Hansard

I thank Jean Turner for bringing the debate to the chamber today. It gives us a welcome opportunity to discuss a lot of health issues that affect communities throughout Scotland.

Jean Turner talked about lost beds. I have looked up some figures and found that 1,509 acute specialty beds in Scotland have been lost since 1998. Nearly one acute bed has been lost every week in the past year—a total of 47 beds. Greater Glasgow has lost 500 acute beds since 1998, and the Ayrshire and Arran area has lost 238 general beds in the same time, with 138 of them being lost in the past two years alone. There have been massive bed losses in ear, nose and throat, general surgery, gynaecology and urology.

The Scottish Executive is pushing centralisation to the five main centres in Scotland and it is downgrading other hospitals with accident and emergency services so that they will have no A and E services. There will therefore be more reliance on using paramedics and ambulances to get people to A and E facilities in centralised hospitals. A health official in Glasgow recently reassured people at a public meeting about their concerns about getting to A and E by saying that ambulances were mobile A and E units. Although we all acknowledge the fantastic work that paramedics do, we could be putting them under a tremendous amount of stress by expecting far too much from them—I suggest that we are probably doing just that.

Of the 15 A and E departments in Scotland, seven are under threat of closure: the Victoria infirmary, the Western infirmary and Stobhill hospital in Glasgow; Ayr hospital; Queen Margaret hospital in Dunfermline; Inverclyde royal hospital in Greenock; and Monklands hospital in Lanarkshire.

NHS Ayrshire and Arran is to shut down the A and E department at Ayr hospital, centralising all emergency services at Crosshouse hospital in Kilmarnock. Five community casualty units will be set up around Ayrshire to deal with minor injuries. A petition against the closure of the A and E unit at Ayr was signed by 55,000 people and more than 5,000 joined a march through the streets of Ayr against the closure. The health board said that the plans represented an investment of about £70 million over the next 10 years, but there was no listening to the community at all. The move will also see complex surgery provided at one specialist site, at Crosshouse hospital, with planned surgery at Ayr hospital.

The issue is patient safety. We hear doctors talking about the golden hour, which is a concept that was described graphically at some of the meetings that I attended in Ayrshire. People who have suffered a traumatic injury have an hour to get to hospital for treatment. If patients who have such injuries have to travel further to A and E, that could put lives at risk. Given Ayrshire's geography and the current use that is made of local A and E facilities, there is a need for two A and E departments, one at Ayr hospital and one at Crosshouse hospital. The geography dictates that the A and E facility at Ayr should be kept open, as there are huge distances to cover—that is a particularly important consideration when there may be a serious, life-threatening incident.

As with the large numbers of beds being lost, there is no slack in the system, as Jean Turner said. The consultation on the A and E facility at Ayr was flawed from the outset yet, according to Dr Bob Masterton of NHS Ayrshire and Arran, it has been the most extensive consultation ever. Ayr A and E department is to close despite massive public opposition and despite the fact that the majority of consultants at Ayr hospital have said that closing the A and E department is not a good idea.

Switching to Crosshouse, which would be the only specialist casualty unit in Ayrshire, could add 30 minutes to some patients' journeys. That could put their lives in danger. Paramedics are not doctors. They cannot do anything in the case of stroke except get the person to hospital as quickly as possible. That is because a stroke can be caused either by a blood clot or by bleeding in the brain, so a scan must be done before treatment is given. If a stroke is caused by bleeding and the patient is given clot-busting drugs, that will kill them. The travel time to hospital is crucial to survival.