Hansard

Greater Glasgow Health Board first produced its consultation document on the future of acute hospital services in Glasgow in April 2000. The central thrust of the proposals was rationalisation of services throughout the city; the redesigning of health provision while maintaining local access for as many patients as possible. The consultation process ended in September 2000 and much has happened along the way.

It is inevitable that any talk of rationalisation in the health service will lead one to think about bed numbers. In 1990, 11,918 beds were available in the greater Glasgow catchment area. The latest figures from the "Scottish Health Statistics" report reveal a reduction to 7,564. Greater Glasgow Health Board's own figures, as set out in the consultation paper, identify a reduction by 389 beds in the first five years of its plan. That must be considered in the context of continuing pressures on acute medical and surgical beds and the winter pressures that often extend much further into the year.

However, it must be borne in mind that rationalisation can lead to improved patient care. I stress that those of us who represent south Glasgow constituencies are fully aware of that. Nevertheless, the current hospital provision in the area is Victorian—both the Victoria infirmary and the Southern general hospital celebrated their centenaries long ago. In the opinion of many people in the south of the city, the hospitals are unsuitable for modern acute health care that befits the 21st century.

I worked in the health service in Glasgow for 20 years, so I am acutely aware that one of the main problems that we face is that a strategic view has never been taken of how to provide acute services in the city.

The issue that causes most concern in the current review is accident and emergency provision. A couple of years ago—long before the consultation process was considered—a decision was taken to reduce that service to two trauma centres in the city. There would be one centre at either end of the motorway network—at the royal infirmary and at the Southern general hospital. The trauma centre at the royal infirmary is being built and will soon open. That decision was taken prior to the acute services review, but it has a huge and important impact on how services are now built.

It has been recognised for many years that Glasgow has suffered underfunding in health provision. That is all the more poignant when one considers that the city has the worst heart disease rate in Europe. The Arbuthnott report sought to rectify that, but the legacy of previous years will take a long time to remedy. In recent years, many hospitals in the south of the city have closed, including the Samaritan, Mearnskirk, Philipshill and Rutherglen maternity. We may appreciate some of the reasons for those closures, but the fact remains that we in the south of the city are now left with hospitals that are well past their sell-by dates and which were built long before some of those that are closed.

It is no secret that Greater Glasgow Health Board strongly favours the Southern general hospital site for the main acute centre in Glasgow. There are many reasons for that, not least the one that I mentioned—accident and emergency provision. However, it is not just about what Greater Glasgow Health Board wants, but about what the people of south Glasgow deserve and what will best meet their health care needs.

The recent consultation process demonstrated that residents in south-east Glasgow in particular favour a more centrally located hospital that offers them the facilities that they expect from a modern health service. The arguments about closing the Victoria infirmary because it is not suitable for such provision might be understandable, but they are hard to swallow when we consider that the Southern general is even older, not to mention the fact that it is surrounded on most sides by a sewage processing plant.

However, the most important issue is provision of the very best health care that is available and how and where that can best be provided. We all agree that much more locally provided health care should be available. Much has been said in Glasgow about the provision of ambulatory care services. In the context of south Glasgow, there is a proposal to site an ambulatory care and diagnostic centre—or ACAD—adjacent to the current Victoria infirmary site. Under the preferred option of the health board, we are told that that would serve 80 per cent to 85 per cent of the population, who could attend for out-patient, diagnostic and minor injury services. Visits to the acute site would be necessary only for in-patient requirements.

However, concerns have been raised—not only by the public, but by senior medical colleagues—on the potential risks of ambulatory care facilities that are remote from their parent site. Indeed, Sir David Carter, in his 1999 review of acute services, said that the success of ACAD units

"depends on the willingness of clinicians to espouse new ways of working and set aside traditional boundaries between disciplines."

I take from that that he meant that the concept can only work if there is willingness on the part of the consultants who are involved.

The main issue is that if Greater Glasgow Health Board is serious about the extensive consultation process that concluded recently, the views of the public must be taken into account. Given the clear expression by so many of their wish for a new, purpose-built hospital in the south of Glasgow, the board must demonstrate willingness to go further in examination of that option. On behalf of my constituents in Glasgow Rutherglen, as well as those in many other south Glasgow constituencies, I ask that a full option appraisal be carried out of all the possibilities that were raised during the consultation process. The people of Glasgow deserve no less. On behalf of the people of south Glasgow, I urge the health board to ensure that the outcome of the process is in the best interests of all. I know that those views are shared by colleagues who have spoken to me on the matter.

The number of members who want to contribute to the debate is welcome. In that regard, I ask that the Presiding Officer consider extending the time that is available for the debate so that all members who want to show their concerns about the process can do so.