Committee
Health Committee, 21 Sep 2004
21 Sep 2004 · S2 · Health Committee
Item of business
National Health Service<br />(National Framework)
I thank the minister for his letter. Like the public, I am sometimes a little confused. I am not convinced that you always get information from the health boards on which to base decisions. We have accepted the acute services review, the acceleration of which seems to have come out of Greater Glasgow NHS Board's trying to clear its debt of £58 million. It must then find the money for the new building programme. I make it clear that everybody wishes the ACAD unit to go ahead.I asked a parliamentary question about safety in connection with units that have had to be moved because of the demolition of wards. The oncology and gynaecology unit was originally going to be slotted into a floor of the new maternity building but—for some reason—the unit had to be sidestepped into temporary accommodation at extra cost. However, high-dependency beds were not put at the service of that new unit. The same number of high-dependency beds exists for the surgeons who already worked there and who work at the new unit. Therefore, there has been compromise on safety, which means that clinicians will be working with each other and trying to see whose case is the most urgent; there will be delays. I would like to think that the minister could intervene and say that the board must find more high-dependency beds. Why was that unit moved so hurriedly without ensuring that high-dependency beds were on offer? We have been told various things about the need to close the casualty department at Stobhill, one of which was that it was done because we required accident and emergency consultants. I accept that the training of A and E consultants in the UK is different from the rest of the world—we have specialised A and E consultants and it is now accepted by the colleges that we have them in A and E departments. Stobhill had a casualty department that was covered by clinicians—a system that worked reasonably well until now, although that is not to say that it could not be improved. However, we were told that if we could get the A and E consultants, the department could be kept open. Those consultants are available to rotate in the next few months, but there is still desperation to close that department, which covers 47,000 people, and to accelerate its closure, despite the lack of capacity in the city. Capacity is a problem, and however one looks at it, those 47,000 people need to be dealt with in other ways. One of the ways—
In the same item of business
The Convener:
SNP
Item 5 is discussion of the national framework for the national health service in Scotland, for which the Minister for Health and Community Care is here. I w...
Malcolm Chisholm:
Lab
The first thing that I want to do is to welcome you to the chair, convener. I am here to answer questions. Some confusion remains about moratoriums and I wil...
Shona Robison:
SNP
Thank you, minister, for your letter, whose contents I welcome. I wish to explore the scope of your letter and to try to clear up some of the confusion that ...
Malcolm Chisholm:
Lab
As I have made clear, decisions about Stobhill and about Glasgow more generally were made two years ago and went through the Parliament at that time. They we...
Shona Robison:
SNP
So you are saying that, where decisions have been taken but not implemented, they could still go ahead between now and March.
Malcolm Chisholm:
Lab
Absolutely.
Shona Robison:
SNP
What about the emergency general surgery at St John's hospital, which is being closed? Would your letter cover that?
Malcolm Chisholm:
Lab
The situation is complex. The bottom line is that the postgraduate dean has said that training approval for junior doctors will be withdrawn this month. Ther...
Shona Robison:
SNP
In short, your letter does not cover any of the services at St John's.
Malcolm Chisholm:
Lab
I would put the question back to you: how could it?
Shona Robison:
SNP
That is what I wish to clarify. There has been confusion, as you have rightly said, and I am trying to clear up some of that confusion.
Malcolm Chisholm:
Lab
No, there has been no confusion whatever about St John's.
Shona Robison:
SNP
What about the overnight beds at the homeopathic hospital in Glasgow, which are currently under threat?
Malcolm Chisholm:
Lab
That is obviously covered under not making a decision during the period when the advisory group on service change in NHS Scotland is reporting. I take this o...
Shona Robison:
SNP
Helen Eadie has previously made some good general points and some particular points about her own patch in Fife. Would Fife NHS Board's proposal to reduce th...
Malcolm Chisholm:
Lab
I have given general approval to Fife NHS Board's right to proceed with that. However, if there are particular things that NHS Fife can do in the meantime, t...
Shona Robison:
SNP
So, out of the examples that I have given, the only one that would be covered by your letter would be the homeopathic beds.
Malcolm Chisholm:
Lab
Yes, but you have not included the other examples that you could have included, such as the generality of better acute care in Lothian and anything that come...
Mr Davidson:
Con
My question is about your thinking when you set up the national framework advisory group, but first I will pick up on a point that you have just made. You sa...
Malcolm Chisholm:
Lab
I completely fail to understand the point that you are making. I imagine that you must be wilfully misrepresenting what I have said. I will repeat my words, ...
Mr Davidson:
Con
I fully agree with what you say about qualifications, standards and training in the health service and I thank you for bringing clarity to the other aspect o...
Malcolm Chisholm:
Lab
Again, the word "moratorium" has slipped into the proceedings. I have been absolutely clear that there is no moratorium. We have to be careful about how we u...
Mr Davidson:
Con
When the chairman of the national framework advisory group came before the committee, he said that he wanted a public debate. I think that you have just supp...
Malcolm Chisholm:
Lab
It would not make sense to revisit things that I have approved and, in that sense, that the Parliament has approved—explicitly in the case of Glasgow. How fa...
Mr Davidson:
Con
Thank you for your clarity.
Mr Duncan McNeil (Greenock and Inverclyde) (Lab):
Lab
When you gave evidence to the committee about the review group some time ago, you made it clear, as I understand it, that the issue was the future reconfigur...
Malcolm Chisholm:
Lab
I am not aware of the remit having changed in the way that you describe. It was always the case that the group would provide a general framework. I always to...
Mr McNeil:
Lab
I welcome the broadening of the remit and I welcome the national debate, as does the committee.Following the discussion that we have had and given your indic...
Malcolm Chisholm:
Lab
I am not picking up your point.
Mr McNeil:
Lab
I am feeding David Kerr's words back to you. David Kerr said that it was his job to go out to those areas. He stated:"We need to understand some of the local...