PLANS for a multi-million pound overhaul of a major city hospital have been criticised after it emerged the revamped facility will boast fewer beds than it already has.
The Royal Edinburgh Hospital, which offers psychiatric and mental health services, is to undergo a huge facelift over the coming decade, with redevelopment due to begin in 2014.
Despite NHS Lothian bosses repeatedly emphasising that the region’s spiralling population will place an increasing demand on services in coming years, the number of beds at the hospital is to be cut by more than a quarter following the first phase of the work.
The health board defended the reduction, saying alternative provision would be provided in the community. But senior MSPs raised concerns over the cut, saying the health board could be faced with a bed crisis in coming years, while the British Medical Association warned that the number of patients who need inpatient care will expand in future.
MSP and Conservative health spokesman Jackson Carlaw welcomed the improvements to the hospital. But he raised concerns that the bed reduction may be “short-sighted”.
He said: “We hear repeated warnings of a dementia timebomb, and other mental illnesses are also on the rise. This is an opportunity to plan properly for the future – we do not want to be regretting a beds shortage in years to come.”
In the areas affected by the first phase of development the number of beds will fall from 256 to 185, leaving just 15 mental health rehabilitation beds, from 55 currently. The number of older people’s admission and assessment beds will fall by ten, to 60. And while later development will see bed numbers in some areas of the hospital increased, by the time the whole of the hospital is redeveloped it is envisaged it will have 484 beds compared with the current total of 517.
The British Medical Association said that no matter how well community-based services were delivered, many patients would still need assessment and treatment in hospitals.
A spokeswoman for the organisation added: “Growing numbers of frail elderly patients, often with dementia, will produce significant pressure on hospital-based services.
“The overall intention should be to maintain as many people at home as is possible, but there also needs to be recognition of, and planning for, an expansion in the number of those requiring some form of residential care.”
David Small, chair of NHS Lothian’s Royal Edinburgh Hospital Project Board, said fewer mental health patients were being treated in hospital settings.
He added: “This has been delivered through investment in community mental health and rehabilitation services such as intensive home treatment teams and crisis intervention services such as the Edinburgh Crisis Centre, as well as new 24/7 supported accommodation in the community.
“Going forward, more community-based rehabilitation mental health care will be provided. This ensures alternative services and a clear programme of investment are in place.”
History repeating itself?
WHEN the new Royal Infirmary was built at Little France, health bosses said not as many beds would be needed.
Despite criticism, they ploughed ahead and when the new hospital opened its doors in 2003, it had 200 fewer beds than the old Royal Infirmary in Lauriston Place.
But in recent months both Health Secretary Alex Neil and NHS Lothian chief executive Tim Davison have said the hospital is too small and expensive measures will have to be taken to expand it.
The Royal Victoria Hospital shut last year and its replacement – the Royal Victoria Building – had 15 per cent fewer beds. NHS Lothian said at the time that more people would be treated at home. But within months, the Royal Victoria Hospital had to be reopened due to a beds crisis and it remains open today.