The NHS Consultants' Association

The Scottish Health Campaigns Network.

The SHCN represents communities throughout Scotland which have various health issues and serves as a collective voice for these groups.

The seeds of the organisation were sown in the northern suburbs of Glasgow, as residents reacted to the on-going loss of services at Stobhill Hospital as it approached its hundredth birthday.

Despite public meetings, marches and the delivery of petitions to successive health ministers at the Scottish Parliament, no progress was achieved in arresting this trend. As a last resort, it was decided to exert pressure by political means.

Dr Jean Turner, a retired General Practitioner, who had practised for many years in the catchment area of the hospital, and who had attended and spoken from the floor at some of the public meetings, was approached, and agreed to stand as an Independent ' single issue 'candidate in a by-election caused by the resignation, on health grounds, of the Labour MSP, Sam Galbraith. At that first attempt, and with a run in time of only three weeks before the election, Dr Turner finished in second position behind Labour, and ahead of the established Lib Dem., Conservative and SNP candidates. The opening salvo had been fired.

A visit to a conference at Kidderminster provided the opportunity to meet with Dr Richard Taylor M.P. and with the journalist and former M.P., Martin Bell. This event proved inspirational and we returned fortified and armed with guidance on future campaigning strategies. Phrases from that meeting are as fresh as on the day on which they were heard. " Hold the moral ground", "Avoid bringing politics into disrepute by sniping or retaliating", together with the definition of Independents as " The litmus test of common sense." And the suggestion that the election of Independents into either Parliament could be viewed as " The ripple of the future."

In 2003, Jean Turner took one of the safest Labour controlled seats and became a member of the Health Committee in the Scottish Parliament, where, of course, health is a devolved matter. If Richard Taylor lit the fire in England, Jean Turner acted as a catalyst for communities in Scotland.

People in a number of areas had taken issue with health boards where they felt that decisions which impacted on communities had been taken with little meaningful consultation. Among the principal concerns were the loss of consultant-led maternity units and Accident and Emergency departments, together with growing unrest about the reduction in in-patient beds throughout the country. Patients, and their relatives, feared being faced with longer travelling times, which, such is the geography of Scotland, could sometimes involve the use of ferries, subject to the vagaries of the weather, which can also affect travel by road and air.

While people were not unaware of the elements presumably factored into the decisions arrived at by health boards, the perception was that these decisions had been imposed without input from elected representatives and were motivated as much by cost as by care.

The challenges faced by health boards include planning for the implications of the European Working Times Directive on staffing levels, the falling birth rate in some areas, the trend towards more day surgery and the shorter time required for post operative care. the trend towards specialisation, the recruitment and retention of health care providers in rural areas and the provision of out of hours service. There is criticism in some communities that boards have failed to recognise and anticipate several of the above factors, which were well signalled in advance. And having acted in response to the challenges facing them, they have not taken communities with them.

From all points of the compass, groups came together at the invitation of the Save Stobhill Campaign in spring of 2004, and the Scottish Health Campaign Network came into being. Individuals who make up the local groups are drawn from a cross section of backgrounds. Understandably, the medical profession is strongly represented, the current chairman being retired consultant haematologist, Robert Cumming.

Members of the NHSCA are well represented and continue to play an active role in the activities of the organisation. The Network is particularly grateful for the financial contribution from the Association which helps to offset the expense of the regular meetings of the central body.

While some of the causes of unrest in Scotland are common to the U.K. as a whole, the extent of involvement of the private sector is, at present, less pronounced than in England, the private sector being historically less established than in the latter. With a few exceptions, the principle of PFI is less firmly rooted north of the border, and where it has been employed, as in Edinburgh Royal Infirmary, the criticisms of that exercise are well documented in Professor Allyson Pollock's book 'NHS plc'.

While the Scottish Health Minister, Andy Kerr, has said that there is no policy of centralisation of NHS services in Scotland, those who judge by results struggle to reconcile this statement with what they see around them.

Can the Network claim to have made any impact on the health scene and to have made health boards, and politicians more accountable?

On his appointment to his new post, the current health minister indicated that he would listen to what people had to say. To his credit, he has met with the Network and representatives from the various individual groups and has noted criticisms as well as positive suggestions from those present. The Health Committee, a permanent group in Holyrood, has taken evidence from a very wide range of organisations, bodies and individuals, and has produced a report with wide ranging recommendations about the future of the NHS in Scotland. ( ref 1 ).

The Health Minister also set up a high profile Advisory Group led by Professor David Kerr and this group has held meetings at several venues throughout the country at which the public took the opportunity to air their concerns about the future delivery of health care over the next twenty years. This report was published in May of this year and received considerable publicity at the time. The Health Minister will further report on its recommendations when Parliament reconvenes after the summer recess. ( Ref 2).

In April of this year, a public debate took place in the debating chamber of Holyrood on 'Reshaping the NHS in Scotland'. This was a unique exercise and representatives from various Royal Colleges, planners, educational establishments, health boards, physicians and surgeons, Community Councils, NHS 24, the Scottish Ambulance Service, Trade Unions, several representatives from groups affiliated to the Network, together with individual members of the public contributed to a full day's debate. This debate was recorded and is indicative of the extent to which health has become one of the major political issues in Scotland, and is likely to remain so in the run up to the next Scottish elections in 2007. ( Ref 3 ).

It is reasonable to ask if the above events would have taken place without the ground swell of public opinion which has grown throughout the country and which the SHCN helps to co-ordinate.

So a number of admirable reports have been published. However, the extent to which the recommendations contained within them are implemented will be the real measure by which the Scottish Executive will be judged.

Clearly, major problems remain to be tackled, some only very superficially touched upon above. These are comprehensively covered in Professor David Kerr's report.

We are all conscious of the advances which have been, and continue to be, made in medicine and surgery. These, of course, further raise expectations of patients and their relatives. Is it at all possible for any Health Minister to attempt to define to what extent the NHS can be expected to realistically meet those expectations? Is there potential for open and honest debate on this fundamental issue? Such openness might help to address some of the unease which lies at the heart of communities and which, to some extent, has resulted in the formation of the Scottish Health Campaigns Network.

Ref 1: Health Committee. Reshaping the NHS? Workforce Planning in the National Health Service in Scotland. SP Paper 275 Session 2 2005. ( All documents, including this, may be accessed at www.scottish.parliament.uk)

Ref 2: A National Framework for Service Change in the NHS in Scotland. Building a Health Service Fit for the Future. 2005 ( May be accessed on www.show.scot.nhs/sehd/nationalframework )

Ref 3: Health Committee Reshaping the NHS in Scotland. Public Debate Monday 11th April 2005