Press Release
4th
February 2008
McNeil Makes Bid for Expert Opinion on
Maternity Services
Independent expert panels should have
the power to recommend the reversal of failing hospital reorganisations – such
as the centralisation of consultant-led maternity services at Paisley’s Royal
Alexandra Hospital – MSP for Greenock and Inverclyde, Duncan McNeil, has told
Ministers.
In
his submission to the Scottish Government’s consultation on how major NHS
service changes should be agreed, Mr McNeil argues that independent experts
should not only scrutinise a Health Board’s plans when they are brought
forward, but should also be able to examine how previous plans are working.
“If
the changes are not delivering the promised benefits,” he said today, “the
panel could then recommend changes, or even complete reversal.
“Take
the ill-thought-out decision to replace consultant-led maternity services at
Inverclyde Royal Hospital with a Community Midwife-led Unit.
The very fact that the CMU is now in the board’s sights proves that any
assurances about the reorganisation delivering a ‘sustainable’ service were
utter nonsense.”
The
Government wants to set up “Expert Panels” to examine each proposal for
major service change which NHS Boards bring forward.
The panel would operate from the early stages of the process of public
engagement as evidence and options are being pulled together. It
would then assess the information and evidence available, ensure all viable
options are considered and provide a commentary thereon.
This would be published before the formal consultation stage, and would
be made available to Ministers as an input to the final decision-making and
approval process.
Mr
McNeil’s submission contends that, while this is all very well, it would be a
missed opportunity if this expertise was lost as soon as a particular plan
reached the consultation stage.
“Rather
than disbanding when any service change plans reach the consultation stage,”
his submission states, “it could be argued that panels should employ their
expertise investigating how previous reorganisations have operated in practice
and whether they have produced the promised outcomes.
“A
prime example for such examination would be the centralisation of consultant-led
maternity services at Paisley’s Royal Alexandra Hospital and the establishment
of a Community Midwife Unit at Inverclyde Royal Hospital.
“The
panel could then recommend further changes, including a complete or partial
revisiting of the decision.”
The
consultation paper is online at:
http://www.scotland.gov.uk/Publications/2007/10/26111633/2
and the full text of Mr McNeil’s submission is below.
ENDS
Question 1: Do you
agree that an expert panel is the most effective way to provide independent
scrutiny? If not, what would be your preferred choice?
No-one would disagree that, with the
exception of certain specialist cancer services, there should be a presumption
against centralisation. Similarly
uncontroversial are the principles that the evidence for service change must
be rigorously and robustly examined; and that the full range of options are
identified and genuinely considered.
Any system which helps make these
aspirations a reality should be welcomed.
Question
2: Do you agree that the role of the panel should be to assess the safety,
sustainability, evidence-base and value for money of proposals for major changes
to local NHS services?
As has been found with previous failed
service re-organisation plans, for example those put forward by the
now-disbanded NHS Argyll and Clyde, these are all key factors which must be
scrutinised and to which poorly conceived plans have insufficient regard.
However, I would submit that the additional
criteria of closing the health gap / promoting health equalities and access to
services should be give equal prominence in the process.
In achieving this, the panel should have
the power to commission external research or opinion on particular questions
or options, should it so wish.
Question
3: Do you agree that the chair should be a lay person appointed by Scottish
Ministers?
The public appointments process should be
sufficiently robust to allow the appointment of the correct candidate.
Question
4: Do you agree that the panel should have a lay majority among its members?
Where the balance of power lies is
important and it is vital to draw the distinction between expert opinion and
vested interest.
It is sensible that the panel be
“composed of people with no direct interest or involvement in local NHS
services”, but there are also other professional interests which the panels
cannot be used to promote.
Question 5: Do you agree that the panel should assess the evidence and
options during the process of public engagement prior to consultation, and
provide a commentary on these that would be available to the Board and to
Ministers in reaching decisions?
Any underlying assumptions must be tested
and potential flaws highlighted at as early a stage as possible.
Question
6: Do you have any other comments on how independent scrutiny should be carried
out, or on the guidance on "Informing, engaging and consulting the public
in developing health and community care services" at Annex 3?
Rather than disbanding when any service
change plans reach the consultation stage, it could be argued that panels
should employ their expertise investigating how previous reorganisations have
operated in practice and whether they have produced the promised outcomes. A prime example for such examination would be the
centralisation of consultant-led maternity services at Paisley’s Royal
Alexandra Hospital and the establishment of a Community Midwife Unit at
Inverclyde Royal Hospital.
The panel could then recommend further
changes, including a complete or partial revisiting of the decision.
Question
7: Do you have any other comments on either the consultation process or your
preferred choice?
However it is decided to proceed, the
overall effect must be that plans are not presented for public consultation on
a “take it or leave it” basis.
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