STOP THE DOWNGRADE Campaign
Next meeting -Thursday 29th October ‘09 7.30pm Kaim Park, Hotel, Bathgate

Failure. - NHS Lothian has failed the people. Let us start with St John’s. A few years ago it was a hospital which everyone could be proud of. A full range of medical, surgical and orthopaedic services. A Burns Unit which was world class. A hospital which attracted doctors from all over the globe. St John’s was the jewel in the crown of NHS Lothian. It formed part of an “integrated trust” with local GP’s surgeries and it occupied the same administrative boundary as the Council. This was hailed by independent experts as an exemplary model for healthcare for Scotland. This was going to be how health services were delivered across Scotland in the future.

Now look at St John’s in 2009. The integrated trust has been dissolved by NHS Lothian. Emergency surgery and orthopaedics have been ripped away without any public consultation. The oldest and most vulnerable patients in West Lothian are driven past St John’s to beds in Edinburgh, many of which are colonised by MRSA or clostridium difficile.
The Burns Unit takes very few patients. Many are now sent to Glasgow. Increasing numbers of medical patients are dispatched to Edinburgh including those with heart attacks and internal bleeding. As a patient you don’t get a choice. You are just sent. The fabric of our modern, well-constructed hospital is being allowed to disintegrate. Never mind the inside of the building. Look at the access roads – pitted and potholed because NHS Lothian know that West Lothian people won’t complain, but just accept things as they are.

What about the Royal Infirmary? This is now the “local” hospital for many West Lothian people! It can’t cope with its workload. It can’t be expected to since the Health Board is centralising services to a hospital which has been built far too small and in the wrong place, miles from where people live. Every week the Royal fails to meet its target to admit patients promptly from A&E. Every week the Royal infects patients with MRSA and other organisms because the Health Board is trying to cram too many patients into too few beds.

A sensible Health Board would be looking at trying to reduce the workload on an overstretched Royal Infirmary. Instead, NHS Lothian is going to create another 50 beds at the hospital. But it won’t stop there. They will need even more beds. Who pays? You do. The real scandal is that the Board may sell even more public assets (£100 million has been sold to date) in the form of the Deaconess Hospital. In the midst of a property slump this is madness. In the context of the public purse this is disgraceful. Once an asset has been sold then it is lost forever.

We are disappointed that the SNP is breaking its promises. They promised “local healthcare.” They have failed to deliver this for West Lothian. They promised to reinvigorate St John’s and make it secure. They have failed to deliver. The cars you see in St John’s belong to the increasing numbers of patients attending outpatient clinics and coming for day case procedures.

Don’t be fooled by Health Board spin about the hospital being “busier than ever” and “secure.” This is utter nonsense. St John’s is being turned into a large outpatient clinic and centre for day-case surgery for the whole of Lothian. Ingrown toenails and minor procedures such as endoscopies will be done at St John’s in increasing numbers. The car park will get even busier. But, if you are really ill, forget it. You will be sent to Edinburgh.

There is an additional insult to West Lothian. The Royal Infirmary IS having to send some of its patients to St John’s. Edinburgh Bed Bureau carefully selects elderly patients (often from nursing homes in Midlothian and East Lothian) and then send these folk to St John’s! This is done with Health Board blessing. Old people, after all, rarely complain.

Stop the Downgrade agrees that St John’s will survive. But we contend that this will not be as an acute, emergency hospital which West Lothian used to have until recently. We deserve more than a geriatric hospital catering for the overspill from Edinburgh. We deserve more than a hospital full to the brim with day-case patients that will go home in the evening. Instead, we deserve a strong, vibrant LOCAL hospital that will cater for the majority of the needs (emergency, outpatient and day-case) of the LOCAL population.

The sad truth is that West Lothian is in a fight for its life – literally (Ask the families of those who died travelling to Edinburgh along the M8). We are in a fight with Edinburgh because this is where the Health Board is based. It is Edinburgh people whose interests are being put first. It is Edinburgh hospitals that are being expanded to take more emergency patients. Meanwhile, St John’s takes Edinburgh geriatric patients who can’t be accommodated in Edinburgh hospitals. We say that enough is enough.

We say that it is now time for West Lothian people to protest at being treated as second-class citizens.
We need to impress upon NHS Lothian that we care about St John’s and that we will do what it takes to make the hospital once again what we need and deserve. PTO
We need to say loudly and clearly to the SNP in West Lothian that we resent being taken for fools and our votes taken for granted. The SNP may be apathetic when it comes to St John’s but we are not.

Stop the Downgrade asks for your support to deliver the following:

1. Immediate rezoning of the St John’s catchment area to take additional patients (ALL patients, not just geriatrics) from northwest Edinburgh. Rezoning will not only bring more emergency patients to St John’s but it will also deliver additional healthcare resources including doctors, nurses and paramedical staff. These are the lifeblood of the hospital.

2. The return of a selective emergency orthopaedic service to St John’s. Patients with uncomplicated fractures should no longer be sent to the Royal Infirmary but instead be treated locally. This is both humane and medically sound.

3. An immediate halt to any plans to create additional beds at the Royal Infirmary. It is economic madness to send more patients to the Royal, create more beds at that hospital through the discredited PFI programme and sell-off valuable public assets in a property slump. The beds won’t be needed if patients are rezoned away from the Royal to St John’s

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Lothian Health Board don’t care about the views of the public and they care even less about West Lothian which they have treated with increasing contempt over the years. The Board consult with Edinburgh people occasionally but fail to do the same with West Lothian even when important services such as emergency surgery are removed. More recently, the Cabinet Secretary facilitated the creation of a Stakeholder Group composed of Health Board and Council members. Senior Health Board members no longer bother to make time to attend meetings and the workplan is months behind schedule. This month’s meeting had to be cancelled because Board members couldn’t be bothered to turn up or provide the necessary reports for its functioning.

We need to lobby the SNP. Fiona Hyslop and Angela Constance are the two “local” SNP MSP’s and they need to be left in no doubt that their silence about St John’s is unacceptable to West Lothian people. Tell them at their constituency surgeries. Write to them or send emails. Embarrass them with your horror stories about long trips to Edinburgh hospitals to get care which until recently you would have got at St John’s. (One day soon you will!).

Within NHS Lothian hospitals you need to complain every time you get care which you think is substandard. If you are stuck for hours in A&E at the Royal Infirmary it is because NHS Lothian is forcing too many patients to be sent to the hospital which they downsized compared to the old hospital in the city centre. And remember that in St John’s if you are moved from one ward to the next it is sometimes done not for medical reasons but instead to accommodate overspill geriatric patients from Edinburgh. So refuse to move or to be “boarded.” Complain in writing frequently and often.

Every single complaint has to be logged and investigated. This costs the Board money. They are already running at a huge loss due to their fiscal incompetence and, ultimately, the SNP government will have to pay.

You can add to this by threatening to or taking legal action if you contract an infection within an NHS Lothian hospital. Overcrowded hospitals which are understaffed represent powerful breeding grounds for bacteria.

We know that NHS Lothian is not providing enough resources to St John’s from the highly critical junior doctors’ letter that recently appeared in the Press.
West Lothian people through reasoned protest can show that they want their old hospital back AND they can help the Royal Infirmary to function more effectively.

News: “Patient Council/Forum” - Members of the SDC team attended meetings recently. We were struck by the fact that our patient “representatives” from this forum, are completely out of touch with West Lothian public opinion. It seems that our “representatives” are content with the transfer of services to Edinburgh and the downgraded St John’s!! Not one of them raised any concern about emergency patients from West Lothian being sent to Edinburgh and elderly folk travelling from Edinburgh to St John’s in their place! This Patient’s Forum is looking for new members and we urge people who really want to represent the views of West Lothian patients to join. Application forms can be sourced from Diane Loughlin at diane.loughlin@wlt.scot.nhs.uk Web Site:

Our new improved site will be on line soon with additional new features at –www.stopthedowngrade.org

Please note that the main number for St. John’s Hospital has changed. It is now 01506 523000

ENOUGH IS ENOUGH
The SDC Team