Meeting date: Tuesday, September 13, 2016
Meeting of the Parliament 13 September 2016
Agenda: Time for Reflection, Business Motion, Topical Question Time, Education Governance Review, Common Agricultural Policy Payments, More Homes Scotland (Investment), Decision Time, NHS Greater Glasgow and Clyde (Services)
- Time for Reflection
- Business Motion
- Topical Question Time
- Education Governance Review
- Common Agricultural Policy Payments
- More Homes Scotland (Investment)
- Decision Time
- NHS Greater Glasgow and Clyde (Services)
NHS Greater Glasgow and Clyde (Services)
The final item of business today is a members’ business debate on motion S5M-00505, in the name of Jackie Baillie, on save our services. The debate will be concluded without any question being put.
That the Parliament notes with concern reports that NHS Greater Glasgow and Clyde’s final draft local delivery plan includes proposals to transfer birthing services from the community maternity units at the Vale of Leven Hospital and Inverclyde Royal Hospital to the Royal Alexandra Hospital (RAH) in Paisley and the Queen Elizabeth University Hospital (QEUH) in Glasgow; rejects the assertion in the plan that “extensive public engagement” has taken place on the proposals and is unaware of any attempt by the NHS board to consult members of the public; believes that denying pregnant women in Dumbarton, Vale of Leven, Helensburgh and Lomond the choice to give birth at the Vale of Leven Hospital runs contrary to the Vision for the Vale, which was published in 2009 and committed the Scottish Government to ensuring that the community maternity unit would be “sustained and promoted”; understands that the plan also includes proposals to close the rehabilitation wards at Lightburn Hospital and transfer emergency paediatric services to the QEUH with the downgrading of the children’s ward at the RAH; believes that the NHS board will make a decision on the proposals on 28 June 2016, and notes calls for the Cabinet Secretary for Health and Sport to intervene and pledge to work with local communities to prevent the closure of health services.17:36
I very much welcome the opportunity to hold a debate on the proposed cuts to health services across Greater Glasgow and Clyde—specifically those that are proposed at the Vale of Leven hospital. Other colleagues will cover the cuts to the children’s ward at the Royal Alexandra hospital, the cuts to maternity services at Inverclyde royal hospital, the cuts to in-patient facilities at the centre for integrative care and the closure of Lightburn hospital. All those cuts were highlighted in January this year and are back today with a vengeance.
I welcome to the chamber campaigners from across the country and from my local area. I single out the hospitalwatch campaign group and the Lennox Herald for their consistent campaign on protecting local health services in my area. I also welcome Marc McLean as a very lonely figure in the press gallery.
Six months ago, we stood in this chamber and debated cuts to our local health services. At that time, the Scottish National Party Government said that there was nothing to worry about. It said that we were wrong and the leaked health board paper had no standing—basically, “Nothing to see here.” In the run-up to the election, the attack on us became even more shrill. We were liars and we were simply scaremongering. Promises were made to local communities, including mine, by SNP candidates, the then Cabinet Secretary for Health, Wellbeing and Sport and even the First Minister.
I like to keep election leaflets to see what promises have been made. Let me read from this one, which was popped through the door of every household in Dumbarton constituency during the election. These are the words of Shona Robison:
“I have been consistently clear that this Government sees a bright future for the hospital, which plays a crucial role in the local healthcare system.”
She also says, in the same leaflet:
“I will not approve any move away from the Vision for the Vale commitment”.
I absolutely support that. Ms Robison has been abundantly clear. However, the health board has not quite got the message, so the suspicion in my community is that a deal has been struck behind the scenes.
In 2009, I whole-heartedly welcomed the vision for the Vale of Leven hospital. It contained commitments to deliver a wide range of services at the local hospital. While we have seen staff numbers drop and a substantial number of clinics cancelled, the vision remains an important commitment for local people in my community.
So important was the community midwifery unit for the Vale vision, it was pictured on the front page. Again, I like to keep Government documents. I never know when they will become useful. The exact wording was:
“The Community Maternity Unit will be sustained and promoted”.
That is the very same maternity unit that is up for closure today. The number of births at the community maternity unit has fallen sharply in the past year, despite the birth rate for women remaining steady. Since 2009, the number of births to women who are resident in Dumbarton, Vale of Leven and Helensburgh has fallen by only 8 per cent, while the number of deliveries at the Vale of Leven CMU has fallen by nearly 70 per cent, with the largest decrease occurring between 2014 and 2015. That suggests that the health board has not been serious about promoting the CMU to local women—which takes me on to its marketing activity.
The health board’s marketing plan promised to promote the CMU with media releases highlighting the positive achievements, editorial briefings and case studies with volunteer mothers speaking out in support. However, a search of the online archives of the Lennox Herald shows that there were only five positive stories about the Vale CMU between 2008 and 2011. They are outnumbered by stories about the health board reducing the opening hours, midwives being redeployed to the Royal Alexandra hospital and campaigners fighting against threats to local health services. Where were the pictures of newborn babies that we all like to see in our local paper?
We were also promised leaflets, posters and information for general practitioners across a wide catchment area. Over the summer, I contacted every GP practice in Dumbarton, Vale of Leven, Helensburgh, Lomond, Clydebank, Bearsden and Milngavie. They were asked to respond to a survey on marketing activity for the CMU. Almost half of them responded, and responses came from every geographical area. Three quarters of the GPs were not aware of any marketing activity for the CMU, and no GPs currently have information leaflets or posters on the walls of their surgeries to promote the Vale unit. At the Vale hospital reception there is not a leaflet to be had. We were promised that the health board would promote the unit, but it has completely failed to do that.
Along came the new centralised maternity booking service, which was introduced in June 2014. It cut out the GP and diverted newly pregnant women to a call centre that is based at the Southern general hospital. Surprise, surprise! That coincided with a 57 per cent drop in the number of babies who were born at the Vale of Leven hospital, even though the total number of births by local mums actually rose by 6 per cent. There were 77 babies born at the Vale in 2013-14, 33 in 2014-15, and the number is down to a handful now. I accuse the Government of closing the unit by stealth.
In May 2010, the CMU was downgraded from a 24-hour service to an 8 am to 8 pm service, with midwives on call during the night. The negative publicity that was generated by the health board’s changes further undermined confidence in the unit. I say to the Government: please do not tell me that this is about safety. I have demonstrated that the actions of the health board have undermined the CMU. I hope that the Government is not really suggesting that CMUs across the country, of which there are many, are unsafe.
The health board has not committed to a formal public consultation of service users and the wider public. Instead we have an engagement strategy that is based on a consultation that was conducted almost a decade ago. The health board just cannot be serious. We need a full three-month consultation with public meetings, so that people have a genuine opportunity to make their voices heard.
I want to believe the health secretary and the Government when they say that there will be no cuts at the Vale. I really want them to fulfil that promise. If the health secretary’s commitment is true, why has not one SNP MSP signed my motion—not even George Adam, Stuart McMillan, Ivan McKee or Gil Paterson, who have a direct interest in the area? If the health secretary’s commitment is true, why has the change not been designated as a major service change? I would be pleased to hear from the minister when she sums up.
If it is designated as a major service change, it must go to ministers for final sign-off. It would be unacceptable if the health secretary said that the matter was for the health board, because that would certainly—as sure as night follows day—sound the death knell for the Vale’s maternity unit.
If the health secretary is saying that there will be no cuts at the Vale, why on earth are we having a pointless and expensive consultation? There is only one thing left to say: “Save our services, deliver what you promised just six months ago, and stop the cuts.”17:45
There is no doubt that the second decade of the 21st century is a pivotal moment for healthcare and healthcare systems—not just in Scotland but around the world. An ageing population, the shift to more multidisciplinary working and rapid advances in research and technology—to cite just some of the trends—present challenges and opportunities that the national health service’s founders could scarcely have imagined. The decisions that we take today on research, on our NHS’s organisation, on relationships between investments in social, community, primary and secondary care and on the education and training of the health and social care workforce of the future will determine how well our health service responds to the challenges and opportunities.
People in Scotland should get the care and support that they need, in the right place and at the right time. That is why we are transforming our health and social care system to ensure that it keeps pace with Scotland’s changing needs.
Notwithstanding that, I support Inverclyde royal hospital and the community maternity unit. I have campaigned to save services in the past and I will do so again. On social media last week, I posted the consultation document that Jackie Baillie referred to in order to encourage people to get involved. I will meet the chief executive and the chair of the health board this week, and I will meet the Cabinet Secretary for Health and Sport later this month. I have been raising, and will continue to raise, the issue in order to encourage the electorate to get involved and to make their thoughts known.
Despite the cuts to the Scottish Government’s budget from the United Kingdom Government since 2010, Audit Scotland’s report “NHS in Scotland 2015” found that health resource spending has increased in real terms. Audit Scotland confirmed that a real-terms resource increase has taken place in every single year from 2008-09 to 2014-15. Westminster has cut the Scottish Government’s capital spending budget by 25 per cent, but our resource spending has increased in real terms, as per the Scottish Government’s commitment and as confirmed by Audit Scotland. Scotland also has a record-high NHS workforce and continues to make advances in diagnosis, treatment and care.
Jackie Baillie spoke about the past and about the campaign that took place in 2008. Through that campaign, Jackie Baillie, other parliamentarians and I succeeded in maintaining the community maternity units, and I would still like those units to be maintained. However, we cannot forget that it was under the previous Labour-Liberal Democrat Executive that the cuts agenda started. We lost the consultant-led maternity service in 2003, which is when the maternity unit issues started. A review took place in 2008, when Jackie Baillie, others and I succeeded in campaigning to save the current formulation of the units, as I said.
Our communities would not forgive us if we simply blamed each other for things that happened in the past or which are currently happening. Will Stuart McMillan join me to resist the cuts? Will he explain why he found it difficult to support my motion?
I genuinely appreciate Jackie Baillie’s contributions in the chamber, but I have said today and outside Parliament that I am campaigning to save the community maternity unit at Inverclyde royal hospital. I cannot make my position any clearer to her.
Greater Glasgow and Clyde NHS Board has a record-high budget of more than £2 billion, which has increased by more than 27 per cent under this Government. Nevertheless, it has been announced that the board is to press ahead with further scrutiny of the proposals that include the closure of seven in-patient beds at the centre for integrative care, and closure of the community maternity units at the IRH and the Vale of Leven hospital in Alexandria. Although it is clear that antenatal and postnatal courses at the Rankin unit in Greenock will remain, the health board proposes to cease birthing services at the IRH.
There are typically 30 members on Greater Glasgow and Clyde NHS board, most of whom are health and finance professionals. The seven remaining members are Labour councillors—one representative from each local authority in the health board area. Once again, we have seen evidence that, unfortunately, the week before—
You will have to hurry along, Mr McMillan.
I am concluding, Presiding Officer. The week before the health board made its proposals, the representative from Inverclyde resigned, so Inverclyde was left with no voice on the board when it made its decisions on the matter.
To conclude, Presiding Officer—
I will take no lessons from the Labour Party on NHS cuts. I will always stand for services being delivered at local level. That is my past record; that will continue to be my record.17:51
I pay tribute to Jackie Baillie for securing today’s debate and thank her for her commitment to the Vale of Leven hospital. I know that local people in Dumbarton and, indeed, the campaigners at the Vale appreciate all her efforts in the Parliament and beyond. I also pay tribute to the campaigners of all the services across the west of Scotland and beyond who dedicate so much of their time to protecting the local community services, and I thank our hard-working and dedicated NHS staff. The pressures and the failures that we see in our NHS are despite, not because of, our staff, who are undervalued, underresourced and overworked by the Scottish Government.
I am quite disappointed. Having heard Mr McMillan’s speech, one would almost have thought that his party had not been in government for almost 10 years, that health was not devolved and that someone else was in control of our NHS. The reality is that the NHS in Scotland is already independent. This Parliament and the Scottish Government set the NHS’s budget and its priorities, and they oversee its delivery. If there are any failures in the NHS and its services, those are the failures of this Government, and trying to blame someone else is simply shameful.
All seven Labour councillors on the health board unanimously opposed the board’s cuts. The reality is that the rest of the health board is appointed by the Scottish Government, and it is they who need to up their game.
Mr Sarwar will be aware that, the week before the proposal was published, the Labour councillor from Inverclyde Council resigned, so no Inverclyde voice was left at the board meeting.
Mr McMillan says that he is a voice for Inverclyde. Let us hear what that voice said during the election campaign. He pretty much called the Labour candidate, Siobhan McCready, a liar for bringing up the cuts that were coming. He said that she was
“playing carelessly with the Inverclyde population by indulging in unfounded information about threats to health services she has gleaned from informal conversation with friends”.
Perhaps Mr McMillan should have “conversation with friends” across Inverclyde who are disappointed with his failure to stand up to his own Government and protect services at Inverclyde Royal hospital.
Responses to freedom of information requests from the Labour Party have found that we face almost £1 billion of cuts to our NHS over the next four years. What was the Government’s response? It did not own up to the fact that we have challenges in the NHS; instead, it said that there are no cuts and went on to say that anyone who suggests that there are is being completely false. That information came from freedom of information responses across the country. The Government should speak to the campaigners at all the hospital services across the country.
Jackie Baillie was called a liar during the election campaign for saying that the Vale of Leven maternity unit was under threat, but she was proved to be right. The hard-working campaigners in the public gallery deserve their time with the health minister, so that she can explain why they were lied to during the election campaign. I have mentioned Inverclyde. Siobhan McCready was labelled a liar for talking about the proposed closure of maternity services at the Inverclyde royal hospital. Expectant mothers in the west of Scotland deserve better than that.
Given that we are talking about letting people down, let me show members the front page of the Greenock Telegraph before the election, where, in order to win votes, our First Minister shamelessly said that there would be no cuts to services in Inverclyde. What has happened? There are proposed cuts and closures at the Inverclyde Royal hospital. The Government cannot run away from its failures on the matter.
What about Paisley? Neil Bibby was accused of being a liar for saying that there was a potential downgrading of the paediatric service at the Royal Alexandra hospital. What has happened? We have seen the facts: there are proposals to downgrade the service. Mothers and families in Paisley deserve better.
It is the same with Monklands district general hospital and the centre for integrative care—
You must close, Mr Sarwar.
Our patients deserve better and so do our NHS staff. [Applause.]
I ask people in the public gallery not to clap or shout out—not that you have shouted out so far, but just in case. Thank you.17:55
I appreciate the opportunity to speak on the motion that Jackie Baillie has lodged on an issue that is of huge significance not simply to colleagues who represent constituents in the west of Scotland but—more important—to the people of West Dunbartonshire themselves, who have utilised the fantastic services that staff at the community maternity unit at the Vale of Leven hospital have provided for many years. I represent the Highlands and Islands, so I am acutely aware that the service has been used by people in, for example, Argyll and Bute, in my region. The Vale of Leven hospital has a wider geographic reach than might at first be imagined.
The Scottish Government’s programme for government continually reinforces the point about the need for the NHS to be more community orientated. Indeed, the first of the four priorities on health for the coming year is
“empowering a truly community health service ... to deliver the reforms needed for successful community health services”.
With that in mind, it is understandable that so many people will be puzzled that the Scottish Government’s idea of delivering more community health services is to sit on its hands, as the CMU is likely to be closed and expectant mothers will be told to make a journey of an extra half hour to an hour to Paisley or Glasgow instead. That is not building more community-led services; it is dismantling them. That is, rightly, a matter of grave concern.
Will the member take an intervention?
I am sorry, but I have only four minutes.
I can give you the extra time if you want to take the intervention, Mr Cameron.
I will take the intervention.
I clarify for Mr Cameron that, under the board’s proposals, there will be no closure of the CMUs. I think that he inaccurately said that there would be closure.
I said that the unit is “likely” to be closed.
Among some of the reasons that NHS Greater Glasgow and Clyde has presented in favour of closure is an issue that the Scottish Conservatives have been raising for some time—short staffing, which cuts across the NHS. In its paper on the matter, the health board said:
“we are finding it difficult to recruit to the CMUs as you need experienced staff who live close enough to attend when a woman presents in labour”.
With a 16 per cent rise in the number of nursing and midwifery vacancies across Scotland in the three months to June, it is no wonder that such a vital service will struggle to cope with demand. The staffing crisis lies at the door of the party that has run the NHS in Scotland for the past nine years.
In 2009, the “Vision for the Vale of Leven Hospital” document stated clearly that the CMU facilities at the Vale of Leven hospital would be protected until 2011. Even as recently as June 2016, the First Minister said:
“we will not approve proposals that run counter to the vision for the Vale.”—[Official Report, 16 June 2016; c 16.]
Despite those warm words, not a single SNP MSP has given their support to Jackie Baillie’s motion. There must be questions about the commitments to the CMU that this Government has made.
Stuart McMillan attempted to contrast the Scottish Government and the UK Government. Let me draw my own contrast: it is well known that NHS spending in England has increased by more than NHS spending in Scotland.
Nearly 2,000 people have signed the petition to prevent closure. It is clear that this is a heartfelt issue in the West Dunbartonshire area. Although the health board has launched a re-engagement process, it must ensure that that does not become a talking shop in which the outcome has already been decided. The process must be open and must truly reflect the feelings of respondents, many of whom will have first-hand experience of using the service.
If the Scottish Government is truly committed to the vision for the Vale and to promoting more community-based services, it and the SNP will join me, my colleagues and others across the chamber in supporting Jackie Baillie’s motion. I commend her for her persistence in pursuing the matter.
As quite a few members still wish to speak in the debate, I am minded to accept a motion without notice, under rule 8.14.3, to extend the debate by up to 30 minutes.
That, under Rule 8.14.3, the debate be extended by up to 30 minutes.—[Jackie Baillie.]
Motion agreed to.
I can see lots of happy faces.18:00
I thank Jackie Baillie for securing this important debate.
This morning, along with Kezia Dugdale, I met dozens of parents and grandparents at the RAH in Paisley, all of whom rely on local NHS services. I can tell the Scottish Government that they echo the thousands of people in Paisley who have already signed petitions to defend the children’s ward at the RAH. Once again, the message was loud and clear: the SNP Government needs to stop its cuts to our local NHS. The transferring of in-patient paediatrics from the RAH to Glasgow represents the closing of the children’s ward as we know it and a closure for the thousands of children who need it.
We know that there has been uncertainty over the future of the children’s ward at the RAH for many months, but the difference between this debate and the previous debate is that we are no longer discussing proposals—we are now discussing the official plan. Anas Sarwar is quite right. Before the election, SNP politicians said that Labour was scaremongering for highlighting the proposed cuts. George Adam described the threat to the RAH children’s ward as a “fantasy”, and in January and March he even told me that I should stop campaigning alongside local families in Paisley to protect it. Through his actions, he has shown that it is obvious that he has been more interested in saving his own job than in saving the children’s ward at the RAH. I hope that, at some point, he will take the opportunity to tell us whether he simply could not understand what the proposals meant for the RAH or whether he was deliberately trying to hide the truth from the people of Paisley before the election.
The time for the SNP Government to come off the fence is well and truly over. I reiterate my call to the health secretary to come to Paisley to meet local parents and grandparents. She should be under no illusion about just how important the RAH children’s ward is to local families.
The concern for local NHS services that has been mentioned is felt in not only Renfrewshire and West Dunbartonshire but Inverclyde. In recent weeks, I have heard from many people in Inverclyde who are extremely concerned by the centralisation agenda that is affecting their local NHS services. Earlier this year, we warned people that there was to be a review of maternity services and exposed the fact that it could affect local provision. Again, all that we heard from the SNP was accusations that we were scaremongering, yet now we see that the birthing unit at Inverclyde royal hospital is also to be axed. As Jackie Baillie rightly said in relation to the Vale of Leven hospital, the birthing unit in Inverclyde should be maintained and it should be supported to provide a service to more mothers instead of closing its doors.
Therefore, I call on the Scottish Government and the health secretary to intervene now, provide the health board with the resources that are needed and stop the plans to close the Inverclyde birthing unit. Local families will be amazed that the Government has not already done that, given that last year Nicola Sturgeon was on the front page of the Greenock Telegraph promising that Inverclyde hospital was safe and saying:
“There are no plans to centralise services out of Inverclyde.”
Again, the reality is that a number of services have been transferred from Inverclyde royal hospital to Glasgow recently, and the removal of the birthing unit is the latest example of the hospital’s downgrading. The cuts are leaving people with a real fear about the hospital’s long-term sustainability.
We have been here before. The Scottish Government wrongly denied that there were proposals to cut and close hospital services. We are no longer discussing proposals—they are now official plans.
It may be past five o’clock but it is decision time for the SNP Government. It is time for SNP ministers to stop sitting on their hands and watching as services are cut back.
On behalf of my constituents, my message is clear: the future of our local hospitals depends on keeping those key services. Ministers must stop saying that they are protecting NHS budgets when they are not and must stop saying that they will keep health services local when they will not. They must give NHS boards the resources that they need and give families in Renfrewshire and Inverclyde the guarantees that they want on their local NHS services.18:05
For the purposes of time and my speech, I will focus on the part of the motion that relates to the Vale of Leven hospital.
History does not bode well for Labour when it comes to the NHS and, specifically, to the Vale of Leven hospital. In 2009, the vision for the Vale ended a decade of damaging uncertainty for the Vale of Leven hospital and for the erosion of services—including accident and emergency—by the previous Labour-led Scottish Administration. The then Cabinet Secretary for Health, and now First Minister, made a commitment to protect the Vale, and this year—on camera and in front of 400 people in West Dunbartonshire—Nicola Sturgeon made the same commitment to the Vale of Leven hospital. If that was not enough, the cabinet secretary reiterated the commitment of the Scottish Government to the Vale of Leven hospital remaining open in front of the Parliament, the public and, again, on camera.
I agree that that was all very helpful and I want to agree with both the First Minister and the health secretary about the Vale hospital. Why, then, do we have the proposal before us today? Does Gil Paterson support my specific call that it should be designated a major service change so that it is signed off by the very ministers who said that they would protect the Vale?
If it was another situation or any other element of the health board, if the Government was telling health boards dominated by the Labour Party to do one thing or another, or if the Government interfered willy-nilly with health boards, Labour Party members and other opposition MSPs would be up in arms. That is not the Government’s job and that is not how it works. The Government will be involved once the process has taken place and not at the present time.
Will the member take an intervention?
I have just answered you, Jackie.
No, you have not; you misunderstood.
That is the answer that I am giving you.
It is wrong.
Thank you very much for that.
Would you two stop having a spat? You can take it outside after the debate.
I apologise. It is not like me, Presiding Officer.
As it stands, Greater Glasgow and Clyde NHS Board is carrying out a review of services and I welcome the Scottish Government’s view that it would be unacceptable if any proposals were not consistent with national policy—such as the review of maternity services that is being carried out—and the view that any proposals must be subject to proper and meaningful engagement with the people affected.
The motion asks for the cabinet secretary to intervene. However, Greater Glasgow and Clyde NHS Board has already initiated a consultation period and we need to encourage everyone with a vested interest to engage with the process.
A serious question arises from the consultation in regards to the community maternity unit at the Vale of Leven hospital. The Vale of Leven and Inverclyde hospitals provide a wide range of maternity care services to women in each locality with 5,000 non-birth contacts each year, which is very positive news indeed. However, the figures for the Vale’s baby delivery service are shockingly low. NHS Greater Glasgow and Clyde had a planned figure of 200 births per year for the Vale, yet in 2015-16 the actual figure stood at just 43—less than one birth a week—and the figure peaked at 112 births in 2009.
It must be remembered that women are advised consistently during their pregnancy by midwives and other medical professionals, including on what happens when complications arise. There is a concern that, with fewer women meeting low-risk criteria, there is a higher chance of complications, and it would seem that women are voting with their feet—
You have to close now, Mr Paterson.
Will you come to a close now, please?
I will, Presiding Officer.
It would seem that mothers are using the Vale for all other maternity services but opting to have their delivery elsewhere. The figures need to be analysed and the question needs to be asked why the vast majority of mothers in the Vale area are not using the unit for delivery. I want to know about that, not just as an MSP but as a father and a grandfather.
I will close. I did take quite a long intervention—
Mr Paterson, you are well over your time. Thank you.
Thank you. [Applause.]
Well, you got a clap, anyway. [Laughter.]
I remind members that they should not make interventions until they are so directed by the chair, whether that be standing up to try to make a formal intervention or muttering from their seats.
I call Alex Rowley, to be followed by Maurice Corry.18:11
As the lone Fifer in the debate, I want to support Jackie Baillie and I congratulate her on lodging her motion.
What we are seeing is a lesson to people throughout Scotland about the centralisation of services, given that we are seeing cuts taking place right across Scotland. The first point that I want to touch on is that there needs to be transparency, openness and honesty from the Government about the cuts that are taking place in health services across Scotland. The question that I ask when I look at the motion is what the review is being driven by. If it is being driven by cuts, the result will be the centralisation of services to save money.
When the NHS board in Fife said earlier this year that it was going to have to cut £30.8 million from its budget, the director of finance said that the extent of the challenges was unprecedented both locally and across the NHS in Scotland as a whole. She said:
“I have not seen the scale of these financial challenges in the whole of my career”.
That was reported in the local press. If that is the case, there needs to be transparency and honesty about the level of cuts that our health service is facing, rather than the Government hiding behind reviews and then centralising services.
My second point is about the point in the motion on “extensive public engagement”. We need to ensure that, when engagement takes place, it takes place properly. The Scottish Government has standards for engagement, and it needs to start with all the facts being placed on the table.
I make those two points to the minister. We need to know the extent of the cuts both in the case that we are discussing and elsewhere so that we can understand what is driving the reviews, and we need proper consultation.
I reiterate that there is record investment in the NHS. We understand that there are challenges. It is right that NHS boards review the services that they provide to ensure that they are the right ones. I agree with and take on board the point that engagement and openness need to be part of the process, but I reiterate that it is ordinary for NHS boards to review their services. Does Alex Rowley agree that that is part and parcel of ensuring the smooth running of our NHS?
I would agree if it was clear what was driving the reviews. The director of finance at NHS Fife said:
“I have not seen the scale of these financial challenges in the whole of my career”.
Massive cuts are being imposed.
My final point is that the Government cannot simply hide behind local health boards, because it is the Government that is saying to them that they have to cut their budgets. That is where we need openness and transparency.
I congratulate Jackie Baillie on securing this evening’s debate and wish her and colleagues in all parts of the chamber who are going to fight for these services every success.18:15
Thank you, Presiding Officer, for the opportunity to speak in this debate on an issue that is very important to many of my constituents in West Scotland, particularly the West Dumbartonshire area and Argyll and Bute. It is a testament to the strength of feeling about the issue that I congratulate Jackie Baillie on bringing it and her motion for debate in the chamber. The motion has support from across the political spectrum in the chamber, except of course from SNP members.
I declare an interest in that all four of my children, including twins, were born in the 1990s in the CMU unit at the Vale of Leven hospital. We received fantastic support there, in sometimes difficult circumstances.
The issue in the motion has attracted the support of nearly 2,000 people in the west of Scotland, who have signed a petition to try to prevent the closure of services at the Vale of Leven hospital. That is a clear indication of the support that exists in the community at large for the services that are provided at the hospital. Their views must be listened to and considered when any decision is being made about the future of the hospital.
I ask that the pending increase in the 2,000 Royal Navy personnel at Faslane and their families, who have needs for medical support locally, are considered seriously by the Scottish Government in its reviews. The public are making it clear how they feel about the closure proposals. I welcome the decision to launch a re-engagement process, but only if it is open and fair and really wants to hear what the local people think should be the future of their hospital and its wonderful NHS staff.
I do not believe that there is any point in pretending to engage with the public if a decision has already been taken behind closed doors and the views of the public will just be disregarded. That would be disingenuous and a complete waste of public resources. This February, the Cabinet Secretary for Health and Sport said that the vision for the Vale remained key for the hospital and ensuring that plans for the CMU were delivered. In June this year, the First Minister promised that her Government would not approve proposals that ran counter to the vision for the Vale. I think that the people in West Dumbartonshire and Argyll and Bute would have been right to assume that those statements meant that the Government and the SNP would be against any proposals to close the CMU at the hospital. Again, that begs the question why no SNP member has given their support to the motion.
The statements from the First Minister and the Cabinet Secretary for Health and Sport were a promise made to the public who rely on their local hospital and to the people of the west of Scotland. I truly hope that the Government will decide to honour that promise.18:17
The document that I hold up is Greater Glasgow and Clyde health board paper 16/45, which purports to lay out the case for the closure of Lightburn hospital. I attended the health board meeting on 16 August, along with the save Lightburn campaign, when this paper was first presented. I have met separately with directors of the health board, along with representatives of the save Lightburn campaign and Parkinson’s UK, to review the case made in this paper in more detail. To my mind, having looked at it, this paper fails to make a case for the closure of Lightburn. The data in it is used more for support than for illumination.
Does the member accept that it was wrong for the local SNP MSP to use parliamentary resources during the election campaign to write to voters in his constituency to say that there were no plans to close Lightburn hospital and that saying so was a desperate pitch from Paul Martin, who was attempting to stand shoulder to shoulder with locals against the closure of a hospital that was not closing? Can he take that back and apologise to the local people?
I have in my hand the letter that I put out during that election campaign, which says nothing of the sort. My letter laid out clearly to constituents the process that would have to be gone through before any closure would take place, which is the process that we are going through now.
As I said, the data in the health board paper is taken from a one-day sample of end destinations for in-patients, which covers all the hospitals in the east end of Glasgow, not just Lightburn, and leaves us none the wiser regarding the relevance or implications of the data. No data is presented to back up the claim that the plans to move services will deliver improved outcomes for patients and no data is provided on how often services that are not currently provided for at Lightburn require to be accessed by in-patients there, which is a key part of the board’s argument for closure.
The board plans to move out-patient services from Lightburn hospital to a proposed new health hub at Parkhead, despite there being no timescale for its construction and none of the required £32 million of funding being in place. The board has directed me to an integration joint board for all the questions that it has been asked about the proposed hub. That is a case of integration being used as a vehicle to shift responsibility rather than share it.
No clarity is given on what measures will be put in place to cover the period between the proposed closure of Lightburn and the hoped-for construction of the new facility. In the meantime, the Lightburn site has suffered significant underinvestment. Recently, part of the site was boarded up. Apart from being an eyesore, that sends the signal that the site and the patients whom it serves are undervalued.
Lightburn serves a local community in the east end of Glasgow with a high proportion of elderly residents. Recovery rates are better when patients are closer to family and friends and they can benefit from frequent visits. The plan to relocate in-patient rehabilitation services to the other end of the city presents visitors, who are often elderly, with transport challenges.
We often hear about tackling health inequalities and shifting resources to the most deprived communities, but the health board’s plan to close Lightburn does precisely the opposite. Resources would be removed from an area that, according to the recent survey of multiple deprivation, contains three of the four most deprived areas in Scotland.
The health board paper stresses the importance of the strategic shift from acute services to the community, but it proposes the transfer of services away from a hospital that is located in the heart of the community to a large acute hospital some distance away. The board has made it clear that the final decision on Lightburn has not been made, and it has stated on several occasions that its proposal is based not on financial considerations, but on clinical factors alone.
The public engagement on Lightburn’s future has now started, and the public will have their say on that local service. I urge all those with an interest in local communities to take part in that process.
The answer to shifting the focus of service delivery from acute services to the community is not to close a hospital in the community and move patients who are undergoing rehabilitation to a large acute hospital some distance away, and the answer to tackling health inequalities is not to shift resources from the most deprived communities to the centre. The answer to improving outcomes for patients is not to move them away from friends and family and reduce rather than improve their outcomes, and the answer to improving health service provision for the people of the east end of Glasgow is not the paper from the health board.18:22
I congratulate Jackie Baillie on lodging a substantive motion, which, in light of the large number of contributions to this very important debate, clearly touches on a number of constituencies and regions. I will use my speech to speak up in favour of Lightburn hospital, as I did in a previous members’ business debate in 2013.
I know from my family experience how widely used and valued Lightburn hospital is. It has a priority for elderly services, and is used by quite a big elderly population around the east end of Glasgow. It would be really detrimental to the service to move it to the other end of the city, because where it is sited now—just off Edinburgh Road—is near to the main bus services, which are widely used by those who access the hospital.
The hospital has a very valued Parkinson’s unit and a dedicated Parkinson’s resource that is used beyond the east end. I know from my previous position as the MSP for Rutherglen that a great number of people in Cambuslang and Rutherglen used it. Services for the elderly and for those with Parkinson’s are very much needed in the east end of Glasgow and beyond, and they must be maintained.
What strikes me about this debate and the debate over the past six months is the absolute brass neck of the SNP. Before the election, a motion came before the Parliament in which the SNP told us that it was
“committed to maintaining and improving safe and effective local services across Scotland, including in the Royal Alexandra Hospital, Vale of Leven Hospital, Lightburn Hospital and St John’s Hospital.”
Sure enough, when the election passed by, the cuts rolled down, and we are starting to see proposed closures.
Is the member aware that the proposal comes from the health board and not from the Scottish Government, and that there is a process to be gone through?
You’ve got to laugh, haven’t you? Who is actually running the NHS in Scotland? We have had SNP MSP after SNP MSP standing up and saying, “It’s got nothing to do with us. We’re only in power. Don’t ask me to take any responsibility.” It is galling.
I return to what Ivan McKee said. Let us look at what Anne McLaughlin said in her letter on House of Commons notepaper:
“I have been in touch with the Scottish Government and have received an unequivocal assurance that Lightburn Hospital is under no threat of closure.”
I want to hear from the minister what communication took place between Anne McLaughlin, the member of Parliament for Glasgow North East, and the Scottish Government. What assurance was Anne McLaughlin given about the closure of Lightburn hospital? It is vital that we know the answers to those questions.
Lightburn hospital is vital to the east end of Glasgow and it is important that there is a strong campaign to save it. It is also important that the SNP starts to take responsibility for some of the decisions that it is taking and that it stands up and is counted on the issue. Let us save Lightburn; let us save our services. Glasgow deserves better.18:26
We have had a robust debate and I know that all members will contribute their views to the on-going engagement. Aside from the robust exchanges, I genuinely appreciate that members have highlighted their personal connections to services that are important to them.
What is not in question is the level of priority afforded to the safe stewardship of the NHS by the people of Scotland. No public services are valued more highly, and I put on the record the Government’s sincere appreciation of the unstinting professionalism and commitment shown by those who work so tirelessly in our health and social care services.
Turning to Jackie Baillie’s motion, I think that it would be helpful to establish some facts. First, contrary to what is stated in the motion, no decisions have been made about the service change proposals that it mentions.
Will the minister designate the proposed cut to the CMUs as a major service change? That is not up to the health board and the Scottish health council; it is ultimately a decision for ministers. Will the minister insist that that final decision is made by the health secretary?
As Jackie Baillie knows, a process has to be gone through—I will elaborate on that during my speech. She knows that no decision has been taken and that a process of engagement is on-going.
NHS Greater Glasgow and Clyde formalised the proposals at its board meeting in August, and—as we would expect—it is now in the process of engaging with the affected local communities, staff and other stakeholders, so that it can consider their views. I encourage local people and their representatives to play a full part in that process.
The process will take the form of three months of public engagement on the proposals relating to the CIC, the community maternity units and Lightburn hospital. It will run from September until November.
Will the minister take an intervention?
I am sorry, but I want to make progress.
That engagement will help to inform the health board’s on-going work with the independent Scottish health council, and that will include coming to a view on which of the service changes should be considered major. The board will reconvene following that work—probably at the meeting that is planned for December—and will then agree the next steps.
Should any of the proposals be designated as major, the board must undertake formal public consultation of at least three months, and its final service change proposals will be subject to ministerial approval. In the case of the proposals around transferring paediatric in-patient and day cases from the Royal Alexandra hospital in Paisley to the new Royal hospital for children, the board will discuss the next steps at its meeting in October. The board has already been clear that, should it move to proceed with the paediatric proposals, that would represent major service change.
The possibility that some or all of the proposals might change as a result of the public engagement that is under way and that some or all might ultimately be subject to ministerial approval means that it would be inappropriate for me to discuss the specifics in any detail beyond reiterating that it would be unacceptable if any formal proposals were not consistent with national policy, such as the on-going review of maternity services. Gil Paterson and Ivan McKee made that point well.
Will the minister take an intervention on the matter of process?
I understand what the minister says about substance, but let us be clear. The RAH proposal is already designated as a major service change. Can the minister confirm that it is not for the health council to decide and that it is within the gift of ministers to say what is a major service change?
As I have said, there is a process to go through—it is being worked through—between the NHS boards and the Scottish health council. If major service change is considered, there will be ministerial intervention. However, I have talked through the process very clearly. I am happy to provide it in writing for Ms Baillie if she still does not get it, but I will now continue with the remarks that I want to make.
I want to be clear that this Government remains committed to robust, evidence-based policy making, as set out in our national clinical strategy. Underpinning that is our long-term commitment to secure local services where possible and develop specialised services when necessary. That will ensure that our health and social care services are responsive to the many challenges and opportunities that we face, from the pressures resulting from demographic change to the continuous advancements in technology.
Where change is advocated, we will ensure that the local boards work with all stakeholders to make the case for it. What we will not countenance is change being dictated to local communities, as has happened in the past—I think that Alex Rowley made the point that open engagement is crucial in such service reviews.
I reiterate that local people can be assured that this Government will always focus our approach on providing as many services as possible as locally as possible.
Can the minister confirm that in her letter, which was written using parliamentary resources, Anne McLaughlin MP said that she was in direct contact with the Scottish Government? Is the minister aware of that direct contact and, if so, what was the form of that contact?
I am not aware of that; I will need to look into it after the debate. I am happy for the member to write to the ministerial team.
No—I am asking you to write to me about that.
Mr Sarwar, I have already asked you not to speak from a sedentary position. Please desist.
As I said, our record in government is one of ensuring that we deliver services as locally as possible, which stands in stark contrast to the record of the previous Administration.
Jackie Baillie’s motion calls on ministers
“to intervene and pledge to work with local communities to prevent the closure of health services.”
We should reflect on what this Government has done for such services since 2007—Stuart McMillan was right to include this point—and compare that with what Labour delivered when it was in power.
Nicola Sturgeon’s very first act as health secretary in June 2007 was to come to Parliament and announce 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 those units, they have provided much-needed emergency capacity, with more than 830,000 attendances between them. We have not just maintained those services; we have invested in them and enhanced them.
What of the Vale of Leven hospital in Jackie Baillie’s constituency? It was this Government that ended a decade of damaging uncertainty by approving the vision for the Vale in 2009, while the Labour-led Administration that Jackie Baillie served under as a minister presided over the closure of the hospital’s A and E department in 2002. [Interruption.] Jackie Baillie may sigh, but unfortunately the uncomfortable truth is that her Labour-led Administration closed the A and E department. Indeed, our approval of the vision for the Vale secured its remaining emergency services and meant that key local services that would have been lost under previous proposals were safeguarded and improved.
On delivering on the commitment to the vision for the Vale, I can confirm that in-patient activity has increased by 36 per cent when compared with 2009-10; that day case activity has increased by 28 per cent—an increase of more than 1,000 cases; that emergency attendances have increased by 12 per cent when compared with 2009-10; and that we have invested £21 million in a new primary care centre, which opened on the Vale site in 2013.
The Government has been consistently clear that we remain committed to the vision for the Vale. We continue to see a bright future for the hospital, which plays a crucial role in the local healthcare system.
Ministers are fully aware of the strength of local feeling in relation to the current proposals about maternity deliveries at the Vale. I today received a petition with around 2,500 signatures from the Lennox Herald. I know that there are people in the public gallery, and I once again encourage all local stakeholders to make their feelings clear during the public engagement work that is under way.
I add that the health board’s review will include working with the chief medical officer to look at midwifery services across the region, and that we have been clear that it would be unacceptable if any final proposals were not consistent with national policy such as the review of maternity services that is due to be published later this autumn.
In closing, I reiterate the Government’s absolute commitment to the delivery of high-quality and sustainable health and social care services. Such services are not static and our clinical strategy underlines our approach to change, where the evidence supports that and as informed by meaningful public engagement. I know that Ivan McKee will ensure that his constituents’ voices with regard to Lightburn hospital will be heard during that engagement process.
Where there are proposals for major service change in the NHS, they must be subject to formal public consultation and, ultimately, ministerial approval. Local people can be assured that, in all such cases, ministers take all the available information and representations into account before coming to a final decision. I look forward to ensuring that all members get their chance to ensure that their constituents’ voices are heard in the review processes.
I thank those in the public gallery for their courtesy.Meeting closed at 18:36.