I must first thank members for their support during the past year. In particular, I am most grateful to Malcolm Allan and James Sandeman. Malcolm for taking the minutes when our secretary had been unable to attend, and James for his excellent notes taken during our meetings with the Cabinet Secretary for Health and Well-being.

Following on the very welcome decision of the Cabinet Secretary to accept the conclusions of independent scrutiny panels, and  to implement the retention of accident and emergency departments at Monklands and Ayr hospitals, the focus has been on the situation at the Vale of Leven hospital in Alexandria.

Greater Glasgow and Clyde Health Board initially decided not to accept the recommendation of the scrutiny panel appointed by the Cabinet Secretary, but she has asked them to review their decision. The Health Board’s intention was to move unscheduled medical admissions from Alexandria to Paisley and also to transfer acute mental health services to Gartnavel Royal Hospital in Glasgow. An extensive consultation process has just been completed and the outcome is awaited.

A significant outbreak of Clostridium difficile at the Vale of Leven Hospital, associated with 18 deaths, has resulted in major infrastructure improvements within the hospital and also the introduction of national guidelines in relation to hospital acquired infections. A very recent press report has commented upon the favourable results of a recent inspection.

Several consultation documents in relation to health have  been issued by the Scottish government.These have included a Bill to allow the election of health board members, a patient’s rights Bill, and a Bill to prevent private contractors bidding for general practitioner services. The Network has responded to these and individual member responses were made in relation to a proposal to abolish co-payment charges.

During the past year Network representatives have met with the Cabinet Secretary for Health and Well-being on two occasions. Details of the topics discussed are available in the minutes on the website. There is however considerable concern in relation to the lack of information that the Acute Services Monitoring groups both North and South of the City of Glasgow are receiving in order to fulfil their function. This is particularly worrying in view of the fact that these ambulatory care and diagnostic units will shortly be handed over by the contractors. I am also aware that medical staff are similarly concerned about the facilities and services to be provided in these new buildings.

In September 2008 the Scotland Patients Association was re-launched at the Scottish Parliament , and the Network was invited to participate in this event. Malcolm Allan and  I manned a stall publicising the activities of our organisation.

During the past year there has perhaps been less press activity in relation to health affairs and Malcolm has outlined the activities in his media report.

Together with Mrs Leigh Smith, Chairperson of the Scottish melanoma group, I met with Jonathan Best, Director of Acute Regional Services, Greater Glasgow and Clyde concerning problems relating to the perceived over- centralisation of chemotherapy in the Beatson oncology unit. There was also the anomaly that chemotherapy was going to be offered in the new ACAD at the Victoria but not on the Stobhill campus. An assurance was given that this would be examined and there was a strong likelihood that a nurse led service will become available at Stobhill.

I attended the Annual General Meeting of the National Health Service Consultants Association in Liverpool and reported on the activities of our group. We are extremely fortunate in Scotland to have a separate National Health Service Act and a government in power which supports the founding principles of the NHS.

We look forward to progressing the aims of the Network in the coming year.

Dr. Robert L.C. Cumming
Chairman, Scottish Health Campaigns Network

                      Scottish Health Campaigns Network
                                               AGM
                                     Saturday 14th February 2009
1) Apologies
Lambert Sinclair
Evelyn McKechnie
Patrick Trust
Isobel Vernolini
Eileen Gorie
David Smith

Attendees
Robert Cumming (Chair)
George Venters (Vice-chair)
Malcolm Allan
John Winton
Ruth Winton
David Atiyah
Vivien Dance
Bill Lawrie
Margaret Hinds
Evelyn Hide
Ken Barr
James Sandeman
Alistair Glen
Jean Turner
Margaret Watt
Julie McAnulty

2) Minutes of AGM 19th Jan. 2008
      Acceptance proposed by MW and seconded by MH.

3) Matters arising from the above minute.

     There were no matters arising from this which would not be dealt with in the  Chairman’s report.

4) Chairman’s report.
 
     This had been circulated to delegates in advance of the meeting.
The chairman added that MA had attended a conference at Dunblane in April organised by the Scottish government.  The subject was ‘Better Cancer Care’and a response was submitted on behalf of the Network.

5) Treasurer’s report.

The treasurer was unable to attend but had made the accounts available to MA.
Balance at the RBS bank on 30/12/08 stood at £900.08. This compared to the balance at 31/12/07 of £946.22
The treasurer had advised the secretary that, in his opinion, the subscriptions should remain unchanged at £50 per group with contributions from individuals.
Proposed by MA and seconded by JW.

6) Auditors report.

The auditors, KB and JW, signed off the accounts acceptance of which were proposed by MA and seconded by MW. The auditors were thanked by the chair.

7) Media report.

This had been circulated in advance by MA who thanked E McK in her absence, for maintaining the website.

8) Election of Office Bearers.

Chair.
The Chairman offered to remain in that capacity for at least a further year if this was the wish of delegates. This was agreed unanimously.

Vice-chair.
GV proposed by KB and seconded by MW
At this point GV suggested that a further VC be appointed to represent rural and other specialised interests. An EGM would be required to alter the constitution and after general discussion no formal proposal was put forward.

Secretary.

The secretary had been unable to attend but as she had not indicated otherwise, it was assumed that she was prepared to continue in Office.  The meeting endorsed this view.

The positions of Treasurer, Media contact and Auditors will remain as before.

9) Minutes of 13th Dec. 2008.
 These had been previously circulated. Acceptance proposed by MW and seconded by JW.

10) Matters arising from above minute.

Geoff. Maudsley, director of Think Tank Reform Scotland has agreed to come to the next meeting and RC will confirm.
GV suggested inviting Prof. Allyson Pollock. This was discussed but it was decided not to pursue this.
Bill Lawrie suggested that, if GM confirms attendance, the media be so informed.

Overnight beds at Stobhill Hospital.
In view of the estimated cost of around £16m RC reported that there was uncertainty as to whether funding by PFI would be available. 

                                                                                                           
Re para5 in the minutes, there has been no response from NS about problems with IT and there has been no further information about BECAD.

Re para 7 (Fife) JW spoke on issue of single beds and that Balfour Beattie has indicated that four bedded rooms could be divided into 2 twosingle bedded rooms but that this would result in a reduction of beds.
JS spoke on the issue of numbers of single beds in the new Southern General Hospital and the difficulty of establishing accurate figures. 1309 single beds are likely to be established out of a total of around 2000 beds.

The report from Prof Allyson Pollock's Department on the EU commission's proposal for a Directive on the Application of Patients Rights in Cross Boundary Health has been sent independently to MEP.
Both have indicated they had received this document but there has been no response from either to date.

11)Vale of Leven Hospital.

VD gave a full report. Consultation finished at the end of January. Leaflets distributed to all households and 19 public meetings took place, each lasting about three hours. GPs support being responsible for provision of unscheduled care/treatment with stroke and heart attack victims being taken to The Royal Alexandra Infirmary, Paisley. GPs may be able to retain about 76% of present unscheduled admissions.  However, 10 consultants from the RAI have written to GPs and Greater Glasgow Health Board stating that they cannot support the principle, so the debate remains open.

Two of the three consultant physicians at the Vale of Leven will be retiring within the next year. There are plans that their replacements may be partly based in Paisley. Anaesthetic cover continues to be supplied to the Vale by locum consultants
PT has prepared a summary which will be circulated to delegates.(Appendix 1)

C. difficile remains subject of police investigation.

12) St Margaret’s Hospice, Clydebank (with 30 beds)

NHSGG and Clyde propose a new build for the frail elderly at Blawarthill but nothing in place. Intention is to change basis to that of a Care Home rather than a hospice for the terminally ill.
Decision may be postponed until 2012
It was reported that Roseanna Cunningham has a Private Members Bill looking at palliative care in Scotland with a closing date for responses of  28th February.
KB proposed that a Press Release be put out by the Network stating the concern expressed by the SPA and the SHCN relating to the future of St Margarets Hospice. He agreed to liaise with MA about the content.

13) Reports from Groups.

Local Health Concern Fife. JW questioned whether the £150m PFI funding for the new hospital in Fife was still in place. He has previously drawn attention to the fact that this figure was first estimated three years ago and has not been revised.
Local Health Concern will meet with NHS Fife on a six monthly basis.

Health Service Forum South East:

JS reported that IT in ACADs will be “in house” as opposed to being provided by an outside contractor. Paper information will be scanned.  North and South Monitoring Groups will raise this at the next meeting on 5th March.

David Atiyah, who had been introduced to delegates at the start of the meeting, spoke about mental health in NHSLothian, and the concern about relocation of existing provision at the Royal Edinburgh Hospital to a new build at Little France.

C.A.T.C.H.E.S.

KB reported that there had been a lack of consultation about the possible closure of a Care Home in Lochgilphead.   As a result of protests, no decision will take made until such time as a consultation exercise has taken place.

14) Next meeting with Nicola Sturgeon.

The SHCN await a date to be offered by NS. A meeting of SHCN will take place prior to then to agree topics.

15) AOB

Discussion took place on the End of Life Bill to be introduced by Independent MSP, Margo MacDonald. The consultation will remain open until 9th March.

MH on behalf of GHFSE supported open discussion.
Distinction was drawn between the principles outlined and physician assisted suicide.
JMcA expressed concern on the widespread nature of the Bill and of the legal framework.
GV expressed the view that choice should lie with patients of sound mind.
MW referred to Human Rights Bill of 1998
JT emphasised importance of improving quality of palliative care and access to expert care provided in hospices.

MRSA:  JS reported that all Health Boards are required to implement schemes by April 2009. He questioned how Boards are to implement control over day surgery.

Minor Injury Units: JW questioned whether any information had been made available to the public about what would be provided at minor injury units.
Patient surveys about hospital care will be piloted over six months in Fife, Dumfries and Greater Glasgow and Clyde.

16) Date of next meeting.
     To be advised when the Chairman receives date of meeting with NS (see 14)

The meeting closed with a Vote of Thanks to the Chair.

Malcolm Allan   

20th of February 2009

CHAIRMAN’S REPORT – S.H.C.N. AGM 2008

The elections to the Scottish Parliament in May of last year have produced a significant change in the political direction of the NHS in Scotland.  Regrettably we lost the two MSPs affiliated to our group, Dr. Jean Turner and Ms Carolyn Leckie.
 Ms. Julie McAnulty and Mr. David Smith both recorded very credible electoral performances, but unfortunately they failed to be elected.
Dr Turner has now become chief executive of the Scottish Patients Association and is making the media aware of her presence by championing patient’s interests.

One of the earliest statements by the new Scottish Government was the announcement by Ms.Nicola Sturgeon, the Cabinet Secretary for Health and Well-being that the Accident and Emergency departments at Monklands Hospital and Ayr Hospital would remain open, and that Independent Scrutiny Panels would be appointed to examine and recommend options, not only for these hospitals, but also for the Vale of Leven Hospital.
The latter panel has now reported, and regrettably Greater Glasgow and Clyde Health Board has rejected the proposals of the panel, including the Integrated Care Model which involved sharing general practitioner /consultant responsibility for maintenance of the services. Ms Sturgeon has asked the board to rethink their position.

Mental health provision in the Vale of Leven catchment area is also the subject of an ongoing appraisal exercise.
 Much is being made of safety and manpower issues.
 In the current shortage specialties of accident and emergency and anaesthetics it is understood that within a relatively short period of time there will be a significant increase in the number of trainees eligible for consultant status.

The Independent Scrutiny Panel’s reports on Monklands Hospital and Ayr Hospitals A&E departments have just been published. These vindicate Ms Sturgeon's decision to maintain them open and highlights the health board’s flawed consultation processes, selective use of information and the lack of sound evidence in reaching their decision to close them.

Also announced were proposals to revisit the democratisation of health boards, a phased abolition of prescription charges in line with the changes which have taken place in Wales,and a review of the method of financing capital projects using not-for-profit trusts instead of the much criticised PFI/PPP, the system currently in use. The Network fully supports these proposals.

The Scottish Health Campaigns Network met with Ms. Nicola Sturgeon in September when a wide variety of topics were discussed. These are recorded in greater detail in the minutes of the Network. The Cabinet Secretary has indicated a willingness to continue a regular dialogue with the Group.
The Scottish Government published its view of the Kerr report in a consultation document entitled “Better Health, Better Care”, to which the Network responded, and Malcolm Allan participated in a one day conference held in Glasgow which discussed this document.  It would be appropriate at this point to record my grateful thanks to Malcolm for his sterling efforts in keeping the media informed of the activities and views of the Network.

Through the good offices of Ken Barr the website of the group has undergone a considerable facelift and now has the
facility for our secretary to readily add material to it.

At the September meeting, we were addressed by representatives of the Scottish Ambulance Service, and we were able to express our concerns about some aspects of the service.

An opportunity arose for me to attend the AGM of the National Health Service Consultants Association in London, at which I gave a brief account of the activities of the Network and described the current health service scene in Scotland. 
 I have subsequently been asked to prepare an article for publication in the newsletter of the Association.

Finally I would like to say that I am most grateful for the continued support of the office bearers and members of the group, particularly our secretary Evelyn McKechnie.

Dr Robert L. C. Cumming
Chairman, Scottish Health Campaigns Network
January 2008

An eventful year started at last year's AGM when the Network was addressed by Professor Allyson Pollock of the Centre for International Public Health Policy at the University of Edinburgh. She is a renowned expert on the problems of PFI/PPP in the provision of finance for public sector projects, with particular reference to the Health Service.

This method of finance continues to provide the funding for most of the major public capital projects in Scotland. Hopefully some lessons have been learned from the failures of many aspects of the first major PFI project, namely the new Edinburgh Royal infirmary.

The provision of new District General Hospitals at Hairmyres and Wishaw by PFI is undoubtedly a major factor in the decision to close the A&E unit at Monklands (the busiest in Lanarkshire) despite vehement denials to the contrary by Lanarkshire Health Board.

The secrecy (on the grounds of commercial confidentiality) surrounding financial information on PFI and private sector contracts is to be deprecated. The recently published full business case relating to the two new ACADs at Stobhill Hospital and the Victoria infirmary are bereft of any significant information relating to this.

Creeping privatisation of the Health Service in Scotland is becoming a reality. The Health Minister can boast that waiting lists have been reduced, but at vast expense. His enthusiasm for meeting targets obscures the poor planning in both staffing and resources which allowed waiting lists to reach unacceptable levels in the first place.

Contractual information regarding the Independent Surgical Treatment Centre at Stracathro has been almost impossible to obtain.

An attempt by Lanarkshire Health Board to introduce the private sector to the running of a general practice in Harthill has been thwarted . MSPs, the media and press were very helpful in bringing an almost clandestine operation to the public's attention.

On a more positive aspect, it was encouraging to note that Greater Glasgow and Clyde Health Board has decided to maintain the A&E services at Inverclyde Royal infirmary thus reversing an earlier proposal that they should move to Paisley.

The situation in relation to the Vale of Leven Hospital remains fluid but in reality there is a distinct possibility that the Integrated Care Model, with consultants and GPs working together may well be fulfilled.

Dr Jean Turner and I took part in a panel discussion at the AGM of the National Health Service Consultants Association in Edinburgh in October of last year and I also gave a paper on the activities of the Network to this group.

In October last year I had the privilege of representing the Network in Holyrood, when I gave evidence to the Health Committee of the Scottish Parliament on the Scottish Health Board (Elections) Bill. The purpose of this Bill was to democratise the representation on Health Boards The Health Committee supported the Bill although its proposer recognised that modifications were required. It was opposed by the Scottish Executive, Health Boards, the BMA and the RCN. Unfortunately, when the Bill came to be debated on the floor of the chamber at the end of January 2007 it was defeated. The Labour rebels who had indicated support for the Bill were placated by the Minister promising a pilot study of the proposals in a single Health Board. My information is that this is likely to be in Fife.

It is however interesting to note a widespread cross party recognition that Health Boards must be required to have genuine and realistic consultative processes with the public that they serve.

The Network also gave written evidence on the proposal to examine prescription charges, but this issue seems to have gone to ground and has not been resolved by the Scottish Executive.

Through the good offices of Malcolm Allan, media coverage of the Network has been good and the organisation has maintained a profile in the national/local press.

During the past year two further meetings of members of the Network and the Health Minister have taken place and the details of these have been reported in the minutes. I feel that it is important that the group should continue with this liaison.

The proposed closure of several A&E units, and the centralisation of some services, continues to be of major concern to the public, not only because of the loss of these services but because management has failed to take on board the issues of access and public transport before proposing the changes. Car parking facilities and the recent introduction by some Health Boards of charging are very unpopular.

With the forthcoming elections to Holyrood it is imperative that health issues should be high on the political agenda and it is good to report that Dr Jean Turner is standing for re-election in the Strathkelvin and Bearsden constituency and that Julie McAnulty is contesting the Coatbridge and Chryston constituency in Lanarkshire, particularly in relation to the issues surrounding the proposed downgrading of Monklands Hospital. The Network wishes them well in their respective campaigns.

I would like to conclude by thanking members of the Network for their continued support and particularly to the office bearers for contributing to the smooth running of the organisation.

Dr Robert L. C. Cumming
Chairman, Scottish Health Campaigns Network
February 2007