News item 21st September 2008. AND WE THOUGHT THE EDINBURGH FRINGE WAS OVER (Annual Review of NHS in Lothian 8th September 2008) A CYNIC’S TALE: Congratulations - to the NHS in Lothian on their self assessment review for this year, held in the Almondvale Football Club. Well attended by local interest groups and members of the public. This review, well orchestrated and stage managed did nothing to ease the concerns of those in the audience eager to hear how parity of services with Edinburgh was going to be achieved. Congratulations - to the Communication and media team, a team well structured and funded to be able to spin any story line to reflect the prepared answers to the set questions. They certainly deserve the awards we have heard so much about. Congratulations to the Executive members of NHSiL for turning up to the review to answer those prepared questions on how well they were doing. After all, they, like the some Consultants in Cardiac Care could have just phoned in. Congratulations - to ---- hang on a wee minute, is there something strange going on --- Uhhh yes “IT WAS A SELF ASSESSMENT REVIEW”. So what, you may ask, So what indeed and does it really matter? Self assessment is to look at yourself and be honest, open and accountable. Honest to the point that you are exposing the full story warts and all. What did we get – everything is almost perfect, no problem areas identified – Corporate hugs all round. Not so for Professor Barbour though who was consistently caught on camera frustratingly tapping his fingers and fiddling with his papers – no doubt making sure every one of his cast of supporting actors were on script. If body language was part of the Self Assessment Review we could have learned a lot. During the course of the short question and answer session, many questions were raised which had a direct impact on the health and well being of the West Lothian Community. In the tradition of good stage management the answers managed to side-step the question. Doctor Charles Swainson, one of the most highly paid members of NHSiL Board, managed in a patronising fashion to quell any attempt by questioners to seek clarification on any answer given. He managed to make his repetitive answers long enough for the final whistle to be sounded (we are in a football club). There has never been nor was there ever intended any Centralisation of services to Edinburgh! Was it not Dr. Swainson who sat at the public meeting in Livingston and informed the community that Orthopaedics and Surgery would be sited in Edinburgh at the (new) Royal Infirmary? Was it not he who said ENT, Head and Neck and Endoscopy would be sited at St. John’s Hospital? Are we missing something here – one site, one service – is that not centralisation? Having drummed it into the audience on three or four occasions that the distance between Edinburgh to Livingston is the same for the return leg of the journey we can be assured of getting that question right if it ever comes up on Postcode Challenge. This response was given in such a patronising way in the form of a dismissal by both Minister and Board member that it came over as an insult to the concerned questioner. The question asked - WHY DO PATIENTS IN WEST LOTHIAN HAVE TO BE TRANSPORTED PAST THEIR LOCAL HOSPITAL TO EDINBURGH FOR EMERGENCY SURGERY- The answer given - if you live in the Lothian’s and require ENT or Head and Neck procedures all travel is equi-distant. Have we missed something again – EMERGENCY SURGERY was the question. Disturbing - to hear the Minister say that she would not be prepared to look at the decisions made in the past, despite this being a pre-election understanding in the quest to make Healthcare LOCAL. Disturbing - that we have a Minister unwilling to recognise that previous Ministers did just that – “The integrated West Lothian Healthcare Trust” was a model of healthcare provision, yet Ministers “unpicked” the decisions made to keep it as such and allowed the then Health Board to rip the heart from our community. Disturbing - that the Minister appears unwilling to look at the specific needs of the West Lothian Community and continues to consider it appropriate to consider Edinburgh hospitals LOCAL to this area. Major plans and initiatives are on the drawing board for St. John’s Hospital, many of these will be to the betterment of Healthcare Services in the Region as a whole. However, not included in the planning is the return of EMERGENCY SURGERY and ELECTIVE ORTHOPEADICS – these services must be considered NOW before it becomes too costly. The people of West Lothian do not want a MEDICAL hospital – nor a CARE OF THE ELDERLY facility - they demand a fully functioning EMERGENCY GENERAL HOSPITAL – That is their right – so Politicians take note – EDINBURGH is NOT LOCAL An apt place for this show to take place, Almondvale Football Club, where better a place to kick around the healthcare football. Where better for the Executive members of NHSil to be shown the red card. Does anyone really know the “offside rule?” A CYNIC