Public meeting NHS Western Isles

Public meeting - 30th November 2005, 19.30 hours
Subject: NHS Western Isles, Service Reform
Location: Stornoway, Town Hall
Attending: 1,000
Purpose: To give the public and staff a voice regarding service reforms
Chair: Cllr Angus Graham (CnES, Gress)

These notes were taken by myself in a private capacity.
Similar points were made by several speakers, which have been grouped together for the purpose of legibility.
On December 1st, Western Isles Health Board are holding a meeting on this matter.
Any comments on matters mentioned welcome

There is an atmosphere of intimidation within Western Isles Health Board (WIHB), as a result of which people do not feel free to speak out. Staff was not permitted to speak out as they were threatened with disciplinary measures if they did. WIHB does not consult the public whom it serves, although public frustration at the lack of consultation is in evidence. The workings of the WIHB are not fully understood. The large turnout this evening demonstrates that WIHB has failed to convince the public of its reforms. WIHB is not accountable to the public, it's a quango (quasi non-governmental organisation), which does not answer to anyone. Local councillors sought a meeting with WIHB to clarify matters on October 25th, but a meeting could not be arranged until December 14th. Consultation was not offered, and questions were not properly answered, or intemperately so. WIHB gave a report of its reforms as an exclusive to local paper Stornoway Gazette only. Professor Sim, head of WIHB, has since written to local councillors to explain.

One of the reforms would be that at night, theatres would be covered by on-call nursing staff. These are not experienced in theatres. It is insufficient and impractical.

Another problem is that the WIHB Chief Executive, Mr Dick Manson, lives on the mainland but commutes to Lewis every weekend by plane, at the tax payers' expense. By virtue of this arrangement he does not contribute in a real sense to the island's economy. Tomorrow evening (December 1st), Mr Manson will explain his plans at the Caberfeidh Hotel in Stornoway at the same time that the ceremony takes place to switch on the Christmas lights. In other words, he shows no interest or commitment to the islands.

Questions that have been asked include:
- where is the recovery plan [there is a 1.5 million pound shortfall in WIHB accounts]
- administrative staff numbers have doubled in recent times, but why should frontline staff face cuts?
- where are the costings for the redesign?
- WIHB cannot vouch for quality of services
- why does WIHB not engage more openly with the public
- why does WIHB say that there are no problems, if 6 formal grievance procedures have been lodged against high-ranking officials within its organisation?

The Western Isles Hospital, and before it, the Lewis Hospital, was a community effort, operated by staff from the local community. Everyone was and still is proud of it.
These changes are affecting staff morale. A listening organisation works better, but no explanations have been forthcoming. Where does the deficit come from, for instance.
If staff is involved with changes, they will be able to offer solutions. Work with staff, with unions. If staff cannot speak to management, credibility will suffer. WIHB staff are talking to local councillors.
Why do student-nurses have to wait for 3 months to have their travel expenses reimbursed. Does the chief executive, Mr Manson, have to wait for 3 months?? Subsistence payments for Mr Manson are a tax dodge. A reduction in travel expenses would help.

Local councillors have found contact with WIHB very frustrating. Staff is urged to express their concerns freely.

It is very sad that this meeting has had to be called in the first place, that the WIHB could not be bothered to speak to its own staff. Why more administrative staff, why not more nurses? There is no formal representation from WIHB present (although Prof. Sim is here in a private capacity). WIHB officials have ridiculed Cllr Graham, saying “Ach, it’s Angus Graham, making a fool of himself, again”. Minutes from a private WIHB meeting have been passed to Cllr Graham. There is a representation on WIHB from CnES (one councillor). Council is underrepresented on WIHB. The way people are elected onto the Board is to be addressed.

The risk is that WIHB be abolished, as happened with Argyll & Clyde Health Board earlier this year. A public meeting was sought between CnES and WIHB, which has not yet been organised. If the outcome of consultation is unsatisfactory, CnES will take this matter to the Scottish Executive.

Councillors from West Harris, North Uist and North Lochs also spoke up to express concerns and delight at numbers present.

Western Isles Kidney Foundation
A renal unit has been discussed for 4 years, since February 2002. At present, dialysis patients are travelling back and forth to the mainland, staying there for a week and returning to the islands over the weekend.
The redesign structure for the NHS, as set up by the Scottish Executive, has proved to be a farce. It has been blanked out by Dick Manson. Minute taking has been blocked and people intimidated. Scottish Executive does not want to know.

Mental Health
Vulnerable people are going to be left in the lurch if there is no resident psychiatrist. WIHB is run by accountants and penpushers. Psychiatric care is at risk, because the current psychiatrist will be leaving shortly. The vacancy was not advertised for 5 months.

Contracts: short term contracts are not to be extended.

Royal College of Nursing: Union rep told staff they’d be victimised if they spoke up.
Patients are discharged too soon, and the readmission rates are going up. RCN representative present states that people have been advised to be circumspect in their statements. Concerns, fear and apprehension have been expressed – nobody was consulted over proposed changes. There is a lack of accountability, and no minutes were taken of meetings. Collective responsibility means that you don’t rock the boat and tow the line. Decisions are imposed from the top down.

Ward closures mean that relatives will need to go to the mainland to visit patients in hospital there. No heed is being paid to the consequences of the reductions. There are social consequences for people going to the mainland, as well as financial. Airfares paid out have doubled. How do families cope with the absence of a parent. The Western Isles has a service economy. Since one surgeon left, 500 extra operations have been carried out on the mainland.

One GP does not believe in preventative medicine – you just leave the elderly and infirm to die. No names given here.

A midwife says she is not intimidated. She is very concerned over the night time cover. No theatre staff will be present at night in the future, although the on-call staff have no theatre experience. Paediatrics has no cover at night or at weekends; GP'€™s will cover.

If a locum consultant costs £800,000 per annum, this makes a pretty decent inroad into the deficit.