Hansard

I welcome the opportunity to discuss the future of GP out-of-hours services in NHS Greater Glasgow and Clyde. I will focus my attention on the cuts that are proposed at the Vale of Leven hospital, but I am sure that other members will speak about the out-of-hours services in their areas because—we should make no mistake—there is an NHS Greater Glasgow and Clyde-wide plan to cut back access to GP out-of-hours services.

According to the recommendations in a paper that was sent to all health and social care partnerships in the NHS Greater Glasgow and Clyde area, the services at the Vale of Leven hospital, Greenock health centre and the Inverclyde royal hospital will be closed between Mondays and Fridays in the evenings and overnight. That will leave just five GP out-of-hours centres covering the whole of NHS Greater Glasgow and Clyde during the week, will put even more pressure on national health service staff and will cause concern for patients. The health board argues that the cuts are necessary due to staff shortages and financial pressure on NHS budgets. Those staff shortages have arisen in part due to the reduction in medical training places that has been made by the current Government.

Since the beginning of the year, services at the Vale of Leven hospital have been withdrawn for hours at a time on at least eight occasions with no notice having been given. Patients who have been sitting in the waiting room have been handed letters telling them that no doctor is available to see them and that they need to go to Paisley. The irony is that the vast majority of temporary closures at the Vale of Leven’s out-of-hours service have happened during the weekend, but the health board wants to axe the service during the week, when it appears to have less difficulty filling staff rotas.

What happens if the cuts go ahead but the health board still does not have enough staff to run the out-of-hours service on a Saturday or Sunday? If it is so concerned about staffing, why did the health board stop trainees doing shifts—a practice that has been allowed to continue in Glasgow but not at the Vale of Leven? Local GPs believe that it is only a matter of time before the service is removed completely.

There has been no consultation on the proposed changes, and the health board has issued empty reassurances via the local media while, behind the scenes, its officials send out papers to the health and social care partnership recommending cuts to the service. Just ask the local GPs in Dumbarton, Vale of Leven and Helensburgh who met me and hospital campaigners last Friday. They are furious about the lack of engagement. Not only have they not been invited to share their unique insight into the needs of local patients, they were not even informed of the proposals. One of the GPs in my area found out about the proposed cuts not from the health board, but on Facebook. Family doctors should be at the forefront of shaping local primary care services, but NHS Greater Glasgow and Clyde treats them merely as an afterthought.

Local GPs, who are responsible for the care of about 75,000 patients across the entire catchment area of the Vale of Leven hospital, have issued a unanimous statement condemning the proposals, in which they say:

“Closure of the Vale service constitutes an unacceptable clinical risk which will be felt most by disadvantaged patients, thereby widening health inequality.”

They claim that the proposals go against Government and NHS Scotland advice, and made the point very clearly that the GP out-of-hours service is a core service that should be local and accessible. It is not a specialised service. There is no clinical argument in favour of centralisation; indeed, the GPs have said that patient safety is at risk if the proposals go ahead. Emergency primary care is one of the most basic components of any local healthcare provision and should be protected.

Let me tell Parliament about the practical implications for patients of the Vale of Leven if the service is centralised in Paisley. This is just one example. I was told about a woman with a heart condition who turned up recently at the Vale on one of the evenings when the out-of-hours service was closed due to staff shortages. When she was told that she would have to make the 34-mile round trip to Paisley to see a doctor, she decided to go home and wait until her local surgery reopened in the morning. Fortunately, in this case the patient’s condition improved, but things could have been very different. That example highlights how vital it is to protect access to local out-of-hours care. If the service is withdrawn permanently, many people from Dumbarton, Vale of Leven and Helensburgh, especially people who do not have a car, will simply not be able to see a GP in an emergency. They might not see a GP at all, because they do not want to bother anybody. My local GPs firmly believe that patients’ lives will be put at risk.

The health board’s own analysis of the footfall at out-of-hours centres shows that the service at the Vale of Leven hospital is well used. Dumbarton and Alexandria have the highest share of out-of-hours attendances of any postcode area in the whole of the NHS Greater Glasgow and Clyde area, but, predictably, the health board once again singles out the Vale of Leven hospital for cuts. On average, more than 120 patients in my constituency use the service on Mondays to Fridays; they would be forced to travel to Paisley. Patients in Helensburgh and the remote communities on the Rosneath peninsula and in Arrochar would face even longer journeys if the service were to be centralised. Local GPs estimate that it would lead to in excess of 500,000 miles of travel annually for Helensburgh patients alone.

In West Dunbartonshire, we have some of the most deprived communities in Scotland and the lowest rates of car ownership. The last bus from the Vale of Leven to the Royal Alexandra hospital leaves at 10 past 6, and the patient transport service does not have the capacity to offer transport within one or even two hours. The poorest patients would be hardest hit and would, in effect, lose access to emergency primary care. Whatever happened to the mantra about prevention and early treatment? If the proposals go ahead, patients will self-refer and end up in the wrong place—at the front door of an accident and emergency department, thereby further increasing waiting times.

The provision of GP out-of-hours services was a key commitment in the vision for the Vale agreement that was signed by Nicola Sturgeon when she was Cabinet Secretary for Health and Wellbeing. I welcomed the Vale vision back in 2009 because it offered stability and promised to retain a range of services at my local hospital. However, in recent years the health board has started ripping up those promises. Maternity services are under review, wards have been closed, and haematology and a host of other clinics have been cut. There are 113 fewer nurses and midwives, and bed numbers have been slashed by a third. Now, even the most basic local service is under threat.

Every time I raise the Vale of Leven hospital in the chamber, the minister, the cabinet secretary or the First Minister tells me that they are committed to the vision for the Vale. However, if that is the case, why has not one Scottish National Party member of the Scottish Parliament signed my motion—not even Stuart McMillan, whose constituents in Greenock and Inverclyde will be directly affected?

The message is not understood by the health board. If the health secretary and her minister are serious about the vision for the Vale—I believe that they are—will they tell the health board to take the cuts off the table? I hope to hear about that from the minister when she sums up this evening.

The out-of-hours service is a basic service. It is not a specialist service and it will not benefit from centralisation. If we remove it, we will be “putting patients at risk”. Those are not my words, but the words of local GPs. On Thursday afternoon after First Minister’s question time, I will have the pleasure of welcoming to Parliament a delegation of local activists from the hospitalwatch campaign. Their recent demonstration at the Vale of Leven hospital was a huge success, with more than 5,000 people attending. I hope that on Thursday they will get the opportunity to meet the cabinet secretary and ministers, and I encourage colleagues from all parties to join us at 1 pm in committee room 4.

The message that we want to convey is clear: stop the cuts and protect local services.