Princess Alexandra Eye Pavilion: SNP must deliver a replacement eye hospital for Edinburgh – Hector Bryson Chawla

The Princess Alexandra Eye Pavilion is a long-renowned centre of excellence and the unit of choice for all UK trainees, yet the Health Secretary is prepared to preside over its destruction. There would be no central hospital in Edinburgh and the service would be dispersed across the Lothians.

The SNP has pledged to replace Edinburgh's ageing Princess Alexandra Eye Pavilion but some are concerned about the lack of detail (Picture: Greg Macvean)

Such ingenuity did not emerge from some crucible of forward thinking. It appeared instead from the back of an envelope because the funds promised for the new building had been dispersed as well.

The proposals are a wish list – optometrists taking over increased eye care in the community, photographs of the eye taking the place of actual out-patients, all-purpose theatre suites occasionally used for eye surgery, and yet high quality to be maintained throughout.

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The inevitable damage to training, research or recruitment gets no mention. It is a medley of the old measures that are already in action and new measures that won’t work.

The participation of optometrists is not a novel concept for Edinburgh. It was was pioneered here, is already maximised and their very skills will produce more not fewer patients to be referred – but to where?

Digital imagery already allows patients to be seen on one day and their eyes to be examined on another but these are not just pictures sent in from a smart phone. They are produced by a swarm of expert staff and priceless fragile instruments in a place that houses them all. Trundling them about in a van is not an option.

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That equipment, theatres suites and staff are expensive and not interchangeable with the rest of medicine is not evident on the envelope. Eye-trained staff can be useful in a general theatre but the reverse is not so.

Edinburgh sends consultants to the Borders, junior staff to Fife and provides clinics east and west. What space then is there for increased community provision?

No hospital would mean no collaboration between the multiple sub-specialities and no research connection with Edinburgh University.

New staff applications would diminish and the domino effect would be felt all over Scotland where certain consultant posts already cannot be filled.

And what about the poor 100,000 out-patients trapped in this diaspora? There would be missed appointments, delays, litigation over the visual loss that would be a consequence of all those ambulance journeys – not to mention the extra carbon tyre print.

If dispersal is such a brilliant idea, why uniquely in Edinburgh and why now a review funded by Scottish government? We, as the helpless electorate, can only hope that this independent study will not subordinate long-term wisdom to transient self-inflicted insolvency.

After all, Finance Secretary Kate Forbes has said that Scotland is a rich country. When she has reflected that London (Moorfields) and Sunderland are both rebuilding on one site, let her come to a sensible conclusion and do the same for the people of Edinburgh at Little France as promised.

Hector Bryson Chawla is a former clinical director of the Princess Alexandra Eye Pavilion in Edinburgh

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