Alex Neil says NHS Lothian Second division health service

HEALTH Secretary Alex Neil has said that Lothian residents have been on the receiving end of a “second division” NHS service.

By The Newsroom
Tuesday, 6th November 2012, 12:00 pm

Speaking after he chaired the annual review to assess NHS Lothian’s performance, Mr Neil also warned that health bosses must “get a grip” of concerns over patient care at the Royal Infirmary.

But despite a tumultuous year plagued by crisis, Mr Neil said he was convinced that NHS Lothian had turned the corner and would be back in the top league of providers within months – after making the comparison which likened the health board with a £1.4 billion annual budget to Queen of the South, currently high-flyers in Scottish football’s third tier.

Giving his assessment, he said: “It goes without saying that Lothian has gone through a difficult period. But I think everything is now being done under the new management team to recover from that position and they are making substantial progress. The plan they have in place is the right one.

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“Now they’re in the second division heading for the first division. By the middle of next year they’ll be back in the premier division.”

The health secretary, who took over from Nicola Sturgeon in September, said that 250 new members of clinical staff are being hired so that NHS Lothian can increase the number of patients it can treat, in a bid to ensure there is no repeat of the waiting list backlog that built up in Lothian.

The news of the work to recruit extra staff came as the health board’s chief executive Tim Davison admitted that Lothian nurses were being put under an “incredible amount of pressure” and that the Royal Infirmary, which opened just a decade ago, is “undersized”.

Mr Davison also acknowledged that “a problem” existed at Lothian’s flagship hospital regarding patient care, following a damning report into the treatment of the elderly at the state-of-the-art facility and a string of concerning revelations from patients.

Mr Neil met with nursing staff at the Western General Hospital yesterday morning, then travelled to Murrayfield where he met with unions and patient representatives before heading the review into the health board’s performance, firing questions at Lothian health chiefs, including Mr Davison. Members of the audience, who were invited to ask questions, raised their own concerns about care standards at the Royal Infirmary.

One retired GP said: “Many at the sharp end of the labour force are in dismay and considering their future.”

Another audience member said she had been treated “very badly” at the Royal Infirmary and blamed “mismanagement” of the health service in Lothian.

“It will not change until someone from the top does something about it,” she added.

One said the problems with elderly care at the Royal had been “going on for years” and that elderly patients were “scared” of being admitted to the £190 million hospital.

Mr Neil said that while most of the patients he had spoken to earlier in the day were happy overall with the care at the ERI, some had raised concerns that their experiences at the hospital were “not as good as they could have been”.

He said: “It’s not blaming staff but the management have got to get a grip and make sure people get the treatment they are entitled to. NHS Lothian recognises that there are these isolated incidents. They will get to the bottom of it and deal with it. I am confident they will take it seriously.”

Mr Davison admitted that reports of poor patient care alongside the damning Healthcare Improvement Scotland report suggested that issues ran deeper than “one or two isolated accidents”.

He added: “I have heard too many anecdotes to suggest there is not a problem [at the ERI]. The inspection report described too many observations that happened and none were acceptable. I also get a tremendous supply of letters from patients and relatives.

“I wouldn’t cast the Royal as anything near all bad, but I wouldn’t cast it as being 100 per cent right. We have got to do something to improve the patient experience.

“There’s very little about treatment. It seems to be about staff not having enough time to really look after individual needs. There’s no magic wand. We need to get into a discussion with staff about what we can do to start addressing it.”

The 250 new clinical staff, including theatre nurses and surgeons, are set to be in place by the end of April and some have already been recruited.

They will be paid for by an above-average funding increase from the Scottish Government, aimed at correcting a disparity in the budgets of Scottish health boards, which has left Lothian approximately £50m short. Overall staffing levels are expected to remain relatively stable at the health board, with other parts of NHS Lothian reducing staff levels.

Reflecting on his six months in the job, Mr Davison added: “It’s a hell of a big ship – we’ve got 22,000 staff – but it’s beginning to turn in the right direction.”


A CRITICAL report published earlier this year found that bullying was rife in some areas of NHS Lothian.

After the health secretary raised the issue, the chairman of the NHS board, Dr Charles Winstanley, said that “a very different atmosphere” now existed at the health board.

Work is currently underway to come up with a set of NHS Lothian values, following extensive consultation with staff.

The abilities of managers is also being assessed, and they may be moved to other areas if it is deemed necessary.


THE health secretary congratulated NHS Lothian on its response to the legionella outbreak earlier this year, which claimed three lives and left hundreds unwell.

In response, Alison McCallum, NHS Lothian’s Director of Public Health and Public Policy, said: “We do not have all the answers yet, but the public has been really helpful in helping us understand the human cost and how we can improve on the response in future.”

Waiting times

IN recent months, the number of inpatient and day case patients waiting for more than the target of 12 weeks for treatment has fallen from nearly 2500 to less than 1000.

Due to a new treatment time guarantee, patients who were added to the list in October have a legal right to treatment by December. Up to 500 patients may miss the deadline, and some could be offered treatment in England or Europe. But Mr Neil said that patients would only sent outside Scotland in “extreme cases”.