Downgrade by 1000 cuts

Provost Tom Kerr: Very concern over possible downgrades
Provost Tom Kerr: Very concern over possible downgrades

THE paediatric unit at St John’s Hospital could be cut to an in-patient midweek service only, cut back to a walk-in service or birth numbers limited, if critically low staffing levels cannot be resolved.

NHS Lothian has found it increasingly difficult to recruit middle grade staff and some ‘key risks’ were put to the NHS board on Wednesday.

Already it is having to pay consultants treble time to ‘act down’ to cover for junior posts and that, plus costly agency staff, are impacting on the balance sheet.

The report also says that there are safety risks inherent in the use of ‘‘external locums of unknown quality who are unfamiliar with the unit’’.

Board members this week agreed to consider short-term contingency planning at the Livingston hospital, which covers all of West Lothian, for both anticipated and unexpected possibilities, including:

nClosing of the paediatric in-patient ward at weekends to concentrate resources Monday to Friday.

nClosing the in-patient department and providing a part-time ambulatory unit, and;

nIn the event of not being able to cover neo-natal services, reducing the number of births at St John’s and only handling low risk cases.

The health board also committed to recruiting more staff, including those from New Zealand and Australia, to mitigate the risk and re-affirmed its commitment to maintaining paediatric, neonatal and maternity services at St John’s Hospital, Livingston, at its meeting.

The Action to Save St John’s Campaign said: ‘‘In every sense our assertions about the threat of downgraded services are now confirmed. But even worse than we had anticipated, they are talking about reducing the number of births at St John’s. The knock-on effects could be catastrophic. We hate to say we told you so with such an important and emotive issue, but we did.’’

The campaign has called on health secretary Nicola Sturgeon to step in.

Provost Tom Kerr from West Lothian Council said he was extremely concerned about any possible downgrading, and felt that some NHS Lothian consultants should be asked to move to St Johns, as they were employed to cover the whole board area.

He said: ‘‘It’s been of real concern to me over the last five or more years the reduction of services at St John’s. It no longer offers 24 hour surgery and my concern is that this is just another downgrading. It is almost downgrading by 1000 cuts.’’

Dr Farquharson, medical director, NHS Lothian said: “NHS Lothian is absolutely committed to sustaining safe and properly staffed paediatric, neonatal and maternity service at St John’s Hospital.”

Dr Charles Winstanley, chairman NHS Lothian, said: “We are doing all that we can and I want to reaffirm the board’s commitment to these services, which has already been expressed time and time again.”

Eddie Egan, vcice chairman and employee director, NHS Lothian, said: “It is clear there is a full financial commitment to solving these staffing challenges. It’s not about money. I would like to thank the staff at St John’s Hospital for the tremendous work they have done to support the service and keep it operating.”

nWill you be affected by any changes at St John’s? What do you want to see happen? Email our newsdesk on or phone a reporter on 01506 844592.