A Very Good Day - Monklands Reprieve is Rubber Stamped

Some days it's all worth it.

I was at Lanarkshire Health Board's meeting today at Almada St. The last time I was in there, it was for four hours with a set of papers the size of a telephone directory and Monklands A&E was condemned. Today, it was two hours, (with a set of papers the size of a telephone directory) and this time Monklands was reprieved.

The devil as always, is in the detail, although there was nothing really surprising.

130 patients are to go to Hairmyres re cardiology. Ok, they have the main speciality for the authority, so won't quarrel with that. Touch any of the other departments and we will. We have not forgotten what happened to paediatrics, when the department moved into Wishaw for six weeks while refurbishing took place in Monklands, and was still there seven years later.

Six haemotology beds masquerading as a cancer centre for Monklands, in a hospital that has no MRI scanner. Still, no surprise; I never believed that there would be a cancer centre at Monklands. I just hope that Maggie's is going ahead.

Airdrie Resource Centre to go ahead; no surprise, this is vital to the Board's plans to place most of Airdrie's GP practices in one place. But please don't try to bring in any private companies or salaried GPs to run the staffing.

Mental health is being prioritised for funding. Is this a first? Still, rather short on detail and I'm wondering how £300 million for primary care, became £100 million today in the words of one of the board members. Where's the other £200 million, guys? Make sure it doesn't end up in that PFI middle management black hole now, will you?

A call for parity of funding under Arbuthnott. Lanarkshire receives £97 for every £100 that other health boards receive. Guess what; I actually agree with the Board on this. Wouldn't it have been nice if you had said two years ago, that this was a funding problem and we could have worked together to put pressure on the government to cough up the cash, instead of spending two years arguing about a shortage of consultant anesthetists? Still, no hard feelings; so long as we get there in the end.

When will the end be? That is what I was asked by one of the reporters and I said without thinking, 'I can see myself here in five years time.'

I hope it wasn't a psychic moment..

PS To any nosey parkers from NHS Lanarkshire looking at this, there's a wee message contained in the picture above. Geddit?

Bad Practice - South Nimmo Takeover

Ok,i've learned my lesson. The last time I started a series of articles praising a government document, the MMC scandal hit the roof. I start a series on 'Better Health, Better Care' and NHS Lanarkshire excels itself. This time it's a GP practice- South Nimmo practice to be precise.

The story goes like this. In March a Dr Carlin retired due to ill health from his practice in Adam St in Airdrie. He had not organised for a partner to take over. In such a case, the responsibility for the practice falls to the local health board. The premises at Adam St needed repair, so Dr Carlins practice was moved to South Nimmo St, where there was another doctor's practice, and a bidding process was started by NHS Lanarkshire.

The practice had been run by locums while Dr Carlin was ill, and two of them, a Dr Ahmed and Dr Shah wanted to bid for the practice. When they asked, they were told that they could bid, but only if they resigned as locums. So Dr Shah stood down as a locum to bid on behalf of himself and Dr Ahmed. He was then told he could not bid, because he was not part of a practice! When the invitations for tenders were sent out, they were sent out to all the GP practices, but Dr Shah and Dr Ahmed were not sent one.

In the meantime, two practices put forward bids. One of them was Wellwynd practice, which is based in Airdrie Health Centre. It already has 15 000 patients and only 4.5 doctors. Airdrie Health Centre is also falling to bits and is overcrowded because several other practices are in there. (By this time, Adam St had been refrbished and was ready to be re-occupied).However it became apparent that for some unknown reason, Wellwynd was the preferred bidder. It was awarded the bid, is not taking on Dr Ahmed with the bid, so that means that at the moment they have 17 000 patients and only 4.5 doctors.

This is the third time that NHS Lanarkshire has behaved in this fashion over a GP practice. First there was Rowallan GP practice, then Harthill, now South Nimmo. Once might be an accident, twice a coincidence; but three? Looks like carelessness to me. We are in a situation where single practices are being subsumed into bigger ones and if I put my cynical thinking cap on, that means they can employ fewer doctors, bring in nurse practitioners instead and possibly even bring in a private company to run the staffing? Bigger practices are more attractive than smaller ones, and the more patients you have on your list, the bigger your global sum. This is money awarded per patient. Wellwynds latest acquistion will bring in £120 000 by my reckoning.

If there are any South Nimmo patients out there, there is a campaign group attempting to take on the health board; their address is http://southnimmo.org/. In the meantime, if you live in Lanarkshire, do try not to fall ill; you'll need 10p if you want to phone someone that cares..