Lack of infrastructure investment leaving patients and staff in limbo

​Foysol Choudhury MSP and Gregor Poynton MP visited East Calder Health Centre recently

Yet, despite years of campaigning and cross-community efforts, NHS Lothian and the Scottish Government have failed to take the lead in addressing this crisis. Capital funding cuts have stalled any progress on a much-needed replacement, leaving patients and healthcare staff in limbo.​

West Lothian has experienced rapid population growth, and this trend is expected to continue. Yet, as demand rises, essential infrastructure investment remains elusive. East Calder Health Centre, originally built for 4000 patients, now serves a staggering 16,000 and numbers continue to rise. The consequences of this neglect are dire: frequent repairs, outdated facilities and persistent safety hazards that threaten patient care.

The fight for a new health centre in East Calder has spanned over a decade. In 2014, West Lothian Council proposed incorporating a health centre into a new partnership development, but NHS Lothian declined the offer. By 2016, NHS Lothian finally sought funding from the Scottish Government for the health centre, with an estimated cost of £4.3 million and a projected completion date of February 2024. Funding issues delayed progress, and by July 2022, stakeholders were still in meetings, preparing a business case.

Despite extensive community engagement – including monthly meetings, public consultations, and options appraisals – there has been no movement towards construction. Instead, makeshift solutions have been implemented, including spending over £300,000 on temporary portacabins.

The deteriorating state of East Calder Health Centre reads like a case study in infrastructure neglect, with over 400 repair jobs carried out in just three years, including £18,000 spent on flooring and roof leaks. Between December 2019 and April 2024, there were 14 cases of Legionella contamination reported in both clinical and public areas, repeatedly disrupting services. Fire doors fail to meet safety regulations, while roof and glass panels are precariously held together with tape. Persistent mould and asbestos risks threaten the facility’s continued operation, and a leaking ceiling with visible holes and water damage further underscores the urgent need for intervention.

The local campaign group, with whom I have been partnering for action, describes these as “temporary fixes to a dead building”. Yet, the response from NHS Lothian and the Scottish Government remains slow and insufficient.

National Implications: A System in Crisis

East Calder is not an isolated case. Across Scotland, healthcare infrastructure projects have been stalled due to capital funding constraints. In a response from the Scottish Government regarding a question I submitted on how much funding it plans to allocate to NHS capital projects from the draft Budget 2025-26, the Cabinet Secretary for Health responded, “further NHS projects cannot be supported at this time, as there remains challenge and uncertainty in the capital budget position”.

These pauses come at a time when NHS Scotland is already struggling with record-high waiting lists and staff shortages. The funding crisis has led to a 6.8 per cent savings requirement for NHS Lothian, more than double the previous mandate, while a recruitment freeze further exacerbates staff burnout and patient backlogs, pointing to an overall struggling national healthcare service.

A Call for Leadership

The East Calder campaign has proven that partnership working between local government, MPs, MSPs, councillors, and community groups can be effective.

But while local efforts have been tireless, from hosting roundtables at the Scottish Parliament to writing letters to NHS Lothian and visiting the health centre numerous times, NHS Lothian and the Scottish Government must now take the lead. They have the power, the funding from Westminster, and the responsibility to step in and ensure that healthcare facilities are fit for purpose.

Cross-party backing for action is clear. In December 2024, I led the initiative to send a joint letter to NHS Lothian’s Chief Executive, signed by MSPs, MPs, and local councillors.

This push for action has continued, with cross-party cross-governmental meetings with the Cabinet Secretary for Health, local developers, and campaign members.

The Scottish Government recently received an additional £1.72 billion for the NHS from Westminster in 2025-26, marking the largest financial settlement in the history of devolution.

A fraction of this funding could transform East Calder’s health infrastructure and ensure safe, modern healthcare for West Lothian, with residents questioning, “Where is the capital funding being allocated if not to health centres like this?”

Another potential avenue for securing investment lies in Section 75 planning obligations, which allow local authorities to require developers to contribute to infrastructure improvements, including healthcare.

The time for delay has long passed. The Scottish Government must move beyond deferrals and finally invest in the infrastructure Scotland’s NHS needs. East Calder’s long-standing campaign proves that community and political will exists – what’s missing is the leadership to turn promises into action. The people of West Lothian have waited long enough. NHS Lothian and the Scottish Government must now step up, take responsibility, and deliver the modern, safe health centres that communities West Lothian deserves.

Foysol Choudhury is Labour MSP for Lothian