The health board would rather punish the hospice than save it


Intensive Care: part 2

by Kenneth Roy

The following question need not detain you long.  If you are a public body and your plan, 10 years in the making, for a new 60-bed nursing home has just collapsed, but a hospice a couple of miles down the road has 30 similar beds which are about to be vacated, and is eager for the work, what would you do? I do not propose to offer a Scottish Review pen for all correct answers received.  We are a poor charity; we do not have enough pens to go round.

NHS Greater Glasgow and Clyde, as a result of its own folly in proceeding with the ill-fated Blawarthill development in the west of Glasgow, now finds itself in exactly the position described.  It can no longer deliver the 60 beds for frail elderly patients nearing the end of their lives, but St Margaret of Scotland Hospice nearby will soon be able to provide half the required accommodation.

You may be wondering why, with so many frail elderly people in our midst, a hospice rated ‘excellent’ by the Care Commission is about to have so much spare capacity.  The answer is simple, if deeply embarrassing for the health board: NHS Greater Glasgow and Clyde had decided to withdraw funding of £1.2 million a year for St Margaret’s continuing care beds.  Instead it was determined to go ahead with the new nursing home built by private capital in which the beds would be rented for profit by a private operator nominated by the board.  Except, of course, there will be no home: the plan is in ruins.

But the hospice hasn’t gone away.  It is still devoted to its patients and goes on providing the skilled, compassionate service it has always provided – for no profit.  Last weekend, NHS Greater Glasgow and Clyde should have announced that, in the interests of the community, it was restoring funding to the hospice on the grounds that 30 continuing care beds are better than none.

NHS Greater Glasgow and Clyde not only failed to make such an announcement.  To the incredulity of all of us familiar with this saga, it declared that it would undertake a ‘review’ of the need for continuing care.  What, another one?  On this subject, the board has produced almost as many reviews as the Scottish Review has produced editorials.  Scarcely a year goes by without one.

This is a shocking way for a major public body to behave.  It prolongs the insecurity of the hospice’s dedicated staff; it breeds anxiety in the patients.

Everyone knows that the health board knows that this is simply a way of buying time.  The board, even in its present desperate condition, refuses to accept the inescapable logic that care for the elderly in greatest need must be provided somehow and that St Margaret’s is best placed and best equipped to do the job.  But the loss of face in bowing to the inevitable is too much for the board to contemplate.  It would rather have another review than admit to the hospice, and to its own members, that it got it hopelessly, irresponsibly, wrong.  It would rather prevaricate further than do the graceful thing and restore funding to the hospice.  I suspect that it would rather do anything than do that.

This is a shocking way for a major public body to behave.  It prolongs the insecurity of the hospice’s dedicated staff; it breeds anxiety in the patients.  The board is now in danger of putting its own needs – the needs of a bureaucracy – before the needs of the dying.

Why does the cabinet secretary for health not intervene and issue a firm instruction to the board?  Only Nicola Sturgeon can say why she has steadfastly declined to get involved in this matter.

In the last 24 hours, more disturbing information has come to light. SR has learned that, as a result of a disagreement about the terms of the hospice’s contract with the health board, the board has withheld £170,000 due to the hospice.  At a recent meeting, when St Margaret’s representatives requested the money owed, they were told they would receive it only when they signed the contract.  The chairman of the hospice’s board, Leo Martin, a Glasgow solicitor, told SR yesterday that the hospice was being ‘punished’ for refusing to sign a contract ‘entirely inappropriate to our needs’.  He described the current situation as ‘incredible’.

Health campaigner John Bannon – the former NHS board member who claimed last year that officials had obstructed him in his search for the truth about Blawarthill – wrote some time ago to the chairman of NHS Greater Glasgow and Clyde, Andrew Robertson, and asked him straight when the money would be released.  Mr Robertson – an appointee of the Scottish Government who is paid £40,000 a year to deal with such inquiries of public interest – has never acknowledged John Bannon’s letter.

The relationship between the health board and the hospice has broken down; the atmosphere between the parties is poisonous.

SR is acutely aware of how this health board does business.  This time last year, when we were convinced that Blawarthill was a disaster waiting to happen, we put seven questions about the deal to Andrew Robertson and his colleagues.  We were ignored.  But then, without consultation with board members, the PR department issued detailed replies to our seven questions to other media organisations.  When John Bannon, still a board member at that stage, raised awkward questions about the viability of the project, and the financial projections prepared by board officials, he was threatened with disciplinary proceedings for allegedly breaching the board’s code of conduct.  His crime?  Talking to SR about a matter of conscience that he had found impossible to resolve with the board’s own chairman and senior management.

The future of the hospice has been the subject of three debates in the Scottish Parliament and of a petition to the parliament containing more than 100,000 signatures; St Margaret’s continues to command strong all-party support.  Yet, despite the collapse of the Blawarthill deal, its future is as uncertain as ever, perhaps more uncertain.  The relationship between the health board and the hospice has broken down; the atmosphere between the parties is poisonous.

The chances of any positive breach in the impasse before the parliament dissolves late next month are remote.  We are about to enter a political limbo.  When, however, the parliament re-assembles in early May, one of the first acts of the new administration – whatever its political complexion – should be to restore order to the affairs of Greater Glasgow and Clyde Health Board.  Andrew Robertson, who must accept ultimate responsibility for the Blawarthill fiasco and the breakdown of relations with the hospice, should be asked to step down to allow a fresh start to be made.

This article was reproduced with the kind permission of Kenneth Roy.
Read Kenneth Roy in the Scottish Review.