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Health Service Forum South East
Minutes of regular meeting of Health Service Forum S.E. held in the Larkfield Centre
on Tuesday 8 June at 7.30 p.m.
Contents
Report on joint meeting of the North and South Monitoring Groups
Mrs Hind’s comments on the joint meeting of the North/South monitoring groups
Report on the GGNHS Board Meeting of the 20 July
Proposed reduction of A&E Provision from five sites to 2 sites i.e. GRI and SGH
PriceWaterhouseCoopers Report to the GGNHS Board 20/7/04
Community Health Partnerships CHPs
Welcome
Welcome from the Chair.
Apologies
Apologies; Bill and Ena Montgomery, Alva Caldwell, Douglas McGregor, Fiona Brodie, Janette Butler, Alastair Glen
Speaker
Speaker; Dr Matthew Dunnigan on ‘How is the NHS Scotland performing in comparison with NHS in England?’ There have been relentless changes in organisation. In Scotland £800 million has been spent yet fewer patients have been treated. 10% more doctors, 5% more nurses, 20% more managers yet 3% fewer patients treated. A fall in productivity! The number on waiting lists has increased by 23% i.e. 2% of Scottish population. Waiting time to see a doctor has risen from 44 days in 1999 to 54 days in 2003. In comparison with England, Scotland’s performance has deteriorated. In England the numbers treated have increased and the waiting lists have fallen by 10%. The Barnet Formula awards £1400 per head to Scotland. The figure for England is £1278 per head.
Dr Dunnigan then addressed more local topics. Why did the contract to build the ACADs attract only one tender ? a) The OBC (Outline Business Case) giving the specification for the buildings was very poor. b) The market has changed and the number of projects has outstripped the supply of bidders. The result is that competition is removed. In an attempt to remedy this a shadow bid is being worked up. We wonder if acceptance of a single bid is legal under European Law?
In general there is a lack of capacity in the system. Centralisation is being accelerated. There is pressure from the College. The European Working Time Directive has reduced the hours which both junior doctors and consultants can work. More doctors will be required to staff the rotas.
Manpower planning has failed!
Minutes
Minutes of 11 May were adopted as correct. There were no matters arising.
Correspondence
Correspondence; A letter was received from the leader of East Ren Council, Owen Taylor, regarding Mearnskirk House. At present the Council is looking at the balance of care along with the Health Board.
An invitation has been received from a Mrs Brannan of NHS24 to visit the Jubilee Hospital and meet with staff, see over the premises and ask questions. Report; An interesting visit. Mrs Brannan has offered to come and speak at a regular meeting sometime in the autumn.
The Forum replied to Mr Taylor asking for an assurance that the closure of Mearnskirk is NOT an option. A copy of the correspondence was sent to Kenneth Macintosh MSP. Both parties have since replied to the effect that they have no knowledge of any plans for closure of Mearnskirk House.
A letter was sent to Mr Calderwood chief executive of GGNHS asking for an explanation of the increase in expenditure on the ACADs from £191m to £265m. A reply has been received from Mr Calderwood. As we suspected the ‘additional’ expenditure is the sum being allocated for the Beatson at Gartnavel. It surprised us that the figure quoted in the Minutes of the Health Board was not queried by any member of the Board at their last meeting in May.
A reply has been received from the GGNHS Board with a diagram showing the relationship of the various parties involved in the planning and constructing of the ACADs. This information was provided by Miss Margaret D. Smith ,Director of Nursing, North Glasgow University Hospitals, with a copy to Sir John Arbuthnott.
Report on joint meeting of the North and South Monitoring Groups
Due to the fact that this was a joint meeting, the normal business of South Group was curtailed by the chair. The closure of Stobhill casualty is scheduled for August 2005. The grounds being lack of Consultant cover, demands made by the Royal Colleges in granting temporary accreditation, and lack of junior doctors. A proposal is being prepared that all meetings should be joint meetings lasting three hours instead of two. The rationale being a) Much of the policy ground covered is common to both groups. b) Senior managers administrators and clinical staff would attend one meeting instead of two. c) Both groups face similar problems and may therefore learn from each other.
Treasurers Report
Treasurers Report; The balance in the bank is £1260.92. Members who have not yet paid this session are reminded that their dues should be paid now if they wish to be kept informed.
Any Other Business
AOCB; Margaret Hinds spoke about the current hospital situation in Glasgow at a meeting in St Aidan’s Episcopal Church in Clarkston organised with the assistance of Alva Caldwell.
The Chair congratulated Eric Canning on being elected to the Health Council.
It was agreed that a Christmas dinner would be organised and a venue would be investigated over the next two months.
Mrs Hind’s comments on the joint meeting of the North/South monitoring groups
The joint meeting was successful. It was clear that the problems of North and South are similar and there could be considerable merit in combining both groups.
In her view the South Group has insufficient time in their meetings to cover important items of concern. At the joint meeting we were informed by our Chairman that matters arising from the minutes of the South Monitoring Group would not be taken until the September meeting. James Sandeman and Margaret had a number of questions held over from the March meeting. This means that items will not be approved for publication until December.
These are just three of the unanswered questions which require answers.
1. Is the Vic going to be successful in the bid for additional monies to open further beds?
2. What is the reason for the escalating cost of the ACAD from the original £56.7m to £112m?
- What is the progress on the re-development of the SGH?
These questions are important and require answers now, and should not be left hanging in the air for nine months. We know the Vic has to close to new admissions week in and week out due to lack of beds. We know patients are lying on trolleys up to eight hours waiting for a bed.
I can only hope that at the September meeting we can have a discussion on future joint meetings, and certainly more frequent meetings to cover matters of importance.
Report on the GGNHS Board Meeting of the 20 July
The GGHB meeting for June was postponed until July due to more urgent business being available in July. We had been told that the number of meetings was being reduced to six from twelve. But we expected the change to happen later and with more warning. The member of the Forum, who attends all Board meetings on our behalf, noted that the meeting was not advertised as it usually is in the press and went into the Board’s web site to discover it was cancelled.
The serious implication of these reductions is that with the “demise” of the Trusts the meetings held by them - twelve per year, have gone. The overall effect on the public is a loss of forty-two meetings per year that the public had access to.
The minutes of the first of the Board’s bi-monthly meetings consisted of a large 370 page document with a supplementary document of the accounts for 2003/04.
Waiting times; Inpatient waiters are shown as complying with the 9 month targets. The Board is now concentrating on reporting the 6 month waiters. They do however stress the difficulty of sustaining the 9 month figures and have flagged up the areas of risk to delivery of the plan.
Outpatient waiters as follows;
CURRENT WEEKS PLANNED MAR 2005- WEEKS
ENT 48 31
Gen Surgery 39 36
Ophthalmology 45 39
Orthopaedics 72 59
Urology 42 26
Proposed reduction of A&E Provision from five sites to 2 sites i.e. GRI and SGH
The proposal was ratified by the Health Minister Malcolm Chisholm on the 10 Aug 2002 however in the debate in parliament on 12 September 2002 he insisted on a review in 2004 involving staff, patients, community groups, GG Health Council, and the Royal Colleges.
Catriona Renfrew presented a paper for approval of a review process to retest the assumptions behind the A&E decision. The paper refers to “enabling a range of interests to participate”, envisages “reporting to the Board in August on whether the process requires modification”.
Three stages are proposed:
1. detailed restatement of the original analysis and of work done since June 2002. a) a list is confined to preparation for implementation and inexplicably includes inpatient planning. b) no reference to transport or the joint recommendation that “local access should be retained where possible”
2. major workshop on 15 October to build on stage 1 and to enable direct debate with key parties.
A Consultation document entitled Draft Car Parking Policy has been issued by the GGNHS Board and is open for comments until October 2004. The Greater Glasgow Health Council has summarised the proposals in their July edition of Health Matters.
The main proposals are:
1. Introduce charges at Glasgow Dental Hosp, Royal Inf., and Princess Royal Maternity, Gartnavel, Western Infirmary, SGH, the Vicky, Sick Children’s Hosp.
2. A number of parking spaces closest to the entrances will be kept clear for patients, visitors and disabled people
3. Charges will be set to reflect the level of demand at different hospitals
4. Car parking charges may be reclaimed by patients on a low income. There will be no charge for disabled patients and disabled visitors
5. Each hospital will be able to issue “free parking” permits for exceptional circumstances
6. Any money raised will be used to improve parking and public transport. Money will not be used to subsidise mainstream NHS services
.
PriceWaterhouseCoopers Report to the GGNHS Board 20/7/04
There was a surplus of £12.135 m for the year 2002-03. By the end of March 2004 the surplus was reduced to £1.794m. The Board requires to make recurring savings of £58.7m but few detailed and clear action plans have been finalised for savings.
The cost of the ACADs at the Vic and Stobhill was quoted as £120m. (Are we to assume that the cost of the Beatson has been deducted from the previous quote of £192m?) PriceWaterhouseCoopers stated that the Board management needs to keep them informed of such developments including the need to seek their views on accounting treatment before contract closure.
The Board does not meet its financial recovery targets, nor does it meet statutory deadline audit statements. Balances are disclosed in accounts which may not be actual balances in terms of recoverability.
PPP/PFI may not be accounted for correctly.
We noted from the minutes (page 190 refers) that a single 24 hour, 7 day acute hospital for Argyll and Clyde will be developed at the existing Royal Alexandra Hospital, Paisley.
Community Health Partnerships CHPs
On the 31 March 2004 the Forum responded to a consultation paper on developing CHPs.
The Divisional General Manager of the Primary Care Trust, Terry Findlay, was impressed by the response and invited us to meet with him at Gartnavel Royal Hospital on the 13 August.
The plan is to replace existing Local Health Care Co-operatives (LHCCs) with CHPs. Although LHCCs were only introduced in 1999 the Trust felt that they could be improved. To the best of their ability the Primary Trust has endeavoured to create a CHP area of operation to follow the boundary lines of each local authority. Glasgow will have 5 CHPs. Rutherglen/Cambuslang will have a separate CHP. Staff presently employed by the Primary Care Trust will be deployed to CHPs to provide the necessary expertise to run the various services expected of the CHPs.
Public/Partnership Forums( PPFs) will be set up and have representatives from groups like ours. The idea is that the public will have an opportunity to express their views and influence the plans of the GGNHS Board. Mr Findlay suggested that the Forum write to him asking to be included in the PPF for the S.E. of Glasgow.
The date of the next meeting is Tuesday 14 September 2004 at 7. 30 p.m.
