Intensive Care: part 1
by Kenneth Roy
It was always an avoidable fiasco, but it has happened anyway. The deal we described this time last year as ‘the most controversial in the history of the NHS in Scotland’ has collapsed. For Europe’s largest health board, Greater Glasgow and Clyde, it is a very public disgrace.
At the end of last week, when it was announced that the redevelopment of Blawarthill hospital in the west of Glasgow had been axed, the media dutifully reported the news from the health board’s perspective as ‘a disappointment’ and ‘a blow’. There was no suggestion that the board had botched it; there were no awkward questions about the failed policy of ‘partnership’; there was no challenge to the financial credibility of the board or its officers. The PR machine was sufficiently well-oiled, the press sufficiently compliant, to ensure that the immediate damage was limited.
The reality of the scandal is quite different. Repeatedly in the first half of last year, occasionally since, this magazine warned that there were ‘serious issues of governance and accountability’ about the board’s handling of the Blawarthill project. We called for ministerial intervention and an independent inquiry. A senior member of the board, John Bannon, came out in support of SR’s campaign, writing to the cabinet secretary for health, Nicola Sturgeon, to alert her to his judgement that the figures didn’t add up and to protest that he was being obstructed in his search for the truth.
Very little was done. The cabinet secretary did call for a report from the health board on the allegations of the Scottish Review and John Bannon. These allegations were rejected and NHS Greater Glasgow and Clyde was allowed to proceed with the sale of valuable public land at Blawarthill to a private developer for an undisclosed sum. The project the health board had proudly billed as ‘a new purpose-built facility financed by private capital’ went ahead.
Or, rather, didn’t go ahead – since the private developer and the provider of the care have dissolved their partnership for unexplained reasons, leaving the scheme in ruins. This could have been predicted. This pretty well was predicted.
Did the board know what it was approving? Did it have any idea of the consequences? Was the consultative process not badly flawed, if not downright misleading? We put all of these questions. None was ever satisfactorily answered.
The centrepiece of the plan for Blawarthill was the provision of 60 beds for the ‘frail elderly’, making end-of-life care a business to be conducted for profit. As long ago as 2000, when the scheme was first mooted, the board claimed that the finance ‘can be sourced immediately’ and that ‘the revenue implications are competitive’. Like everything else about the project, these forecasts turned out to be hopelessly optimistic. It took 10 years to get to the stage of signing missives.
SR studied in detail the document which formed the basis of the public consultation in late 2000/early 2001. Nowhere in this document was it stated that the 60 beds to be rented for profit at Blawarthill would replace the continuing care being provided at St Margaret’s of Scotland Hospice in Clydebank, a few miles down the road. Nowhere was it stated that, as a result, the hospice would lose much of its public funding. Indeed, the hospice was not mentioned at all in the consultative document.
Did the board know what it was approving? Did it have any idea of the consequences? Was the consultative process not badly flawed, if not downright misleading? We put all of these questions. None was ever satisfactorily answered.
We put a further question: “Why, with scarce resources and the ability to make a rational choice, would any public body commit to such a project when the service is already being provided by a hospice rated first-class in every department by the Care Commission?” Beyond a feeble statement by the board that the withdrawal of funding from the hospice was unconnected to the Blawarthill development – an explanation unworthy of serious attention – this question remains hanging in the air.
John Bannon himself was completely unaware that Blawarthill would impact in any way on the viability of the hospice. He was so appalled by the discovery that, although he was ill at the time, he took it upon himself to investigate the deal. He found that the revised blueprint which went before the board in early 2008 bore no resemblance to the original consultative paper. He found serious inconsistencies in the financial projections and reached the conclusion that the board’s officers were not in possession of the true cost of providing the care service at Blawarthill. He encountered an unwillingness to co-operate with his inquiries. All this he reported to the cabinet secretary for health.
The consequences of ministerial non-intervention we now see all too clearly. A major public body under her stewardship has been badly embarrassed and exposed as inept and arrogant.
Meanwhile, SR was discovering some disturbing facts about the care provider nominated by the health board: that the company was facing serious financial problems; that the Care Commission had upheld, partially or completely, no fewer than 373 complaints about its homes in Scotland over a four and a half year period; and that the company had hired a crisis management consultant. This information was fully reported in SR and made available to Nicola Sturgeon. In an attempt to be helpful, and in the hope that an adroit political initiative might still save the health board from its own folly, we even contacted Alex Salmond’s private office a few hours before we published the first of a series of damning reports.
We must be fair to the cabinet secretary for health: she may have taken the view that this was essentially a matter for the health board and that it was not her business to micro-manage its policies and decisions. Yet the public feeling was, and remains, extremely high: the threat to the much-loved hospice, Scotland’s oldest and largest, as a direct result of the health board’s actions, had inspired one of the largest petitions ever to come before the Scottish Parliament, attracting more than 100,000 signatures.
The consequences of ministerial non-intervention we now see all too clearly. A major public body under her stewardship has been badly embarrassed and exposed as inept and arrogant. But at least there is an important consolation in all this: the hospice will be saved.
Or will it?
This article was reproduced with the kind permission of Kenneth Roy.
Read Kenneth Roy in the Scottish Review.
