A SHAKE-UP of healthcare in the west of Scotland was announced yesterday - with Argyll and Clyde services being absorbed into two other health board areas. NHS Argyll and Clyde is to be scrapped after running up huge debts. NHS Highland will take over the part within the Argyll and Bute Council area, with the remainder transferring to NHS Greater Glasgow.
NHS Argyll and Clyde will disappear on 31 March next year following the Executive's decision in May to pull the plug on the authority and offer up to 80 million to write off its debts.
Andy Kerr, the health minister, said the decision to match boundaries recognised the increasing co-operation between health boards and local authorities in delivering services, such as free care for the elderly.
But the decision was attacked by those who had wanted to be included in NHS Greater Glasgow, including Mr Kerr's Labour Party colleague and Dumbarton MSP Jackie Baillie, who described the move as a "victory for the vested interests" of health and council bosses.
The Argyll and Clyde board covers an area of about 2,880 square miles in Argyll and Bute, Renfrewshire and East Renfrewshire, West Dumbartonshire and Inverclyde, and serves a population of 418,750. The Executive says that redrawing the boundaries will not affect patients' day-to-day use of health services. Access to hospital services will still be decided on the basis of clinical need, and treatment will be as close to home as possible.
For example, patients living nearer the Central Belt but transferring to the expanded NHS Highland area, would continue to use services in Glasgow.
Mr Kerr said: "What matters most to me is making sure patients get the best services available. This is the time for a clean slate and a fresh start, to put local planning and delivery on a stable footing and to make sure we have sustainable, high quality services for the future."
Both Highland and Greater Glasgow will be given extra budget, in line with the Arbuthnott formula, to take account of their expanded areas.
Garry Coutts, the NHS Highland chairman, said: "There are a lot of similarities between areas of Argyll and Bute and areas of the Highlands. We can learn from each other in the development of rural healthcare, to the benefit of everyone."
Professor Sir John Arbuthnott, NHS Greater Glasgow chairman, also stressed that hospitals which patients use would continue to be determined by patient and general practitioner preferences.
But Ms Baillie said nine out of ten people in Helensburgh did not want to be transferred to NHS Highland and she demanded assurances from Mr Kerr over where patients would be treated.
"If he is about protecting people's services as he said he was in May, he needs to make commitments to provision at the Vale of Leven Hospital and the Helensburgh Victoria Infirmary so this community is not just reassured but guaranteed positive services in the future."
Allan Macaskill, leader of Argyll and Bute Council, gave a cautious welcome to the announcement but said there were still areas of concern to resolve. He said bringing the whole of Argyll and Bute under NHS Highland best meets the needs of the community.
"However, there are issues regarding representation, governance, funding and established local partnerships that should be considered during transition to the new health board."
Eleanor Scott, a Highlands and Islands Green MSP, claimed that the root causes of the massive debt that led to the break-up of NHS Argyll and Clyde had not been fully tackled. "This means that particular care will be needed to ensure other boards, including NHS Highland, don't run into similar problems," she said.
Ros Derham, the Royal College of Nursing union's officer for Argyll and Clyde, welcomed assurances that the changes should not affect where patients access healthcare. But she said RCN members had concerns about funding and their own job security.