Patients face bottom of list for refusing to travel for treatment

THOUSANDS of hospital patients in the Lothians are to be told they face being put to the bottom of waiting lists if they refuse operations in private facilities on the other side of the country.

As part of a raft of new measures being proposed by health chiefs to clear a massive backlog of overdue operations, some patients would be contacted directly by staff from private hospitals and offered treatment in Glasgow after being seen by NHS doctors.

The company could offer to arrange travel to the hospital and a hotel for a patient and a relative as an incentive, but they will be warned that if they insist on being treated in a local hospital, they may have to wait longer for treatment.

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The proposals to increase the number of NHS Lothian patients being treated in private hospitals are part of new £20 million plans to be announced at a board meeting today to deal with the waiting list crisis.

Latest figures show that at the end of May, the number of inpatients and outpatients waiting longer than they should have to for treatment rose to more than 7200, despite the health board spending at least £4.8m already this year to tackle the issue.

Health chiefs say that although the waiting times backlog has taken longer to clear than first expected, they are confident that the increased use of private hospitals and other measures to increase capacity will see numbers finally fall, although union chiefs, patient groups and MSPs have raised concerns.

Tom Waterson, Unison branch chairman for Lothian, said he had “huge concerns” that patients’ medical records and personal details would be passed to private companies which will contact patients on behalf of NHS Lothian.

He also expressed fears that private companies could subject patients to a “hard sell” when attempting to persuade them to agree to procedures in private hospitals in a bid to make money.

He said: “The problem has to be fixed, but the money has to be put in directly to patient care and should not be used to prop up the private sector. It costs more and has a negative effect on patients.”

“These companies are there to make money. The Scottish Government have been quite clear that there is no room for the private sector in the NHS, yet here we are, stuffing their mouths with gold.”

Lothians Labour MSP Sarah Boyack said she would discuss the new proposals with Health Secretary Nicola Sturgeon at a meeting today.

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She said: “What’s clear is just how large a gap there is between patients needing treatment and NHS Lothian’s ability to meet the waiting times target. The bulk of the £20m that the board has budgeted to tackle the backlog will be paid to the private sector. That cannot be a long-term solution. It’s clear that NHS Lothian needs to recruit more staff and generate more capacity.”

Of the £20m required in the current financial year to fix the waiting lists problem, £5.2m is expected to be paid to BMI Ross Hall hospital and more than £1m should go to Nuffield Health hospital, both in Glasgow, to treat patients.

It is predicted that a further £3.4m will be spent at Spire Murrayfield Hospital and just over £1m has been earmarked for the Edinburgh Clinic.

Orthopaedic patients, undergoing operations including knee and hip replacements, and those waiting for urology procedures are expected to be among those offered surgery at private hospitals. NHS Lothian has acknowledged that treating patients in the private sector will cost significantly more, but said it has secured a discount on list prices and “further volume discounts”.

Margaret Watt, chairperson of the Scotland Patients’ Association, said the proposals were “totally unacceptable”.

She said: “We should be looking after our own. When people are ill they want their relatives and friends around them.”

Nearly £3m will be spent on increasing capacity for Lothians patients at Golden Jubilee National NHS Hospital in Clydebank, which already has a long-standing agreement with the health board, while more than £6.5m has been earmarked for internal improvements to address underlying capacity problems at NHS Lothian’s own facilities.

NHS Lothian will continue to look for opportunities to send patients to neighbouring NHS boards, while patients could still be sent to the north of England for major operations, if the patient agrees.

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Of the £20m cost of the new measures, half has come from NHS Lothian funds including £6m of non-allocated funding and £4m which had already been earmarked to cut waiting times.

The other £10m will be an advance from the Scottish Government, and will be paid back from ongoing funding over the next two years. As well as the current targets, NHS Lothian is under pressure to reduce waiting lists before the Patients’ Rights Act comes into force in October, legally requiring health boards to treat patients within 12 weeks of the date that treatment is agreed with their clinician.

Andrew Jackson, associate director at NHS Lothian, said the focus on the reduction of waiting times was “unremitting”. He added: “Ideally we would like to treat every patient that’s waiting in NHS hospitals, but with the number we’ve got waiting it’s not going to be possible. We’ve got to think about what we can do to get them seen as soon as possible. If that means using the private sector we will do that.”


NHS Lothian chiefs have confirmed that new measures have already been put in place as the investigation into the waiting list scandal progresses.

Entries on waiting lists are to be closely monitored in July in an attempt to uncover inappropriate practice, while staff have also been issued with new guidance.

An earlier report found staff at the health board had been wrongly suspending patients from the lists in order to hit government targets.

Andrew Jackson, NHS Lothian’s associate director, said: “We have picked up stuff that hasn’t been running exactly as we would wish over the past few months, but we don’t want to come across these things by accident.

“By and large, when someone has been doing something wrong it’s not because of malintent.

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“But irrespective of whether it was a misunderstanding, it’s still not the right thing.”


PATIENTS could be put to the back of waiting list queues if they refuse an operation at any hospital within a 97-minute drive from the centre of Edinburgh, under new proposals.At the outset of the waiting lists crisis NHS Lothian told staff that only hospitals in the Lothians, or Golden Jubilee Hospital in Clydebank – with which they have a long-standing agreement to send patients – were considered “reasonable” places to send patients for operations. If a patient turned down an offer of treatment at a “reasonable” hospital they would be put to the bottom of the waiting list.

But it has now been proposed that the policy is revised to include all hospitals within a 97-minute car journey – how long it takes by car to travel from NHS Lothian headquarters in Waverley Gate to Golden Jubilee. In future private or NHS hospitals in Dundee, Perth, Stirling or the Borders will be deemed reasonable. Children could have to travel further for treatment and the location will still be classed as reasonable, as there are fewer specialist facilities.

1 Waverley Gate

2 Spire Murrayfield Hospital

3 Spire Shawfair Hospital

4 BMI Fernbrae Hospital

5 BMI Kings Park Hospital

6 Carrickstone House

7 Golden Jubilee Hospital

8 Nuffield Glasgow

9 BMI Ross Hall Hospital

10 The Priory Glasgow