Last Thursday (12th September) in Parliament I questioned the Scottish Government over the revelations that two NHS Lanarkshire hospitals recorded the highest levels of mortality in the country. I asked the Cabinet Secretary for Health and Wellbeing Alex Neil what action the Scottish Government was taking to ensure patient safety at Monklands, Wishaw and Hairmyres hospitals.
My question came shortly after the news that Monklands, in the Cabinet Secretaries own constituency, and Wishaw were singled out for their ‘high standardized mortality ratios’ in the official data on hospital deaths published on the 27th August.
Whilst these figures must be met with a great deal of scrutiny, we must look underneath the numbers and find out what is really going on.
I welcome the news that a review will be carried out by Healthcare Improvement Scotland and I look forward to reading the findings of their investigation. In the meantime I would urge the Scottish Government to do everything in its power to ensure that all the necessary steps are taken to reverse this worrying trend. The priority here is that the highest quality of care is provided to the people of Lanarkshire as patient safety is paramount.
My question and the response I received can be read on pages 6 and 7 of this document.
In an article and letter in this week’s Airdrie and Coatbridge Advertiser I was accused of having some kind of “agenda” against Monklands Hospital.
The accusation related to the Modernising Mental Health proposals currently undergoing review by NHS Lanarkshire at the behest of the Cabinet Secretary for Health and Wellbeing, Alex Neil (who is also MSP for Airdrie and Shotts).
This accusation is, to be frank, complete and utter nonsense. As a young child I spent a lot of time of at Monklands, and I have nothing but respect and gratitude for the hospital and its staff.
It saddens me that some people – including those who should know better – feel the need to turn any debate about health provision within NHS Lanarkshire into a debate about Monklands Hospital.
For what it’s worth (and as I made clear in the response I gave to the Advertiser) at no point have I ever called for services to be removed from Monklands Hospital. What I do want, however, is what is best for patients throughout the whole health board area.
NHS Lanarkshire’s Modernising Mental Health proposals were the product of a lot of hard work and a lengthy consultation process. They were supported by health professionals and service users and the previous Cabinet Secretary for Health, Nicola Sturgeon MSP. They were also in line with the Scottish Government’s own Mental Health Strategy.
As such, I was surprised and disappointed that just 10 days after becoming Cabinet Secretary for Health, Mr Neil ordered NHS Lanarkshire to suspend and review the proposals. The cost of that decision can be seen by the fact that, almost six months on, no alternative plans have been produced.
Some people will continue to resort to petty and personal attacks. I prefer to deal in facts.
I believe decisions over local health services should be taken locally; that Scottish Government policy should not be changed at the drop of a hat (or the reshuffle of a cabinet); and that a health board has a duty to act in the best interests of all of its patients, wherever they happen to live.
I was pleased to have the opportunity to speak in last week’s debate in the Scottish Parliament on the Scottish Government’s Mental Health Strategy. My contribution to the debate can be viewed here, at 44.50.
Mental health is still dogged by stigma and ignorance, with many people still unwilling to admit its legitimacy or potential severity.
Mental health problems are closely linked to, and exacerbated by, stress and anxiety. With the economy stagnant, jobs at a premium and welfare reforms and revised capability assessments cutting away at the social fabric, today’s society is, for increasing numbers of people, especially in poor and deprived areas, a worrying place to be.
It comes as no surprise, then, that a study conducted by a group of Glasgow based GPs has reported a stark rise in the number of patients reporting with poor mental health.
Against this backdrop, I welcome the Scottish Government’s commitment to improving Scotland’s mental health, as outlined in its Mental Health Strategy.
But a Mental Health Strategy is of little practical use if it is not adhered to.
For the past few years NHS Lanarkshire has been working to improve its mental health services and to shift the emphasis of care from inpatient to community based provision (as recommended by the Mental Health Strategy).
NHS Lanarkshire’s Modernising Mental Health proposals, which had the full support of the previous Cabinet Secretary for Health, Nicola Sturgeon, as well as that of local service users, were due to be presented to the NHS Lanarkshire board in September 2012.
However, the new Cabinet Secretary for Health, Alex Neil MSP, intervened and instructed NHS Lanarkshire to revise the proposals. According to an email sent last September (2012) by officials in the Scottish Government’s health department, a final decision will be made “soon”. It is now Janauary 2013, and we are no further forward.
As a local MSP – for Airdrie and Shotts – Mr Neil was a vocal critic of NHS Lanarkshire’s proposals. However, as the Ministerial Code makes abundantly clear, Ministers should exercise extreme caution before intervening in portfolio matters within their own constituencies (a fact that Mr Neil recognised, albeit belatedly).
Given that the plans were supported by Mr Neil’s predecessor, I find this apparent volte face by the Scottish Government both frustrating and confusing.
Consistency is a valuable commodity in politics, as in life. This is perhaps especially so in the provision of health, where the right decisions are not always the easy ones.
There is little use in publishing a Mental Health Strategy only to refuse to implement it in practice, whatever the underlying reason.
I do not know what the future holds for the future of mental health provision in NHS Lanarkshire. All I want is what is best for service users. That is what they deserve, and I hope that is what they get.
In late 2012 I met with representatives of HemiHelp, the UK charity for Hemiplegia, to dicuss what I could do to help them raise awareness of a condition that remains little known.
Hemiplegia, which affects approximately 1 child in 1000, affects one side of the body (similar to a stroke), resulting in weakness or partial lack of control.
The exact causes of Hemiplegia are unknown, although it is generally thought to originate from damage caused at some point during pregnancy.
Understanding Hemiplegia, and how it can affect your child, is vital, and that is why I wrote to NHS Lanarkshire regarding the provision and prominence of information about the condition in NHS Lanarkshire hospitals.
NHS Lanarkshire’s response was encouraging, and I have been assured that consultant paediatricians do everything possible to ensure that parents receive verbal and written direction to the HemiHelp website.
To make accessing the appropriate information easier, the Board has also included a link to the HemiHelp website on the internal NHS Lanarkshire website.
I hope that other Scottish NHS Boards will follow the example set by NHS Lanarkshire, and do everything they can to ensure that those affected by Hemiplegia have all the support and information they need.
It is well known that Scotland’s suicide rate is higher than the UK average. In an attempt to address this, the previous Labour administration introduced a target in 2002 to achieve a 20% reduction in suicides by 2013.
It seems that this has reaped partial dividends: over the past 15 years, the suicide rate in Scotland has followed a consistent downward trajectory.
However, there is one worrying exception.
NHS Lanarkshire is the only health board area where suicide rates have risen over three consecutive periods, from 395 deaths between 1997 and 2001, to 444 between 2007 and 2011 (an increase of 12.4%). Over the same periods, the average Scottish rate fell from 4391 to 3980 (a decrease of 9.4%).
Research on suicide shows that the rate tends to be higher in areas suffering from high deprivation and unemployment; it is especially high amongst men under the age of 35.
Lanarkshire (where there is a high level of unemployment amongst young males), reflects this: the rate of suicide amongst men is considerably higher than amongst women, with 64 male suicides in 2011 compared to 30 female.
Any suicide is a tragedy which has a devastating impact on all involved.
On a local level, I would like to see an investigation into why suicide rates within Lanarkshire continue to rise. I would also like to see an increased emphasis – both in terms of publicity and finance – on anti-suicide initiatives such as Choose Life, and charities such as Papyrus and the Samaritans.
No one should ever be left to feel that suicide is the only option.
Given the recent swathe of voluntary redundancies and the well publicised travails of NHS Lanarkshire’s 3 Accident and Emergency departments, I was surprised and somewhat disappointed to learn of the high salaries being paid to NHS Lanarkshire’s executive board members.
10 board members are paid a combined annual total of £1.69million – a sum exceeded only by NHS Lothian, and well in excess of that paid by NHS Greater Glasgow and Clyde, whose board members collect .
Whilst a case can be made for highly skilled clinicians to receive a good salary, it is less easy to justify the number of Executives and Board Members earning in excess of £100,000.
Moreover, I cannot understand why NHS Lanarkshire has 4 more Executives and Board Members on over £100,000 than Glasgow, especially given that Glasgow has more than 3 times the number of senior clinicians in the highest salary bracket – 920 compared to Lanarkshire’s 253.
It seems that the salary structure in NHS Lanarkshire is weighted more towards the management than the medical staff.
No one objects to individuals being well paid when they produce good results, but given the staffing shortages in Accident and Emergency and Mental Health within NHS Lanarkshire, I am not convinced that this is in fact the case. I will be meeting with senior management over the next few weeks and will certainly seek their views on this issue.
I was extremely concerned by the recent report from NHS Lanarkshire that revealed the extent of the staffing shorthall at Monklands A&E, and indeed across NHS Lanarkshire.
The report described the situation at Lanarkshire’s 3 Emergency Medicine Departments – at Monklands, Haimyres and Wishaw General – as “very fluid and vulnerable”, with the position within Monklands A&E referred to as “particularly fragile”.
Whilst I was alarmed at the scope and scale of the staffing shortfall, it is important to emphasize that the concerns raised in the report are not new. NHS Lanarkshire knew in 2007 that it lacked the resources to sustain existing Accident and Emergency services; yet, despite the clear and ongoing impact this has had on patient care, over the past four years Nicola Sturgeon has failed to invest the additional £50 million that NHS Lanarkshire said was needed to maintain all three A&Es.
This failure did not prevent Alex Neil from spending his entire election campaign scaremongering about Monklands A&E; but, once again, neither he nor Nicola Sturgeon promised to find the money to deal with the problem they caused, and the response from NHS Lanarkshire, which actively discouraged people from using A&E departments, is truly alarming.
NHS Lanarkshire clearly needs help to find a financial solution to the difficulties caused by this SNP Government, and I intend to meet with NHS Lanarkshire Chief Executive Tim Davison at the earliest opportunity. I have also written to Nicola Sturgeon to find out what action she is taking to address the challenges facing NHS Lanarkshire.