider point, local people can be reassured that the Government will always focus our approach on providing as many services as possible as locally as possible. That is our record in government, and it stands in stark contrast to that of the previous Labour-led Administration. Richard Leonard’s motion calls on the Parliament to build a new Monklands hospital, but it is appropriate to conclude by reflecting on what the Government has done for local people since 2007 in comparison with what Labour delivered when in power.
In the 2007 SNP manifesto, we promised to keep vital health services local and to reverse the decisions to close Ayr and Monklands A and E departments. That was not a Labour Party manifesto commitment. Nicola Sturgeon’s first act as health secretary in June 2007 was to announce to the Parliament that we were overturning the previous Labour-led Administration’s decision to close the highly valued A and E departments at Monklands and Ayr hospitals. Since our decision to save the A and E at Monklands, it has provided much-needed emergency capacity, seeing more than 700,000 attendances.
We have not just maintained the service; we have invested in it and enhanced it. Under the SNP Government, the number of emergency medical consultants in NHS Lanarkshire is up by 300 per cent, from eight to 32 whole-time equivalent posts. The Government’s support for NHS Lanarkshire includes a cash-terms increase in the health board’s budget of £469.6 million. Overall, staff numbers are up by 16.6 per cent, or 1,441 whole-time equivalents, with consultants up by 81.4 per cent and qualified nurses and midwives up by 19.3 per cent, or 646.1 whole-time equivalents.
As I have said, we welcome and are supportive of NHS Lanarkshire bringing forward proposals to refurbish or replace Monklands hospital for the benefit of local people. However, given the range of services that are required on site to support a core A and E service, one might wonder whether, had the previous Labour-led Administration’s decision to close the A and E at Monklands not been overturned by the SNP Government, there would now be a hospital there to refurbish at all. [Interruption.]
If I can be heard over certain people, I call Monica Lennon to wind up the debate for Labour.15:48
There is a simple choice before us today: support the Labour motion to keep University Hospital Monklands in the Monklands community; or support the SNP amendment, which leaves the door open to taking the hospital out of the Monklands community. We all need to understand that. Scottish Labour is clear in welcoming investment in a new state-of-the-art hospital for Monklands, and we will fight to keep the Monklands in the Monklands community.
Will the member take an intervention?
What an utter disgrace it is that Fulton MacGregor, the SNP MSP for Coatbridge and Chryston, has described our endeavour as “shallow”. He may have grown up next to the Monklands hospital, but after today he will find it hard to look his neighbours in the eye. We have heard that the public consultation process has been farcical. It has been heavily criticised by my good friend Alex Neil, who says that it has led to a “stupid decision” to make Gartcosh the preferred site.
I described the motion as shallow because there is nothing to it. The Government amendment has a lot more to it, and the Labour Party should support it.
I think that we have heard enough on that, but I repeat that the motion is simple—it is to keep the Monklands in the Monklands.
Will the member give way?
Yes, but briefly because I have to make progress.
This is where—
Hold your horses, Mr Briggs. You have to be called first.
That is where we think that Labour is confused. Is Labour saying that the only option is to rebuild on the current site—that is its policy? Given that we have just had a consultation on lots of other opportunities and parties are—
That is too long an intervention.
I want to make some progress. We have said enough about the consultation, and the minister has plenty of notes to take away.
I turn to some serious points. Moving the hospital away from Monklands and out to Gartcosh would increase travel costs for many staff who live in the local area, especially those who are on the lowest wages. Alison Johnstone helpfully said that, in general in Scotland, we have inadequate levels of public transport. She also talked about the downside of longer patient journeys. Those are fundamental issues. There is nothing in the proposals to move the hospital to Gartcosh that would improve accessibility and journey times for patients.
Alex Cole-Hamilton made some really good points when he talked about hospitals being “central to the fabric” of communities. What looks good in a plan is not always best for people in the area. We are not talking about a paper exercise, and we cannot afford to get it wrong.
I support the Scottish Government’s town centre first principles, and I hope that it will not abandon them in respect of Monklands.
If the flagship Queen Elizabeth university hospital can be built on the site of the former Southern general hospital in Glasgow, why is it not possible to build a new Monklands at the Monklands site? Rebuilding on the same site is not without its challenges, but it is entirely possible. We have the expertise and design teams in Scotland to deliver state-of-the-art hospitals, and there is no reason why that cannot be achieved in Monklands.
A lot of attention has been given to the cost savings that could be gained from rebuilding on a new site at Gartcosh, but not enough focus is being given to what would be lost by leaving Monklands. Elaine Smith mentioned the Maggie’s centre and the Lanarkshire Beatson, for example. Both are state-of-the art facilities, less than five years old, that cost tens of millions of pounds, and they are co-located. What about those facilities?
We have heard a lot about health inequality, which is important. In Monklands, there are high levels of deprivation, some of the worst health inequalities and low levels of car ownership. Moving the hospital out of Monklands will only make the situation worse. The long-term advantages of the hospital remaining in Monklands are significant, and they have not been adequately reflected in the benefits and the financial analysis.
In conclusion, we have been forced to bring this motion to the Parliament to speak out against the decision to move the Monklands out of Monklands amid deep concerns about, and public criticism of, the consultation on where the new hospital should be built, the ramifications of which will be felt for years to come.
The choice before the Parliament is clear: we can either support the decision to move Monklands hospital out of the community for decades; or we can give an unwavering commitment to the people of Lanarkshire that the current hospital should remain in the community in which it belongs. That means keeping the Monklands in the Monklands area.
There will be a terribly brief pause before we move on to the next item of business, as there is no time in hand. With such short debates, I have to ask members to get to their seats and get ready right away. There should be no wee friendly—or unfriendly—chit-chats.