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Western to keep vital cancer services as move ruled out



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Published Date: 29 August 2008
PLANS to move vital bowel cancer services away from an Edinburgh hospital have been ruled out.
In a letter to the city council, health secretary Nicola Sturgeon dismissed any shift of the service from the Western General to either St John's Hospital or the Edinburgh Royal Infirmary.

It comes as a blow to campaigners who want to secure more
of the Lothians' services for St John's in Livingston, and see the colorectal surgery base as an ideal candidate for that.

It also means that the hundreds of people every year who use the service at the Craigleith hospital will not have to travel further.

Doubts have surrounded the service since plans surfaced in 2005 to move the department to the ERI amid fears the Western could not cope with housing the service.

"Stop the Downgrade" protesters at St John's then called for it instead to be moved to Livingston as a rare acquisition for that hospital.

The SNP-led West Lothian Council also called for the transfer, but was opposed by the city council, which passed a motion asking for the services to be retained in west Edinburgh.

Ms Sturgeon said: "NHS Lothian indicated that there is clinical evidence, in the form of better clinical outcomes for patients, for retaining the integrated colorectal surgery service at the Western General Hospital, rather than moving it as planned to the Royal Infirmary of Edinburgh.

"I understand that the board's decision was based on clinical advice that it would be beneficial to retain cancer related services together at the Western General, and also on the conclusion that medical staff rotas could be made compliant with the European Working Time Directive."

That directive was initially one of the factors that cast doubt on the service's future there.

Ms Sturgeon continued: "Since it appears that retaining the integrated colorectal surgery service at the Western General has no negative impact on patients, and is justified by the clinical evidence, I support the board's decision."

St John's did formerly provide colorectal surgery, but that was carried out by one surgeon and ceased in 2004.

The news was welcomed by former city Labour leader, Councillor Ewan Aitken, who was in charge when the council tabled the motion in favour of the Western.

He said: "I congratulate the health minister for putting clinical analysis before party political agendas. Retaining this service at the Western will mean better patient care, more lives saved and better use of NHS resources."

500 people a year are diagnosed with bowel cancer, with half of those surviving more than five years with the disease.

West Lothian councillor Gordon Beurskens, part of the Stop the Downgrade campaign, said: "To say we are disappointed at the decision is an understatement.

"The clinical delivery of this service is primary and we believe St John's should have been considered for that."





The full article contains 483 words and appears in Edinburgh Evening News newspaper.
Page 1 of 1

  • Last Updated: 29 August 2008 10:21 AM
  • Source: Edinburgh Evening News
  • Location: Edinburgh
  • Related Topics: West Lothian
 
1

alex paterson,

edinburgh 29/08/2008 12:15:17
Well done Nicola,why move to a new shop when the one you have works successfully.
2

Howard Moon,

29/08/2008 12:57:26
They're still quoting Ewan Aitken?

What does former LP Eleanor McLaughlin think of this?
3

Think Tank,

29/08/2008 13:20:17
It is frankly ludicrous that gastrenterology services in Lothian are split across two sites- the RIE for "upper" gastrointestinal problems and the Western for "lower" or colorectal issues.

It would be FAR more efficient to house both services under the same roof- the Royal makes most sense.

Moving colorectal to St John's is a laughable idea that quite rightly has been rejected out of hand.

Imagine a Livingstone resident involved in a major trauma...requires ambulance to Royal A&E (no trauma at St Johns) then discovered to have a perforated bowel...requires another ambulance back to St Johns when stable. Bad enough the current situation of an ambulance across town.

But once again local non-medical people think they know what's clinically best.
4

Brodric,

29/08/2008 15:44:14
Think Tank - well said.

A friend of mine recently had to go from Liberton to Livingston for a consultation in something or other that had been removed to St John's. This is just ridiculous. Going from a city to a concrete village 20 miles away for treatment.
5

bigsis,

edinburgh 29/08/2008 17:26:01
'...in something or other that had been moved to St Johns' - Brodric you may need to understand that there have been many vital services removed from St Johns because the ERI and WGH were so overspent as a result of not properly managing their resources, and plundered the resources at St Johns to redress their own financial balance - this is not a secret and can be justified by empirical references if you bother to check. People in West Lothian have been the losers here - for treatment of surgical emergencies they now have to be transferred many miles to ERI, intorducing potential life-threatening delays, because the specialist surgical specialties have all transferred out to ERI. St Johns, once independent of Edinburgh as West Lothian NHS Trust, well administered and financially viable, has been desecrated at the expense of a much poorer administration by being forced to join up with the rest of Lothian. The fact that your friend went for a consultation infers that their condition was not a life-threatening one. Both you and your friend should be very thankful. Do try and remember that whether you live in a concrete jungle or an ivory tower, it doesn't matter where you are treated so long as it meets your most urgent and immediate needs. You'd better not stray too far from your concrete jungle of a hospital out at Little France just in case an unexpected illness befalls you!
6

patientpower,

29/08/2008 17:49:46
Hear Hear #5 we have heard of lives lost during the ambulance journey to Edinburgh after by passing St John's you are quite right to point out that actually West Lothian has been the victims of the biggest financial disaster ever perpetrated in Lothian the PFI scandal the fact that it involved health and was done with little care for the lives of us out with range is dreadful. From the West of West Lothian it is 33.5miles to the RIE front door along the busy clogged at a stand still M8 corridor, now #1, 3 & 4 how does that sound to you? Emergency accident heart attack how much of a chance do you think we stand. Well done Nicola you have broken your promises and those of your Lothian MSP's keep services local they and you said how is that local, Fiona Hislop and Angela Constance promised the return of services. All including Nicola and Alex Salmond stood here on Health priority and we voted on Health You now need to stand up and deliver, the people of WL are partly responsible for where you are we ousted our MSP and Council in an bid to save St John's but what we give we can take never forget. WL are people too Nicola with votes and voices.

7

Think Tank,

29/08/2008 22:34:18
#6

I see exactly where you're coming from and I think there is an issue about not having any emergency surgical cover in St. John's. But you're not fully understanding of the level of surgical cover required to make it feasible- you're talking general surgical consultants plus specialist registrars and an orthopaedic emergency team 24 hours a day.

To have that just for an area the size of Livingston doesn't make service sense. Yes you could put a "surgeon" in St John's, but how would you feel if your chance of surviving emergency surgery was actually better with the specialist surgeons based at the Royal, even with the ambulance transfer?

The lay reaction to service centralisation always seems to be negative (it's a "money saving" exercise). Actually, it can be a very positive move- gathering together the best medical teams with the best equipment under one roof, rather than providing a diluted service across three sites (Royal, Western, St.Johns). Ideally of course the Royal would be somewhere in West Edinburgh, thereby closer to Livingston.

However, since you mention the "Livingston heart attack" patient, thanks to centralisation, the cardiac catheterisation lab at the Royal is one of the finest in the country, with some of the most experienced operators (better rate of post-intervention outcome than virtually any site in the UK). Centralisation has allowed a 24/7 intervention service (previously only during working hours with inferior 'clot-busting' drugs at other times). So your Livingston patient stands a damn site better chance of making a good recovery by transfer to the Royal than receiving inferior treatment strategies in St Johns (which actually did happen before "downgrade").
8

Navy Lark,

West Lothian 30/08/2008 09:03:57
This decision by the Minister not to even consider the return of Colorectal services to St. John’s Hospital will prove to be the “blunder” which will lead to the loss of the SNP lead coalition on West Lothian Council. She has, in past months made statements on the future of this hospital, one of the current three in the region. Safe in our hands, she says – but is it? Her latest demonstration of full support for NHSiL, based on flawed information clearly demonstrates her inability to address healthcare issues in West Lothian.
Flawed because the consultation process only considered the RIE and WGH as the sites for this service, at no stage was SJH ever considered Despite this hospital hosting elements of the colorectal service in the past, and did it with great efficiency and expertise. Initially RIE was chosen then NHSilL did a U-turn and settled for the WGH. As yet there has been no public statement regarding this change of mind.
Flawed because once again she has shown no courage to challenge an unfair consultation. NHSiL has for many years been using “smoke and mirrors” to fudge the centralisation of services in Lothian, these fudges are in place to support the highly expensive leasing arrangements for the PFI hospital at Little France. NHSiL are experts at the illusion game and sadly the Minister has not felt the wool being pulled over her eyes. In May 2007 we saw a new administration elected to Holyrood, but it has been business as usual since then – same advisors, same policies Independent reviews have been taking place in the west of Scotland (the Minister’s home turf. But despite calls for independent reviews in the East (Lothian) nothing has been either done or considered.
I have no doubt when the West Lothian Healthcare Councillors wake up to this decision “appalled” and “disgusted” will go no way to express their true feelings at yet again being “knee-capped” by a Minister and Administration which they rested their hopes and aspirations. The Councill
9

Think Tank,

30/08/2008 13:07:50
But with respect Navy Lark,

If you ask any of the colorectal CLINICAL team at the Western where they think the best location for their service is (to provide the best clinical operation), they will say the Royal Infirmary. Nobody would pick St Johns and have a split of service for your gut between hospitals 25 miles apart.

POLITICIANS who don't have to listen to CLINICAL need are all for 'spreading services out', but as I explained in my above post it makes no clinical sense.

This is why I firmly believe that NHS decision making should be completely independent of politicians- and yes that would result in greater centralisation because it's often clinically better.

Instead, the CORRECT CLINICAL decision will now be used in a POLITICAL game to try and discredit the West Lothian administration.

Keep politics out of healthcare!

10

Navy Lark,

West Lothian 30/08/2008 15:12:30
I fully accept your view " Think Tank" POLITICS should indeed be kept of of Healthcare services. However that is not the world we seem to be living in. Patients will have to still commute by ambulance etc between the WGH and RIE why not cenralise the service completely. If SJH is an equal partner then why was it never considered in the consultation?
The Health campaigning Councillors on West Lothian Council should now be considering whether there trust in the SNP has been abused and considering withdrawal from the joint administration.
Shame on Nichola sturgeon for not supporting the RETURN of this service which would have guaranteed the future of SJH.

 

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