The First Minister
of Scotland has endorsed the closure of Ward 15, the Children’s
Ward, of the Royal Alexandra Hospital citing as the main reason the
advice of clinicians. Basically they have resorted to flying in the
face of the well worn maxim that advisors advise and Ministers
decide. But this is a Government decision and there’s no hiding
behind expert advice can disguise that. I don’t decry the role of
experts in helping form Government decisions but if government
slavishly accept their advice and form policy only on that basis I
have to ask myself why we bother to have politicians and we don’t
just let the experts run things.
What has been sadly
overlooked is that clinicians have vested interests in these
decisions. They would not be human if, when asked whether they would
recommend moving to a shiny new facility they would reject the idea.
It’s almost like a promotion and who would reject that? Why would
they want to stay in a facility that despite there being no plans to
close it only 2 years ago has been run down so quickly that a mere 2
years later it is portrayed as virtually derelict and unfit for
purpose? Why would they want to stay and fight for better facilities
at the RAH Children’s Ward when the plan of the Health Board and
the Scottish Government has clearly been to run it down at a helluva
pace? Little wonder they are demoralised and want to move.
The clinician
advisors are experts and when patients are presented to them they are
very good at what they do. But they have no interest in how those
patients get to them and are extremely vocal about late and missed
appointments. They are not experts in transport infrastructure but
just expect that patients will cope, and they don’t really care
how. The new hospital is very poorly served by public transport but
that counts for very little because people who have to use buses
can’t really be experts. Can they? Well they’re experts on buses
but nobody really cares about that.
Clinicians are also
not experts in social cohesion and the type of local services that
form a network which is the basis of a community. That isn’t their
problem. They deal with patients as individuals as they should, but
someone, and that someone should be the First Minister, should be
looking at the bigger picture and taking responsibility for keeping
communities alive. Localised health provision is a large part of
that. The Government shouldn’t be guided only by clinicians in this
respect. Investment in local health facilities is an essential part
of what defines a community and this closure is a cut in local
provision. It’s not a reorganisation. If you start with 2
facilities and end up with 1 then that’s a cut by any definition.
People in our poorest communities are the real experts in the effects
of cuts but that kind of expertise is neither wanted nor needed.
They’re dependent on local services so they must be poor. Their
expertise doesn’t count.
Much is made by the
SNP of the proximity of the new facility to the old one. I live about
4 minutes from the RAH and I know that it takes at least 20 minutes
to get to the new hospital from the RAH. A month ago they were
telling me it was about 15 minutes from the old one to the new. Maybe
in light traffic that could be done. Last week they were saying it
was 7 minutes and now they’re telling me it’s just 5 minutes down
the road. So maybe I worry too much. At the present rate I reckon
it’ll be at the end of my street in about a month. But I think that
might be a bit of misplaced optimism.
I hope the Scottish
Government will think again, take into account the views of the other
experts I have identified, and reverse this cut.
