Hansard

I want first to state clearly that, in raising the issue of proposed car parking charges, I intend no general criticism of West Lothian NHS Trust. Along with many other people in West Lothian, I campaigned for the establishment of an integrated national health service trust. I believed in the value of that approach in 1998, when the campaign took place, and I still believe that the integration of primary and acute services in West Lothian will offer great advantages to the whole West Lothian community. I also speak as someone with a personal interest in the well-being of the West Lothian health service and as a user of the health service—my two youngest sons were born at St John's Hospital at Howden in Livingston. As a former non- executive director of the previous West Lothian trust, I speak with specific knowledge of the issue.

Before I move on to discuss the issue, I welcome the support that I have been given by a neighbouring MSP, Mary Mulligan, by many other Labour members and by members from other parties, including Fiona Hyslop. I believe that Lord James Douglas-Hamilton also intends to express his support today.

Cross-party consensus on the issue of car parking charges is not new. It arose first a couple of years ago, when I was a member of the trust board. At that time, I joined the SNP councillor Peter Johnston and the former Conservative councillor and trust chair Isobel Brydie to oppose a proposal to introduce charges at St John's

Hospital. The political consensus on the issue extends beyond the Parliament, to West Lothian Council, where the Labour and SNP groups co-operated to agree a resolution in opposition to the proposals.

I believe that the trust board has gone wrong in respect of both the principle of the decision and the process by which it made it. The introduction of car parking charges should not be used as a back-door method of funding clinical services. That principle has been emphasised to trusts in Scotland by the Scottish Executive in its recent memo, which states that

"any decisions taken should not be driven by the desire to generate income."

The principle would appear to have been compromised by the option that has been taken by the trust board, which states clearly in its option paper

"that a net income estimated at approximately £200K could be realised" per annum.

When the options were being discussed on the trust board, one of the directors commented that the alternative in terms of cost to adopting the option recommended would be to close 18 surgical beds. That suggests that the trust's decision was motivated partly by the desire to raise income for the trust to fund clinical services. On at least two occasions, I have requested justification of the director's statement, but I have not yet received a direct answer to the questions that I have asked.

I do not believe for a minute that Lothian Health would allow the trust to reduce the number of surgical beds in the way that has been suggested; I suspect that the possibility was raised as a scare tactic to persuade some of the directors to vote to introduce charges. If the trust board genuinely believes that it requires increased funding, it should not try to disguise that issue by introducing car parking charges, but discuss it with Lothian Health. If it brought its concerns to my attention and convinced me that they were well founded, I would be happy to meet Lothian Health with the trust board.

I do not believe that there is a more general funding problem, as Lothian Health will receive an increase in the region of 4.9 per cent in its budget for the forthcoming year, which is well ahead of both general inflation and wage inflation in the NHS. That accords with the Executive's programme to invest in the national health service.

The proposal to introduce car parking charges has also been justified on the ground that charges already exist at major Edinburgh hospitals. I do not believe that that is a valid argument, as Livingston does not suffer from the same levels of congestion as the city of Edinburgh. I understand also that the headquarters staff of Lothian Health continue to enjoy free parking. It seems wrong that direct service providers and users should pay charges when the directors of Lothian Health do not.

One of the biggest mistakes in the decision- making process was the failure to consult adequately the people of West Lothian. When people campaigned for the establishment of the West Lothian trust, they expected to continue to be involved in key decisions that the trust faced. The Executive has also made it clear that it expects all quangos to be fully accountable to the people whom they are there to serve.

The trust board has failed to engage the people of West Lothian on the issue. The only justification that I have heard for the failure to consult is that

"the board did not need to consult since it was clear to all that the issue of car park charging would be very unpopular."

If any public body believes that the course of action on which it is about to embark will be unpopular, there is even more reason to hold a full consultation exercise.

The trust board failed to give local residents the opportunity to express their concerns about fly parking in residential streets. It did not give health service users the opportunity to express their views and, importantly, it did not give itself the opportunity to explore the alternative measures to deal with the parking problems that the local authority or other people might have proposed.

I wish to express my concern about the disproportionate effect that the introduction of charges will have on members of staff in the NHS and on members of the public on lower incomes. At this late stage I call on the NHS trust in West Lothian to suspend its plans to introduce car park charging, to comply fully with the circular from the management executive and to enter into a full and meaningful consultation with the community in West Lothian to identify alternative solutions.

Finally, although I hope that the trust will reconsider its position on the issue, I wish to restate that I have great faith in what the integrated trust in West Lothian can achieve. I will continue to support the trust and hope that we can soon put this matter behind us and return to the central issues of how we can work together to improve the health and life chances of the people of West Lothian.