The tough medicine prescribed by The Royal College of Physicians of Edinburgh (RCPE) that we must sacrifice our local health services for the greater good is indeed hard to swallow.
The premise is that we meekly accept whatever budget settlement is imposed. Surely it would be better for the health of the nation if everyone interested in improving health care came together to identify what we need to run a high quality health service and then challenged politicians to find the resources?
Instead we are told that times are hard and we know best. This somewhat patrician approach taken by the RCPE will not play well in communities such as ours in the East End of Glasgow where the second fight in six years to save our local Lightburn hospital is well under way.
Local campaigners persuaded Nicola Sturgeon, then cabinet secretary for health, to overturn the previous closure decision and we’ll do what we can to urge Shona Robison to reach the same conclusions.
What Sturgeon recognised was that local services are cherished because they are there – they are local, forming part of the fabric of the community. And in the Lightburn’s case, it was clearly delivering services aligned with the Scottish Government’s health strategies. It still is – nothing has changed.
Ours is one of the most disadvantaged communities in the whole of Scotland where people live shorter lives and those lives are often wracked by the poor health and chronic conditions associated with poverty and disadvantage. How will those people benefit from removing essential health services?
How is it clinically better to run the risk of people, particularly if old or ill, declining treatment because of the inconvenience for them and their families of being treated in some distant hospital?
Likewise how will it be clinically better for expectant mothers going into labour to spend two hours travelling in an ambulance or clinically better for a child to be shipped across the country for routine hospital treatment?
The battle to save the Lightburn is not just a local issue because if we tolerate this then who will be next? Local hospitals, facilities and services are under review all over Scotland with arguments around “centres of excellence” providing the smokescreen for budget-driven service cuts.
The logical conclusion of the RCPE position is that Scotland will end up with a handful of acute facilities, a few regional non-inpatient clinics and minor injury treatment centres and a hugely increased use of care or nursing homes for anyone needing non-acute but longer inpatient treatment for recovery or recuperation. This is the model that the NHS in Scotland appears to be implementing and it presents a fundamental challenge to the principle of an NHS free at the point of use.
Where does the burden of cost shift to if people of all ages are routinely admitted to care and nursing homes rather than their local hospital?
Will that burden fall on local authorities and health and social care partnerships – with consequential impacts on their budgets – or will it fall on patients themselves as costs currently do for short and long-term nursing home residents?
These are big questions for the NHS in Scotland and they will need answered sooner rather than later. In the meantime, the immediate fight to save the Lightburn goes on. Not just for the sake of the people in the East End of Glasgow but for the sake of every community with a local health facility.
Gerry McCann of the Save Lightburn Campaign lives in the East End of Glasgow and was diagnosed with Parkinson’s in 1997 at the age of 35. He helped to create and run the Young Parkinson’s Network, and the East Glasgow Parkinson’s Support Group at Lightburn Hospital