Hansard

The Southern general hospital, in Govan, will be the only accident and emergency/trauma and general hospital on the south side of Glasgow until Hairmyres hospital, beyond Newton Mearns, because there will be only out-patient and day surgery facilities at the Victoria infirmary. Patients who do not travel by blue-light 999 ambulance will make their way to the hospital of their choice by whichever transport is available to them—not necessarily to the hospital that the health board managers think that they should attend.

I was reminded by a member of accident and emergency staff that a minor injury is only a minor injury once it is diagnosed. Such injuries will be treated on all national health service sites. The see-and-treat model is being tried and is found to be helping with waiting times at accident and emergency and casualty departments. However, tonight I will speak about the importance of having enough in-patient beds.

Last September, the bed modelling assessment for the health board had to be completed before the final business case for the new Southern general hospital could be submitted. Despite asking Robert Calderwood for the result of that, at the north monitoring group in Glasgow, time after time we have received no answers. In the 21st century, we still have patients lying around for hours on trolleys. However expensive and comfortable they are, that is shameful. If we had enough beds, that would not happen.

Recently, one of my constituents spent 13 hours lying around on trolleys while being transferred between Stobhill hospital and Glasgow royal infirmary. A general practitioner friend was allowed to transfer her from Stobhill to Glasgow royal infirmary, but that did not make any difference to the length of time that it took for her to be treated. Why can we not get bed numbers right for those who are unfortunate enough to be sick? What confidence can people have for the future if we cannot get it right now? Will we get it right in future? People are advised that we do not need beds because we have new technology and because the NHS works differently: more people are treated as day patients or in primary care in the community; therefore, we do not need so many beds.

GPs are encouraged to make great efforts to keep elderly people out of hospital and to prevent readmissions. To my knowledge, primary care has always tried to do just that, but more highly trained staff will be required to cope with the number of patients who are discharged early into the community as well as those who are not admitted to hospital.

Years ago, it would have been a disgrace for someone to come out of hospital with a bed sore, but that happens more frequently now. Such a sore is very painful for the patient, it is open to infection and it makes more work for the nurses.

We know that 98 per cent of all NHS work is in primary care. An out-patient department will deal with 85 to 90 per cent of the 2 per cent of patients who go to hospital. In-patient work makes up a very small proportion—10 to 15 per cent—of the work of NHS hospitals. Bedblocking happens when people are fit to leave hospital but there is no bed for them in the community. Intensive care beds are frequently blocked because there is no other bed in the hospital that can take the patient—not even a high-dependency bed. Patients cannot be admitted for elective procedures if there is no bed; nor can a free high-dependency bed or intensive care bed be lined up for them for post-operative care. That means that clinical decisions are compromised, and there may be serious delay in rescheduling theatres and beds for another day.

One of my constituents was caught up in that. She was to have a serious operation, but it was cancelled at very short notice because an emergency case took her bed. The psychological work-up to her operation and the preparation that she had done to have her job covered for the three months of her recovery period were shattered.

NHS staff are saddened by the fact that slack never seems to be factored into the system, despite research that indicates that infection rates rise if hospitals run at more than 82 per cent bed occupancy. The same is true if wards are short staffed and if patients are transferred around or between hospitals. Intensive care units work best at 75 per cent bed occupancy.

Some of our intensive treatment units—one at the Southern general and one at the Glasgow royal infirmary—are short of beds. By that I mean that they have the beds but not the staff to cover them. Clinicians are worried about infection rates. If MRSA or one of the other common infections breaks out, there are not enough isolation beds or single rooms. I would like us to carry out low-risk surgery on high-risk patients and to add general and medical services, perhaps attached to intensive care beds and coronary care units, to the ambulatory care and diagnostic units at day hospitals. That would create more slack and relieve the strain on Glasgow royal infirmary, the Southern general and Gartnavel. I ask the minister to consider that suggestion.

Patients are sent home far too frequently from day surgery. The onus is then on the patient to find their way home. One of my constituents had to leave in a wheelchair. Instead of being able to go back to work, he had to get his son to help him out of the car and to the toilet that evening, because his wife was not well enough to do that. It is unfair for responsibility to be placed on the patient in that way.

I want the minister to realise that patients suffer because we do not have enough in-patient beds. That puts strain on hospitals and their staff, and has a knock-on effect on all areas of the NHS.