27th. April 2011. I am appalled by NHS Lothian’s conduct. We have been repeatedly assured that there would be no further removal of services from St. John’s. This service downgrade has not appeared in any Board papers so even the non executive directors have been kept in the dark. So the tail is wagging the dog-again. Nor has it been brought to the Stakeholders Group, whose remit requires service re-design to be discussed before implementation. This shows a complete contempt for the Cabinet Secretary who agreed the remit. This is a duplicitous and underhand way to manage St. John’s, as the letter suggests it might not even be safe. It says they will ignore internationally recognised risk modelling, “and see whether or not the service is being used appropriately”. So they will cherry pick the patients at the Royal, and send the others back to St. John’s, assuming of course they survive the journey. Last August we were told by cardiology lead Dr. Andrew Flapan that only the most serious cardiology patients would go to the RIE. They have changed their minds, and in the process denied the people of West Lothian the consultation they are entitled to. According to their statement, they are still going to press ahead. So they have made their decision, and now they will consult on it. So we are going to return to the good old days of 2004. Their conceit is utterly deplorable. Moreover, this simply hasn’t been thought through. Can the RIE cope with the extra work? Are there enough ambulances to make the transfers, given that we have already seen difficulties with ambulance cover in recent years? And what about the 5 or so people daily who will end up at the RIE who don’t have cardiac chest pain? Will they be provided with transport home? Probably not. If this is allowed to happen, then cardiology at St. John’s is over, as is the Medical Unit. This letter has caused unprecedented fear and alarm in the local community, and has undoubtedly brought the reputation of NHS Lothian into disrepute. In 2008 NHS Lothian dismissed a staff nurse for having the temerity to question the accuracy of statements by Dr. Flapan. They said she had caused “fear and alarm” in the local community, and that this was both “irresponsible and unprofessional”. By their own standards, clinicians and senior management’s heads should roll. If the Chair of NHS Lothian does not sort this out immediately, then I will be calling on the Cabinet Secretary to directly intervene to remove the incumbents responsible for this reprehensible mess. Last year this “Board within a Board” was referred to not as “a Board managing a crisis, but a crisis masquerading as a Board”. That criticism now appears all too generous. Councillor Gordon Beurskens. Action to Save St. John’s Hospital. Whitburn & Blackburn Ward (7)