Hansard

I congratulate Jean Turner on securing the debate.

As has been said, Greater Glasgow and Clyde NHS Board faces some major health and health care challenges that need to be tackled. Health inequalities are greater in that board's area than in Scotland as a whole and they rival the challenges that exist anywhere in the United Kingdom. That is partly why the board has undertaken a substantial and ambitious service modernisation task, which has been begun but needs to be carried through. Along with its staff and partners—including the local authorities—NHS Greater Glasgow and Clyde is committed to tackling those challenges. It has our support in doing so through the acute services strategy that was agreed some time ago.

It might be useful to consider the issues of acute bed numbers and capacity planning not just in the context of Greater Glasgow and Clyde but in an all-Scotland context. As several members pointed out, there are parallels between what is happening in Glasgow and what is happening elsewhere in Scotland. Some of the fundamental points apply equally across the country.

Prime responsibility for planning hospital services, including acute bed numbers, rests with NHS boards. As has been said, hospital beds are an important and expensive resource, but other resources are equally essential. Care also depends on appropriately skilled staff, modern diagnostic equipment, well-organised out-patient clinics, flexible and responsive primary care teams, trained mental health community teams and good-quality interventions that avoid the need for hospital admission in the first place. Every part of the health care system is linked to other parts and they are all essential in delivering patient care.

Planning bed numbers is not simply a matter of getting the volume right. Available beds must be in the right specialties and at the right level to meet clinical need. The number of intensive therapy unit beds in the NHS throughout Scotland has risen steadily, from 159 in 1999 to 177 this year. Those are the most expensive and highly specialised beds in the NHS. As has been mentioned, at the same time, the number of beds in surgical specialties has reduced, which reflects the fact that more and more patients are being treated as day cases. The rate of day-case surgery has risen from 57 per cent in 1997 to 66 per cent now, which is very nearly two cases in three. Our ambition, which is based on clinical advice, is for that figure to continue to rise and to reach 75 per cent, or three cases out of four, by the end of the decade.

I suspect that it will be scarcely believable for many members to hear that, in 1990—only 16 years ago—the average length of a hospital stay following cataract surgery was more than five days. Nowadays, most cataract patients are treated successfully and discharged on the day they go to hospital. The NHS now carries out more treatment in out-patient departments and GPs' surgeries, which avoids the need for admission to hospital at all.

Jean Turner's motion refers to the importance of waiting times. We agree with her about the importance of decreasing those times, but it is important to say that having fewer surgical beds does not mean less treatment and nor does it mean longer waits; it simply reflects the more modern and effective ways of delivering surgical treatment. As members will know, the figures show that, as surgical bed numbers have come down, waiting times have come down. For example, compared to 1997, 11 per cent more principal operations, 250 per cent more angioplasties, 104 per cent more knee-joint replacement operations and 58 per cent more cataract operations are now undertaken in the NHS. In the context of that significant rising level of surgical treatment, waiting times have come down to a point at which no patient with a guarantee now waits more than six months for treatment and the NHS is on target to deliver a maximum wait time of 18 weeks.

Jean Turner said that she would like the NHS in Glasgow and Clyde to keep acute bed numbers under review. I assure her that the board is doing that and will continue to do so throughout the enlarged area. That is essential if the board is to deliver its acute service strategy successfully. That strategy, which is for the modernisation of the way health care is delivered in Glasgow and Clyde, will result in a total investment of about £950 million in modern hospital facilities throughout the city and region by 2013. The investment will deliver a range of improved services for residents and patients in the area. Work on the new Beatson oncology centre—a project that involves £85 million of capital funding—is nearing completion and the centre will begin to admit patients early in the new year. There will be 170 in-patient beds at the new Beatson and 45 day-case beds, which will replace similar numbers of beds in existing oncology units.

Work has started on the new diagnostic and day-treatment hospital at the Victoria site and work will commence soon on the developments at the Stobhill site. Together, those projects, including equipment, involve an investment of about £200 million. The hospitals, which will open their doors to patients in spring 2009, will be able to treat more than 80 per cent of patients who are currently treated at the existing Stobhill and Victoria hospitals. However, they will do so with a lot fewer in-patient beds. Again, that has been decided on the basis of clinical need. There will be only 12 short-stay surgical beds at each of the new hospitals because day-case patients do not require acute hospital beds.