News item 3rd September 2008

UNDER NEW MANAGEMENT
(but) BUSINESS AS USUAL

The decision by the Minister of Health and Well Being, Nicola Sturgeon to write to Edinburgh City Council dismissing any shift of the Colorectal service from the Western General to St. Johns gives me the clear cause for concern on how she relies on the advice and guidance of those around her. Although I have every respect for Ms. Sturgeon, and I am sure she means well, I have this stay awake at night thought of her falling into the old trap of trying to impose from the office what only can be imposed from the bedside and local community.

Reports have been made and obviously discarded indicating that “centralisation of services are flawed”. Here we have a decision which is central for Edinburgh residents but at opposite ends of the City. A decision based on clinical advice that it would be beneficial to retain colorectal services in the two Edinburgh Hospitals and also on the basis that staff rotas could be made compliant with the European Working Directive (could/would/perhaps/maybe).

St John’s Hospital up until 2004 did provide colorectal surgery. The service received a glowing local report from the Clinical Standards Board of Scotland, who commented “The review team commends the integrated approach to palliative care at St. John’s Hospital at Livingston. The hospital palliative care support team offer an integrated, patient-directed approach to palliative care and are able to provide continuing support and advice on the management of ALL palliative care symptoms”. Shortly after this report was published this service along with others was moved to Edinburgh. Has the Minister taken this report into account when considering the location of the service? – I doubt it.

My main concern however is the unfairness in the decision making process, St. John’s Hospital is one of the three Acute Emergency Units in Lothian yet it was never considered in the review process, If it had been and the outcome was in favour of the Western General /Royal Infirmary there would have been no debate on this issue. The decision would have been seen to be fair and transparent based on not clinical grounds but patient-directed.

Let me be clear I am not in any way criticising any Board decisions nor am I representing or speaking on behalf of Lothian Health Board. My comments and my concerns are personal. I am only too aware of the penalties which can be invoked if free speech is utilised, I refer of course to the persecution of a nurse who now has to face a disciplinary hearing for writing to a local newspaper and to the former Board member forced to resign for speaking the truth.

The Minister has publicly stated that our local hospital is safe, yet services which could have guaranteed that are not being considered, how can this be true? I note with increasing concern that any reviews which she sets up appear to be in the West of Scotland, now is the time to take action on the East and order a full, open and transparent review of service needs in West Lothian.

If St. John’s is to be denied colorectal surgery, bring back Emergency Surgery and Elective Orthopaedics. If funding has to be found then please find it.

Based on the apparent inaction by the Scottish Government in supporting the return of services to St. John’s I will have to now consider, over the next few months my personal relationship with the Local Council Executive. 12 months and a bit on I have not seen any move to reduce the personally expensive re-routing of our community to Edinburgh for care – Bunion, be in the RIE by 0730 then wait around for a simple procedure to be carried out then come to the Lauriston Clinic for follow up and dressing – bypassing St. Johns on each journey.

Minister – yes we are under new management, but business cannot be allowed to be continued as usual – USUAL was not why we were elected.
Shame on you, Minister, for not supporting the return of colorectal services, which would in their own right have sustained the long term future of St. John’s Hospital.

John Cochrane

Executive Councillor
Livingston North