Brenda Morgan-Klein says Scottish Labour needs to learn lessons from its recent high-profile campaigning on Monklands Hospital.

 

The recent Scottish Labour campaign on Monklands Hospital (MH) in NHS Lanarkshire (NHSL) was deeply flawed, and we must learn lessons from it. It was divisive, alienating for sections of the hospital’s catchment area, and failed to engage with basic facts on every aspect of the issue.This is worrying given the party’s aim to campaign in ways that ensure progressive and improved outcomes for patients.

The campaign was led by Richard Leonard, and culminated in a parliamentary debate and vote. It argued that a planned replacement hospital must be built on the current site in Airdrie and not on a new site at Gartcosh, the preferred choice of NHSL, which was in the middle of a long running and substantial public consultation when Labour’s campaign was launched.

The Scottish NHS faces a host of serious challenges at both local and national level. It is right that this has always been, and continues to be, a priority for Scottish Labour in campaigning inside and outside of parliament. Many of the problems faced are extremely serious, such as the acute shortage of general practitioners and Audit Scotland’s recent concerns about the financial sustainability of the service. There are also rapid changes in medical care to consider and the rise in numbers of elderly patients. These and other challenges are very familiar. Many of them are complex and intractable.

The challenge for any campaign is to consider the evidence in its specific context, understand communities on the ground, and develop new thinking and ideas. Surprisingly, given its high profile, the campaign on plans for the MH replacement did not engage with the available evidence on key issues, displayed a poor understanding of the catchment area of MH, and failed to consider the risks to patients and staff of building a smaller hospital on a congested site.

The first problem with the campaign was that it showed no interest in what kind of hospital patients and staff in Lanarkshire need and want in the 21st century. The hospital catchment area is projected to experience the steepest rise in over 75s in Scotland in the coming years, and serves areas with high levels of poor health and deprivation. So the challenges are considerable, both to provide more capacity and to use that capacity more intelligently.

As you would expect, a great deal of work has been done on this by NHSL. To summarise greatly, the proposal is for a low-rise hospital design incorporating green spaces where aspects of hospitalisation that cause stress and pose health risks for patients are designed out. The proposal has been driven by a model of care developed by clinical staff at MH, where the right facilities are next to one another and where patient journeys determine where key elements sit.

The planned design requires a 40 acre site. It is proposed to have a transport hub on the hospital campus, which is next to a railway station and is served by a well developed major road network. The plans are ambitious, even inspiring, and substantial work has been done on modelling patient and staff journeys in accessing the hospital.

The failure by the party’s campaign to consider the clinically-driven design meant that the campaign ignored the issue of whether it was even possible for NHSL’s ambitious plans to be realised on the current site – a point to which I will return.

The second problem is exemplified in a statement made early in the campaign that no one should have to leave town to use their hospital. The speech appeared to imply that the hospital simply served Airdrie, and to ignore the actual catchment area of the hospital. Later in the campaign this was widened to Coatbridge and Bellshill and ‘other areas’. In fact the hospital also serves the northern corridor of North Lanarkshire including the substantial towns of Cumbernauld and Kilsyth. The entire northern area is a longstanding hospital desert and patients there have had to leave town to access a hospital for generations.

It was not clear if this early speech and later utterances demonstrated simple ignorance of the actual catchment area of the hospital, or a willingness to ignore and therefore render invisible a substantial proportion of patients using the current and future replacement hospital. This was all the more galling because patients in places such as Cumbernauld and Kilsyth have enormous difficulty accessing the current hospital (indeed all NHSL hospitals) by public transport and many have to resort to expensive taxis. The transport issues being highlighted by the campaign are already an issue for the current site. So staying on the current site does not resolve the question of access for all of the hospital catchment area.

The third problem was the assumption that the logistics of building on the current site need not detain the campaign. In fact the logistics make for grim reading and jeopardise not only the current design but progressive outcomes for all patients wherever they live.

Building on-site would mean closing the car park and hospital services on the periphery of the campus, such as the very busy David Mathews Diabetes Centre, for several years. This would be enormously difficult for patients and staff alike. Where would patients and 100s of construction workers park in the highly congested residential setting? How would the small scale residential road network cope with the construction traffic as well as hospital traffic? Moreover, the current hospital is full of asbestos, and demolition on an operational site poses real challenges not least to the health of patients and staff.

The site is just too small. It is in a congested area, and it suffers from other infrastructure deficits including very poor drainage and sewerage. An insistence on building on that site would compromise the carefully developed design determined by an enlightened model of patient care. It would require staff to work in a very stressful setting, and would probably mean a high-rise design without the green spaces and patient centred approach – in fact, a second rate 20th century hospital. This would be a tragedy for generations of patients.

My last problem with the campaign was the way in which it was careless and disrespectful of the civic engagement around the proposals, given that the public consultation was in full swing throughout the campaign. This consultation involves various stakeholders including community councils, health service unions, individual citizens and indeed clinical and ancillary staff across the different phases and elements of the consultation.

The current phase of consultation utilised social media, public meetings and a wide range of innovative engagement to get its point across. People in my community were talking about it. There is also evidence from this phase that NHSL has learned from earlier phases and has pushed the question of transport and access up the agenda as a result. The presentations led by clinical staff were excellent.

Despite all this, the consultation was described in parliament, according to reports, as not engaging people meaningfully, and the campaign saw fit to launch a petition (focused on a small geographical area) before the current consultation phase was even closed. Civic and consultative processes matter in a democracy, and not just in this context. They encourage active citizenship, public money is spent on them after all, and community councils and other stakeholders work hard in debating issues and submitting a response. This entire activity was effectively ignored by the campaign.

Labour’s campaign petition encouraged people to believe that the years of sifting through options in earlier consultation phases could be ignored, and to believe that a first class hospital on the current site was deliverable when clearly it is not. Campaigns that are doomed to fail and ignore the evidence actually obstruct meaningful engagement and are ultimately alienating for communities. It certainly succeeded in alienating large numbers of patients living in the northern corridor which the campaign chose to airbrush out of the equation.

Communities in Cumbernauld campaigned hard for a Cumbernauld hospital in earlier phases of the consultation on the replacement hospital, but that would have reversed the access problems and left patients living near the current hospital with the awful problems of access currently experienced by patients in the north corridor.

The Gartcosh proposal offers the possibility of a state of the art hospital with a planned transport hub on campus at the heart of a major road network and next to a railway station. Further community and trade union campaigning and negotiation will be required to ensure there will be good public transport and access for all patients and staff, not just those living in the specific area Labour’s campaign concerned itself with.

 

Ensuring Scotland’s NHS not only survives but develops in the coming years will take all of our creative resources. Nothing about the choices we face is easy and superficial slogans and unsophisticated campaigns will not help. We must be concerned with evidence, developing new policies, doing things differently and respecting communities and staff on the ground. This campaign ignored all the evidence and demonstrated a poor understanding of the issues and communities involved. Scottish Labour can and must do better than this.

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30 thoughts on “Another view on Monklands Hospital

  1. Looks like another halfarsed, pathetic attempt at petty point scoring, which, like the equalisation of pay for women council workers in Glasgow, will blow up on their faces.

        1. Thankyou for your comment Heids
          It was the petty point scoring remark as Alec Neil SNP MSP and Neil Gray SNP MP are both very vocally backing the campaign to build on the present site .

  2. Thanks Brenda for a very insiteful and informing piece on this issue. I had seen Richard fronting this campaign on social media but had no understanding of the back ground until now. NHSL would have certainly done a lot of work in respect of best location with particular emphasis on the whole community and transport.
    In the 21st century we can no longer continue with our premis of having a hospital in every town. We no longer have the professionals to staff them and if we did then the majority of the professionals would not want to work in them. Here in Tayside we have a number of smaller hospitals/minor injury units and despite major efforts to recruit to posts professionals just don’t want to work in them. Preferring the much busier, high powered and more experience inducing Ninewells, Perth Royal Infirmary and Stracathro (the latter two is another story for another day).
    We must also remember for highly trained clinical staff that critical mass is also an issue. It means having the experience and confidence to carry out highly complex procedures that the operator has experienced before. I would much rather have a surgeon who has carried out a heart transplant or brain surgery or vascular surgery last week than last year. This includes many other specialists that are not medics such as interventional radiologists, neuclear medicine scientists and blood transfusion scientists.
    However, when I voiced this to Richard at our CLP meeting during his leadership campaign he argued against this and informed me that he heard this all the time from Health Boards and decried the concept. Whilst I absolutely appreciate that the NHS is a very complex organisation I would encourage those outwith it to give some thought and understanding to its complexities and its workability in the 21st century. Especially under a growing population of an older more complex generation and a younger more complex saving of lives at an ever earlier and earlier prematurity with the consequent associated morbidities! In an age where the Internet makes us all ‘expert’ let’s never forget the real experts in the NHS, their extensive training, experience and expertise does give them an edge, so let’s give them their place! Let’s get them on board use their knowledge so as you say Brenda so as ‘Scottish Labour can do better’

  3. See my reply on Facebook. This campaign was ill conceived and not in the long term interests of North Lanarkshire

  4. I’ve had enough from my Labour Party members who have totally ignored the involvement of man good labour members and supporters who have over the last year attended numerous meetings with staff managers local people substantial number of charity organisations and plus many many service user led organisations and elected members who sit on a number of active health and local government partnership boards and locality groups across all of Lanarkshire since the building of any hospital isn’t only for the use of those residents who live close to the building, but for the use, if required every citizen who lives in Lanarkshire.

    I am a lifetime Labour Party and trade union member, I have for the last two years been very active on and around Lanarkshire being part of the task force involved with the introduction of Integrated Health & Social Care Services throughout Lanarkshire and still alongside many hundreds carry out the day to day duty of ensuring the services being implimented into communities hospitals and health centres are directed to the needs of our people not just for today but years ahead.

    This new state of the art hospital is desperately needed to meet the future needs of our citizens and as a representative of such a group I need to ask my labour Leader to look again at this whole situation and not to rush in as the party did before in respects to Monklands as he is walking the death walk for his party on this subject and the ground swell is far too much for him to not heed.

    I make my feelings known for the sake of keeping a safe well cared for Lanarkshire and not a bit of political get back at the SNP.

    The future care and treatment for my family and children grand children and now great grand children is way above that of getting a Labour Government elected under such a totally rediculous campaign leading new members as did the Grand Old Duke of York.

    I urge the Scottish Labour Party to think.quickly and reverse this policy because I will alongside many many more long term lifetime labour supporters kill this move which may very well kill the chances of a Labour party on power again in Scotland. LISTEN TO THE PEOPLE .
    BACK OFF NOW.

  5. I live in North Ayrshire Brenda
    This is one of the best and important blogs I have seen on labour Hame
    I have seen the story on news bulletins and heard it on FMQS all of the points you have raised I have not seen before the needs of the local people must take precedence .
    I have not really followed it .
    I am a labour Party member and I believe politics should be taken out of the NHS .Record amounts of money is being spent I think we need to look at what we expect of the NHS what it does well and why what its problems are and why .etc
    In 2014 15 I was a patient in Crosshouse Gartnavel and Queen Elizabeth hospitals I had to take an early ill health retirement .
    I still have to attend GP Surgery and Gartnavel nurses still visit medication oxygen etc .
    So I know and see what the NHS has to do for me.
    From what I saw all opposition parties at Holyrood were opposed to the move .
    Maybe if you could get leading NHS specialists to speak out in favour and patients groups that would help
    And get your case across more effectively on TV News activate local people to contact local MSPS and MPS
    And Francis great comment don’t give up .
    Get onto Monica Lennon and health people in other parties and don’t give up .
    And let us know via Labour Hame whats happening and use the press

  6. The Scottish Government will be pivotal what are the views of the FM and Health Secretary and patients and relatives plus the people who work there .
    That’s what should count

  7. Brenda I commend you for your excellent article l agree with everything you say in particular regards to being more transport friendly and also serving a wider area and being for the many not the few. (This is the best article l have read on here to date so well done you).

  8. Richard Leonard said: “People across Airdrie, Bellshill, Coatbridge and the wider area are angry over plans to close Monklands Hospital and relocate health services to a totally different site in Gartcosh.

    Over 5,000 people have signed my petition calling on the SNP health minister to intervene and stop this disastrous decision from being taken by the health board.

    Closing the hospital and relocating services to an area of North Lanarkshire which is ill-served by public transport would hurt working people across the Monklands.

    It is vital that health services are rooted in the communities in which they serve as much as possible. That’s why any new hospital for the Monklands must be built in the Monklands, preferably on the existing site.”

    Richard Leonard or Brenda Morgan-Klein? Lets have a referendum.

  9. Brenda just had a look at some of the stuff on the Monklands Website
    Most of the opposition seems to be according to Alec Neill MSP and Neil Gray MP the Gartcosh site is to remote local people not consulted and a poor bus service to the new site .
    I know how important it is to have a good local bus service to Hospital .
    May I suggest as you have probably already done suggest to the politicians at least improve the bus service to both areas .
    Possibly look into and learn from the planning and building of the new Queen Elizabeth Hospital the old Southern General

  10. I have to use oxygen 15 hrs a day c pac at night I live in North Ayrshire
    Wednesday night Halloween at 10pm I noticed my machine was working but no oxygen was getting to me ..
    Had to be the air hoses .
    I phoned the emergency number .At 10 0 6pm Operator told me go to back up engineer will phone
    11 10PM Engineer phoned told me approximate arrival time.
    1205am today Thursday engineer arrived changed air hoses 1220am left everything working he had travelled from Glasgow this is great NHS work .
    The van they use is the size of a large Ambulance so I spent today explaining why this mini tank was parked in the street .should not have bothered no one noticed they were all in bed .
    My respiratory nurse also informed me in no uncertain terms me being tired is no reason not to go out walking
    So I did twice haha .

  11. Just seen on CH4 news
    Child who suffers from severe epilepsy is in a coma slowly getting worse in front of her parents eyes .
    They are pleading with the hospital to try cannabis oil although it might not work .
    I don’t know the law regarding this but surely in cases like this we have to do it

    1. David the UK is always slow and its reluctance to speed up legislation to authorise doctors to prescribe medicinal cannabis as a matter of course for the treatment of medical conditions is is paltry. The UK is making it as hard as possible for the prescribing of medicinal cannabis currently the treatments can be prescribed only by specialist doctors in a limited number of circumstances where other medicines have failed. On the contrary Australia trialed medicinal cannabis starting in January 2015 and all the evidence and findings have been published and they are way ahead of the game. The UK is to slow to change the sooner we have an lndependent Scotland then I am sure a Scottish Government would implement any changes a lot quicker and in the best interests of the people. Meanwhile TV news item’s will continue to show folks who want but cannot get medicinal cannabis prescribed for their children or loved ones and continue to suffer. I am of the opinion that Westminster Politician’s have a vested interest in protecting pharmaceutical companies as some of these politician’s may have been lobbied and have a vested interest in doing so, and that’s the main reason for holding up and obstructing the prescribing of medicinal cannabis.

  12. Thank you for your comment Ted
    It was in the press last week a family having to go abroad for treatment

  13. Ted
    I have just had a look at what other countries are doing they don’t waist time where its needed its given

    1. David thanks for your update l think that unless somebody or their immediate family is directly affected by a particular illness, disease, medical condition there is no great sense of a rush to do anything at all that is possible in the here and now and as a matter of urgency to aid assist and if need be as is the case of medicinal cannabis change the law to make it more accessible. I cannot understand why it takes so long to get things done in the UK why can’t the UK Government instead of spending folk’s tax money’s on Trident and conventional arms and ammunitions instead plough the money into medical research for treatment’s and cure’s for all manner of illnesses, diseases, and medical conditions. I salute everybody from the bottom to the top of the NHS from cleaners up to doctors and anybody who works in the care sector who are care workers. I have an idea that when employees are taxed in their salary that the tax system is set up and changed so that employees can stipulate that the part of their tax deduction that goes towards Trident and conventional arms and ammunitions that it goes instead to the NHS and medical research.

      1. Just read on STV News website doctors can prescribe medicinal cannabis oil to patients referred with chronic needs to a specialist from today .

  14. how enlighting to read an article that’s puts the needs of the people ahead of labours unionist party politics, its been a long time coming.

  15. Thanks for your comments Ted Davy
    The shame and tradegedy of this is the treatment that will give them hope appears to be available all political parties need to grab this by the horns and deal with it .
    The public will back it .
    Our NHS is brilliant Halloween night I had a problem with my oxygen equipment at 10pm they had an engineer at my home midnight up and running again 20 past midnight .
    Cant ask for better so all parties record amounts of money is being spent on Scotlands NHS we need to take the politics out of it .
    That would take real political courage to think that.

  16. Should read medicinal cannabis for patients referred with exceptional clinical needs .

    1. David if you want to get an idea about Politician’s not making a decision have a look at a movie title ‘Eye ln The Sky’ staring Alan Rickman and Helen Mirren although the subject matter is more serious about military drones it gives you good sense of the indecision of politicans and their inability to take responsibility and make a decisions hence medicinal cannabis.

  17. On both tonights news channels they say the Health secretary has sent the process to revue

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