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Health matters

Brian Taylor | 15:52 UK time, Wednesday, 6 June 2007

What makes a politician happy? Aside from winning elections, of course.

Well, the small fry mostly take delight in securing minor internal party gains. Ousting Fred from the branch chair. Dissing Wilma at the delegates meeting.

The bigger fish, those in government, crave more. They want either to stiff their (external) opponents or to win popular acclaim for their actions.

Today at Holyrood, the Health Secretary Nicola Sturgeon neared Nirvana.

She overturned a decision by her predecessor Andy Kerr, infuriating him in the process. And she was cheered from the public gallery in so doing.

The decision? To maintain Accident and Emergency services at Ayr and Monklands hospitals in line with the SNP’s election pledges.

We can dispense fairly swiftly with Joy Number One. New governments frequently overturn decisions taken by their opponents. There would be little point in changing governments if they didn’t.

Let’s look more closely at Joy Number Two: the public reception.

Ms Sturgeon was cheered by hospital campaigners in the gallery - and no doubt will never have to buy her own drinks again in Ayr or Airdrie. But, in the by-going, she evinced a theory of governance which may prove intriguing.

She said: "Public opinion cannot and should not override genuine concerns about the safety of services. But neither can public opinion be ignored. Health Boards and responsible government must balance local views and circumstances with wider considerations of clinical quality, sustainability, safety, and value for money."

At one level, unexceptionable. The minister was merely saying that, all being equal, you should do nice things to people rather than rotten ones. But link this with her further announcement of an independent scrutiny panel to review the reshaped hospital plans in Lanarkshire and Ayrshire.

Two points occur. Firstly, I rather agree with Ross Finnie of the LibDems who queried, ever so gently, what the scrutiny panel will now do, given that the minister has already ruled that A&E will continue at Ayr and Monklands.

Secondly, it is envisaged that this scrutiny panel mechanism will be routinely used in future. To what end? To enforce public opinion? Or to shape it, to mould it to accept the inevitable?

First principles. The people are never wrong. If only the politicians would listen and act accordingly. But what do the people want, given a choice? Do they want smaller, community units - or larger hospitals with greater certainty of 24-hour expertise?

The answer? We want big, expert hospitals. And we’d like one at the end of the street, please.

You see, I do not believe it is about “consultation”. I do not believe the good folk of Ayr and Monklands would have changed their minds one whit, regardless of how extensive the consultation had been. I do not believe an independent scrutiny panel would have made any difference whatsoever.

Rightly or wrongly - they firmly believe rightly - they wanted their A&E units kept open. They cheer politicians who say yes to that. They hiss those who say no. End of story.

Self-evidently, Scotland cannot station a hospital the size of Edinburgh Royal Infirmary at the end of every street. Particularly given the pressures on staffing and sustaining expertise, Scotland has to choose. That means ultimately that elected MSPs, Ministers, have to choose.

This was a confident, assured performance from Nicola Sturgeon. She had prepared well - and was ready for her critics. She has chosen to retain A&E at Monklands and Ayr.

It will be fascinating to watch the reception if and when she follows her principles and takes a decision contrary to local opinion because of the “wider considerations” noted above.

Comments

  • 1.
  • At 04:20 PM on 06 Jun 2007,
  • michael wrote:

A classic example of "democracy" at work. And as often the case, a perverse decision is made having ignored all the evidence available. We can now look forward to NHS Lanarkshire announcing the opening of the Monklands Neurosurgery , Cardiac Surgery and Liver Transplant Units, as surely there is a popular opinion ( not to mention demonstrable need)in favour of these in Airdrie and Coatbridge.
Nicola Sturgeon has followed her gut instinct with this decision. Unfortunately it is the brain which is the organ of thought and reason.

  • 2.
  • At 04:28 PM on 06 Jun 2007,
  • andrew wrote:

Excellent move by Nicola Sturgeon today. I don't belive in buckling to public opinion all the time, difficult and unpopular decisions have to be made in government at times, but to close A+E in Ayr would be ridiculous. (I don't know the situation in Monklands so can't comment). Closure of Ayr would have meant a huge journey for patients to Crosshouse. It would be a least an extra 15-20mins to cover the distance. As morbidity for heart attacks and other coronary conditions increases rapidly with time then people would have died if Ayr closes. What extra price should be paid to save life? Philosophical question I know. Andy Kerr for one didn't think it was worth it. Ayr is a borderline tory seat so no surprise they were in the firing line.

  • 3.
  • At 04:37 PM on 06 Jun 2007,
  • Paul Marshall wrote:

If A+E is retained at Monklands - all the supporting services that go along with it will have to stay too. Namely: intensive care, coronary care, high dependency, acute medical and surgical receiving, inpatient medicine etc.

The anaesthetists within Lanarkshire stated they cannot staff three ICUs within Lanakrkshire, nor can they attract medics to three relatively small seperate Lanarkshire ICUs.

So how is Nic and her independent panel going to sort that out? Will the revised proposals be a half-hearted attempt at appeasing voters? I for one will not go to an A+E with the services mentoned above. To do so would be lunacy.

  • 4.
  • At 04:45 PM on 06 Jun 2007,
  • Peter Thomson wrote:

A report by cardiologists indicated that the closing of Monklands A&E would increase the numbers of avoidable cardiac deaths in the area given the high level of cardiac disease: due to poor diet, excessive alcohol use and deprivation.

Not all those in Public Health agree with Professor Kerr as his findings take no cognisance of the nature of Scotland's remote and rural population's medical needs.

If you are in the central belt with goodish public transport then you can get to most the main hospitals in the central belt in around an hour. To get a MR or CAT scan living in Galloway is a five hour round trip. To get radiotherapy involves a trip to Edinburgh another five hour round trip.

Maybe I am a bit daft but I have this thought that if the key regional hospitals were properly equipped to first world standards that it would be easier for the consultant or his senior registrar to come to the mountain in terms of patient care, outcomes and effectiveness than the transfer and stress to patients of shifting them two to three hours away from their families.

Easy access to family has been shown in a number of studies to improve outcomes.

Just don't get me started on #@#$#@ PFI / PPP and is cost to NHS Scotland and tax payers

  • 5.
  • At 04:54 PM on 06 Jun 2007,
  • Leuchars wrote:

Ok Brian , you were with Andy Kerr on this one.
It's a b*gger the old public opinion thing.
It can turn whole countries around and leave the journalists spinning.


  • 6.
  • At 06:05 PM on 06 Jun 2007,
  • s scott wrote:

It is interesting that Nicola Sturgeon believes that public opinion is to be the guiding factor in the SNP's governance. So will the death penalty be introduced as the public have traditionally wanted this while the politicians have, on a vote of conscience traditionally rejected this. Sturgeon's words smack of, at best populism, and at worst niaivety.

While I applaud the decision, I wonder about the appliance of logic behind it. How will Sturgeon defend any decision that goes against public opinion. I believe that these stupid words will come back to haunt her.

  • 7.
  • At 08:13 PM on 06 Jun 2007,
  • Clamjamfrie wrote:

In terms of saving Ayr, I start by declaring a blatant prejudice: it saved my life.

The case for centralising services that require expertise and heavy technological investment can easily be made. I could plan the creation of the world's best A&E by pooling all the best doctors and nurses across all the specilisms in Scotland together and give them a disproportionate share of resources and base them in,say, Stirling. Everyone can get their can't they?

On the other hand I could plan for some form of medical cover in every hamlet in the land. Both propositions are preposterous because there is always a trade off in making policy decisions. That is why effective consultation is needed. Despite the claims of some, the consultations relating to Ayr were examples of the most terrible and prejudiced manipulation. They would have done credit to the worst excesses of East Germany. Under such circumstances, the actions of the likes of Maybole and Girvan Community Councils in fiercely fighting for services, not in their backyard by any means, but within 15 miles or so of their populations was a just campaign. If the lesson to be learned is that in the future effective consultation based on an open and honest consideration of the facts is required, then today has served democratic accountability well.

  • 8.
  • At 08:27 PM on 06 Jun 2007,
  • sacrebleu wrote:

The combined populations of North and South Lanarkshire Council areas is a shade more (630,000) than the City of Glasgow (620,000). Why shouldn't there be three A & E Units to support the people of Lanarkshire when there are more than that in Glasgow?

If they are needed - and clearly they are, then let's find the money to staff them properly. Goodness knows, the health issues in this area demand the best services. Well done the SNP!

  • 9.
  • At 09:26 PM on 06 Jun 2007,
  • Peter, Fife wrote:

Good decisions on A&E units at Ayr and Monklands, we in Dunfermline West require a similar reprieve for the Queen Margaret Hospital; we were being offered a hospital downgraded to a glorified medical centre to permit Fife Council to centralise all that is medically wonderful into their seats of power, Kirkcaldy and Glenrothes

We were told that better survival rates were almost guaranteed with paramedics treating patients on their way to state of the art A&E, this laughable when we currently do not have enough paramedics or ambulances for emergencies, let alone this shuttle service to Kirkcaldy.

Die being transported or die waiting for an ambulance, the outcome is the same; Queen Margaret, Dunfermline next Nicola.

  • 10.
  • At 10:05 PM on 06 Jun 2007,
  • Paul Marshall wrote:

To poster #8. Glasgow will be reducing to two A+Es also. The Royal and the new South Glasgow hospital will be the only two major emergency receiving hospitals for all of Glasgow. Gartnavel will receive emergencies but not to the scale of the other two. The reason Lanarkshire (and Ayrshire) is different is because of the large population, geography and poor health.

As you point out, North and South Lanarkshire has a population of Glasgow. But the primary difference is that Greater Glasgow is relatively compact, served by excellent public transport and decent primary roads. Lanarkshire is massive, has no public transport, and has terrible "A" class roads everywhere. The population is on the up as people move from the two cities into the commuter belt.

I as a nurse think that far too many people are admitted to hospital for conditions that can be effectively managed in the community. However, until there is a massive investment and culture change in the provision of primary care we need the hospitals.

We would all like a major hospital on our doorstep, but unfortunately that is daft. However, we need hospitals that reflect the needs of the population they serve. Lanarkshire NEEDS three hospitals.

In addition to my post about consultant anaesthetists in Lanarkshire. I was thinking. With Glasgow losing three hospitals with ITUs (Western, Stobhill and Victoria) surely all of the consultants based there cannot go to the three remaining hospitals with ITUs?? So can they not come to Lanarkshire to staff three seperate units? I dunno, I don't get paid enough to make those decisions. Poor nurse stories to follow...

Living in a rural part of Ayrshire as I do its possible to feel that even Ayr A&E is a long way away!

I am not an SNP fan but on this occassion I think that they have struck the correct balance. There are arguments for centralising services but this approach must take account of the needs of areas which have large but less centralised populations.
In Ayrshire it seems our choice may be to die a) because we have to get taken a long way to a centralised A&E or b) die because our more local A&E cant be staffed and funded properly. Some choice! Me - if I gotta go maybe I'm better doing it local.

The Sunday Times highlighted some recent alarming research on excess death rates in Scotland due to poor health service (details on my blog). This argument about the location of an A&E seems not to address these issues one jot.

Living in a rural part of Ayrshire as I do its possible to feel that even Ayr A&E is a long way away!

I am not an SNP fan but on this occassion I think that they have struck the correct balance. There are arguments for centralising services but this approach must take account of the needs of areas which have large but less centralised populations.
In Ayrshire it seems our choice may be to die a) because we have to get taken a long way to a centralised A&E or b) die because our more local A&E cant be staffed and funded properly. Some choice! Me - if I gotta go maybe I'm better doing it local.

The Sunday Times highlighted some recent alarming research on excess death rates in Scotland due to poor health service (details on my blog). This argument about the location of an A&E seems not to address these issues one jot.

  • 13.
  • At 10:22 PM on 06 Jun 2007,
  • Andy Moffat wrote:

Didn’t the SNP agree with the previous Executive’s health strategy at committee level but changed it when they realised there could be a few votes in it for them?

  • 14.
  • At 11:01 PM on 06 Jun 2007,
  • EdinNeville wrote:

This is a shockingly poor decision which will most definately cost lives far away from the cheering that happened today. The general population is idiotically obsessed with 'oor poor wee hospital doon the road'. Resources and staff are finite. Fact. Spreading them thinly will only result in a poorer overall service. Me, I would rather travel a few more miles for a better quality service. Plain common sense.

  • 15.
  • At 11:09 PM on 06 Jun 2007,
  • eilidhwhiteford@yahoo.co.uk wrote:

What's the point of having an A&E service if it's 20, 30, 40 miles away? Distance matters in emergencies. Whatever the arguments for centralising more specialist services, A&E needs to be based in or close to the communities where people live. Maybe as patients we really do know what's in our own best interests, and those of our family and friends who face having to contend with long, stressful, expensive journeys just to visit.

  • 16.
  • At 11:41 PM on 06 Jun 2007,
  • derek barker wrote:

It wasn't about Nicola wearing her heart on her sleeve,it was about a balanced decision,it was a ministerial choice'it was about the politic's of the truth (there is always more than just oneway)i stand and applaud Ms Sturgeon and say to her on this issue not too KERR to much about what the so called expert's say,the public know that centralizing care is an affort to the principle of DEVOLUTION and a con trick to widen the scope for private health care in Scotland,"WELL DONE LASS"

  • 17.
  • At 11:47 PM on 06 Jun 2007,
  • Kevin G wrote:

I for one welcome the move today, as an Airdrie Onion living in coatbridge it was one of - but not the only - the reasons I switched my vote to SNP this election.

Whether Nicola Sturgeon and Alex Salmond believe it was the right thing to do or not, they had no choice but to overturn Andy Kerr's dumb decision.

The SNP pledge to do so won over many voters in May. With their 2010 referendum 'unlikely' to happen and the scrapping of the council tax in serious trouble they didn't have a hell of a lot of promises left to stick to.

Regardless of the motives behind it the next time Nicola Sturgeon's in Airdrie she can pop into the Imperial for a pint on me (if I'm there!)

  • 18.
  • At 12:22 AM on 07 Jun 2007,
  • John O'Donnell wrote:

Why...........Let's save every damn hospital department and discipline because the people want it. Let's have community hospitals with every single discipline going as that is what local people would no doubt want. You have pandered to public fear Ms Sturgeon and threatened well thought-through plans to create super units where complicated health care can be delivered in successful and cost effective ways. You may have won a few votes out of this but, ultimately, the lives of people will be compromised and people like me will hold you to account over the next 4 years. Shame on you! It shows your inability to govern in the interests of the people of Scotland but simply to pander to public fear. Shame on you!

  • 19.
  • At 01:15 AM on 07 Jun 2007,
  • Hugh McNeill wrote:

How on Earth can Andy Kerr get away with saying this decision will cost lives?
I am sure that, for every "expert" who agrees with that statement there will be one that has the opposite view.
This is not constructive opposition, it's scaremongering!

  • 20.
  • At 02:26 AM on 07 Jun 2007,
  • Locum wrote:

Being in the unique position of having worked in both these departments as an A&E Dr in the past year, I can honestly say this is a mistake. Monklands despite having three consultants in A&E, delivers non existent training for their junior staff. And as for Ayr, I would crawl on my broken hands and knees to get to Crosshouse in Kilmarnock for treatment; the place is a shambles. I can quite understand the public concerns about the proximity of acute services and the perception of reassurance that it provides. Having seen the in from the inside, though, what really matters when you are unwell is not how long you travel in an ambulance to get there but what happens when you do. This populist cop out will not save lives, and surely that is the point?

  • 21.
  • At 03:58 AM on 07 Jun 2007,
  • Tom wrote:

Well done Ms Sturgeon. A politician who honoured her pre-election promise. Do you think SNP should have broken their promise?

I am disappointed in your apparent support for Andy Kerr. An opportunist who made sure he kept his own constituency's A&E open while closing others. You seem to be missing the point that Monklands already HAD a working A&E unit. Keeping it open is not that radical. Kerr wanted to close it. That is a REDUCTION in service not an improvement.

Your comments about the scrutiny panel are pretty daft. The resources available for A&E units are, like every other NHS facility, limited. None of them can ever have ALL the ideal resouces they might require for every possible emergency. The Minister has decreed the units will remain open. The Panel and Board's duty is now to present proposals on how that can be best achieved and what restrictions might be necessary. That is the way most businesses work. The Boss says what he wants done. Yours is to provide a way of doing it.

Kerr's scaremongering about people dying was disgraceful. Most cases going into A&E are a long way from fatal. In serious cases it is just as likely that they would die due to the ridiculous journey from Airdrie to Hairmyres - try it in the rush hour sometime.

Everyone accepts that some NHS re-organisation is necessary and desirable but the public were quite right to oppose the closure of their existing A&Es

  • 22.
  • At 08:43 AM on 07 Jun 2007,
  • Jeff Duncan wrote:

Why vote at all (and perhaps because of ex-Labour spin Ministers like Andy Kerr hundreds of thousands of Scots do not vote all) if the overwhelming majority opinion is ignored?

Nicola Sturgeon and the SNP are providing to the people of Scotland what has been missing for many decades - true accountibility and carrying out the wishes of the people and not faceless civil servants in W1.

It's enough to make you believe in democracy :-)

  • 23.
  • At 10:24 AM on 07 Jun 2007,
  • Cory MacRae wrote:

One thing the SNP should remember when making decisions like this, we elect a responsible government, not a representative one.

The SNP have disregarded the wider opinion of experts and doctors in this and bowed to pressure from a vocal minority that probably didnt even examine the replacement plans for mini centres that would have dealt with over 80% of all A&E requirements closer to the home of the average patient than at present. They would have stabilised the remaining 20% in order to get them to a specialist care facility as safely as possible.

It is far easier to be in government when you are in opposition and I suspect this is a lesson the SNP will be learning the hard way fairly soon. If the SNP want to retain their authority they should be asked when they will be putting forward to Parliament the bill to create a referendum on Independence. This is the one thing that they were absolute in promising the people, now that they are in power I haven't heard one member mention it. I suspect the resulting parliamentary vote on that one may wipe the smirk of Mr. Salmonds face for a while.

It is never an either-or situation.

We need a A&E nearby for emergency work and a larger hostpital with the ability to perform complictaed proceedures not too far away.

  • 25.
  • At 10:44 AM on 07 Jun 2007,
  • Bedd Gelert wrote:

Interesting to see that a similar debate is going on in Wales, even though it is a fraction of the size of Scotland, and so arguably could cope with slightly longer journeys to Accident & Emergency.

But then one has to balance that against Welsh roads being 'long trails a winding' and so far slower for ambulances. There is something to be said for having greater expertise in larger hospitals.

But once the smaller community hospitals are closed they will stay closed, whilst there are no guarantees in life that the quality of service at the larger infirmary will remain superior for ever.

  • 26.
  • At 11:15 AM on 07 Jun 2007,
  • Andrew Haddow wrote:

One thing which none of those in favour of centralising A&E services has really address is this. Can ambulance staff keep people alive and minimise further harm until they reach one of the centralised units? Indeed the retired ambulance crewman, who was interviewed on Reporting Scotland, about A&E at Ayr underlined the fact that while care may be better at a central unit, emergency cases will still have to travel greater distances to get there.

Consultation?

the consultation model, having been adopted by the centralist establishment, has tended to set parameters, to divide and exhaust consultees, and thus to provide more the appearance of decentralisation than the substance (empowerment, transformation), or as Pablo Leal has it,

"Official development has largely co-opted participatory processes, reducing them to technocratic machinations, designed mostly to improve the effectiveness and efficiency of the ‘delivery’ of development packages, rather than transform the dominant power structures which perpetuate people’s marginalisation and powerlessness."
http://home.btconnect.com/tipiglen/consultation.html

Sláinte
ed

  • 28.
  • At 11:58 AM on 07 Jun 2007,
  • Dick wrote:

Having been through a not dissimilar exercise where our Council wanted to shut three local village schools and build a new one some five miles away I can vouch for the fact that "experts" do not always get it right and people's instincts are generally correct.

We drove a coach and horses through their arguments and eventually won the day not for emotive reasons but on the basis of the quality of service and good old economics..

  • 29.
  • At 12:02 PM on 07 Jun 2007,
  • G King wrote:

The retention of full A&E at Ayr Hospital can only be a good thing. Ayr Hospital has all the departments that are needed to support an A&E unit, and closing it would have eventually led to the downgrading of the hospital and further centralisation of in patient services in Ayrshire.

Having recent experience of both hospitals I know what one I would want to be treated in and it isn't the one near Kilmarnock

  • 30.
  • At 12:09 PM on 07 Jun 2007,
  • Poppaea wrote:

Bread and circuses - is that how the SNP intend to win 'popular' support for their minority government?

  • 31.
  • At 12:38 PM on 07 Jun 2007,
  • Dan Ritchie wrote:

I have to say I think this is a great step forward for Scotland showing that it is a new government that will lead and not be bullied by the money folks in Westminster.
Some of the comments here are a bit silly as the principle of A&E seems to have been overlooked. It is there for fast treatment of Emergency type nature eg. RTA its no good to have to drive a neck injury or similar for many miles. Speedy treatment is the purpose. Heart surgery etc should indeed be regionalised with centres of excellence distributed accross Scotland. I have seen the excelent work performed by local initiatives 'first responders' these voulinteers are required as it is recognised time is of the essence.

  • 32.
  • At 02:31 PM on 07 Jun 2007,
  • maggie cairns wrote:

I am glad A & E was 'saved'by the SNP. Being born and brought up in Coatbrige and soon to be a Dr come August 1st I am well aware of the health problems affecting the surrounding areas which 'the Monkland's' covers. Everyone knows that Monkland's was axed because it wasn't PFI...it had nothing to do with centralising patient care.

  • 33.
  • At 03:52 PM on 07 Jun 2007,
  • William Campbell wrote:

I am impressed that, away from the media hype and local campaigners, the debate on the blog is far more balanced. In particular, I endorse the contributors who are beginning to reflect on the difficulty the new administration is going to find in dealing with the realities of being in government for the first time.

One of your correspondents mentions the Queen Margaret Hospital in Dunfermline. The SNP in Fife garnered votes by campaigning to save facilities there - but Nicola told us on Newsnight that she wasn't going to change that decision as "it wasn't in the manifesto"! Who can say whether these votes won the SNP the final seat they needed to form their government?

The SNP have run election campaigns for years by campaiging on the local changes they would make if elected. They have been known to promise directly contradictory actions in neighbouring constituencies. (I could bore you with an instance from 1974!)

Chickens will come home to roost.

  • 34.
  • At 03:57 PM on 07 Jun 2007,
  • Stewart wrote:

Some things never change in Scotland

No matter what government is in charge Labour or SNP the opposition supports try to demonize the exec.

My family live in Ayr both within 5 miles of Ayr hospital so I am over the moon that if something happens to one of them its not a trip up the A77 of death to CrossRoads. May only be 10 minutes for Prestwick and Ayr but add 20 -30 mins depending on time for someone inGirvin and you might as well call the funeral director when you call the ambulance.

Andy Kerr is a toe rag. How will keeping 2 A & E open where people will get help faster cost lives ?

Something doesnt quite add up. I think the Labour spin machine has more than one wonky wheel and there beginning to look like pathetic scare mongers.


  • 35.
  • At 04:05 PM on 07 Jun 2007,
  • Stewart wrote:

32#
Couldnt agree more


Looks like we will all be paying for President Blairs vison long after he has reyired with his PM pension and 10 million pound book deal

  • 36.
  • At 10:11 PM on 07 Jun 2007,
  • Emergency Doc wrote:

The public can have what it wants, and what it has been promised by the SNP - but you will have to pay for it in increased taxes. This money would fund the numbers of specialists and support staff required to provide a modern service in each one of these hospitals.

I am sorry to be paternalistsic, but the public doesn't actually know what they think they know here, and the SNP has simply pandered to parochial hysteria in order to win votes.

Gone are the days of local 'casualty departments' run by one or two specialists. The nature of the business, the expectations of the public and the change in lifestyle expectations of medical and nursing staff dictate that a 21st century emergency department be staffed by many specialists; ditto the intensive care unit etc etc.

Glasgow, Lanarkshire and Ayrshire have a small window of opportunity here to graduate from the middle ages of emergency care provision - do it quick before the window closes!

Bottom line - would I (or any of my colleagues) want to work in one of three mickey mouse 'casualty' departments in Lanarkshire (for that will be the effect of the SNP decision); each one struggling to staff itself; each one struggling to see the critical mass of major illness and major injury necessary to train staff and retain the skills of specialist medical and nursing staff, each one running a draconian duty rota incompatible with a family life???

No way!!!

Prescription for Ms Sturgeon: Mitte - Reality - one tablet, bis in die sumendum!!!

  • 37.
  • At 12:09 PM on 08 Jun 2007,
  • Stewart wrote:

#36

Wow another Doc only talking about himself. he must be unique.

Its not what the government wants or the doctors but whats better for the patients and what is deffinetly not better for someone having a heart attack is waiting 20 minutes for an ambulance and then a high tail up the A77 which can often be blocked at certain key areas. if you can survive an hour you might have a chance.

Unlike someone in Girvin could be in Ayr in half the time.

  • 38.
  • At 02:58 PM on 09 Jun 2007,
  • Karen wrote:

For me personally it wasn't just the fact that they were going to shut down the A&E in Monlands it was also the fact that they chose to close down the most needed and most efficient A&E in Lanarkshire. The reasons they chose to downgrade Monklands to only a cancer unit hospital were ridiculous! Although I understand that soecialist units are needed why not downgrade one of the other hospitals in Lanarkshire? Why Monklands? Monklands is the oldest and therefore would need the most work done to it to bring it up to standards. It infuriates me to read some of these comments when people start talking about things they know nothing about. Well I shall take it upon myself to enlighten some of you with some facts about the three hospitals in Lanarkshire and some facts about Monklands.

Monklands is the sickest area in Lanarkshire.
ONCE famously described as “The sickest place in western Europe”, Monklands has a terrible health record.
Rates of heart attacks and strokes are higher here than almost anywhere else in Britain - only Glasgow is worse.
Although Lanarkshire’s health record is shocking, the figures for Airdrie and Coatbridge are even worse. So why close down Monklands A&E???
A greater number of people die at a younger age in Monklands than anywhere else in the county.
In the latest figures available, there were 262 premature deaths in Monklands - compared to 194 in East Kilbride.
For every 100 people who die across Scotland, about 116 people die in Monklands - the highest mortality rate in Lanarkshire. In East Kilbride the mortality rate is almost the best in Lanarkshire at just 98.9.
The mortality rate among men under 65 in Coatbridge is 167 while the rate for women in the same age group in Airdrie is 143 - again both well above the Scottish average of 100.
There can be no doubt that Monklands is the community most in need of accident and emergency services.

It is the busiest A&E in Lanarkshire
NHS Lanarkshire’s own figures show that the A&E department at Monklands is the busiest of the three emergency units in Lanarkshire.
Between April 2004 and March 2005, a total of 17,374 patients were admitted to the A&E unit at Monklands.
Hairmyres Hospital in East Kilbride by comparison admitted more than 2000 fewer patients to its A&E - 15122 - during the same period.
Wishaw Hospital treated fewer still, having 13,847 emergency inpatients.
The health board insists that two-thirds of those who attend at A&E have ailments or injuries which could be treated by a minor illness or injury unit.
However, that still leaves one-third - tens of thousands of patients - who suffer a serious or life-threatening condition which requires immediate emergency treatment.
These people who currently attend their local hospital at Monklands would in future have to travel to Wishaw, East Kilbride, Glasgow’s Royal Infirmary or even Larbert in Falkirk to get that treatment.

It is the most efficient A&E department
DESPITE the fact that Monklands A&E is the busiest of the three in Lanarkshire, it is still the most efficient.
Hairmyres and Wishaw - both new state-of-the-art hospitals - have repeatedly closed their doors to patients since they opened.
Their patients were diverted to Monklands which, despite accepting a greater number of admissions, continued to take in the sick and injured.
The Advertiser can reveal that in the space of 19 months, between April 2004 and December 2005, Hairmyres closed its doors to emergency admissions on 48 occasions.
Wishaw Hospital closed on 110 occasions.
In comparison, during the very same period, Monklands Hospital closed just ONCE.
Over that period, Hairmyres was closed for a total of 602 hours and Wishaw for 1387 hours.
Yet again, Monklands was shut for a total of just 24 hours.
Monklands’ exemplary performance in staying open while other less busy A&E departments closed their doors shows why it would be folly to axe it.

Sorry about the rant, it means a lot to me because my mother has worked in the hospital for years and years. She has told me herself how this is going to affect Airdrie and how she will loose her job and have to work in a hospital elsewhere.
Again sorry for the rant I only want to enlighten some people with facts as to why it was a good decision made by Nicola Sturgeon to keep the A&E open.

  • 39.
  • At 09:00 AM on 11 Jun 2007,
  • michael wrote:

#38

Monklands has more than 100 extra beds compared to Hairmyres; perhaps this explains why Monklands so rarely closes.
Closures may only be for a matter of hours. Also compare with rest of Scotland, not just Lanarkshire.

They also seem to admit everything, rather than treat and send home promptly.

Worse health in Airdrie and Coatbridge?
Give up the fags and alcohol! It might just help. See comment # 1

Higher death rates in Airdire & Coatbridge? Maybe the care they receive at their local hospital ain't so good after all

  • 40.
  • At 10:15 AM on 11 Jun 2007,
  • Elaine ... wrote:

*Quote*(Some dementia patients have gone years without leaving their NHS hospital wards,BBC Scotland learns)

Thank you to the BBC for raising awareness about this unacepptable level of So-Called-Care ...
I was Outraged after reading this news report ... Has any of these appointed politicians, any real idea what's happening around our Health Care Service???
In the meantime Taxpayers Billions, have gone into worthless, useless, blah, blah, blah!
This Continuing Treatment Is Primitive, and Irresponsible ...
This Neglect Has To Stop Now!!!

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