Paediatrician warns about falling care standards
Drop in staff levels blamed as posts left unfilled
THE future of children’s wards in as many as four Scottish hospitals should be reviewed amid safety concerns about the standard of care, a senior paediatrician has warned.
Dr Peter Fowlie, Scotland officer for the Royal College of Paediatrics and Child Health, says vacancies for paediatric staff are so severe it would potentially be better for children to travel further, than rely on an unstable service nearer home.
He described locums flying in from Europe for days at a time to provide medical cover and said there were stories raising questions about the suitability of some of them.
Dr Fowlie said: “There just simply are not enough staff, with all the working-hours rules and regulations and the feminisation of the workforce and maternity leave, to support the rotas and out-of-hours cover in all of the paediatric units.”
His comments come after gaps in the core paediatric workforce around the country were revealed by The Herald.
Some health boards are operating with half the number of middle-grade children’s specialists they need, unfilled posts have been repeatedly advertised, and in the Borders two jobs have been unfilled for two years.
Managers in some areas rely on locums and on occasions consult- ants working successive days and nights to keep services running.
Dr Fowlie, who works as a consultant in Scotland, said the situation meant there was a risk a parent would one day arrive at their local hospital to find there was no paediatric doctor there.
He said: “It is very possible that there might not be a doctor there or if there is a doctor there it might be someone who does not have the training because if you rely on locums, which many of these hospitals have had to do
There is anecdotal evidence that services have ended up with a locum who with hindsight ... has been unsuitable
over the last few years, you cannot be as comfortable with the standard of that locum compared to someone who is part of the established workforce. These people will literally drive up or fly in for a couple of nights work and disappear again.”
He said references were obtained for such temporary staff, but added: “There is anecdotal evidence that services have ended up with a locum who with hindsight … has been wholly unsuitable.”
The Royal College has set out 10 minimum standards that all paediatric units should meet. Asked how many units would face re-organisation if these were applied in Scotland, he said: “There would probably be discussion around three or four.”
The number of consultant paediatricians in Scotland has hardly changed in the last four years and there has been a 20% fall in consultants in community paediatric services.
Health Secretary Alex Neil told the Scottish Parliament last week there was a 34% rise in paediatricians since 2006 but it emerged the number peaked in 2009 and has been around 220 since.
Jackie Baillie, Labour’s health spokeswoman, said: “The SNP promised that no services would be cut. To find out that there has been a reduction in paediatric doctors since 2009 really does put at risk the ability to keep local paediatric services open.
“Once again, there is an expert voice raising concerns about the NHS under the SNP’s watch.”
AScottish Government spokes-person said: “It is the responsibility of NHS boards to plan and deliver clinical services, including paediatrics, and NHS boards are required to consider relevant local issues and demographic changes and assess the resultant demands and implications for service delivery.
“The use of locum medical staff supports NHS boards to ensure service continuity during times of planned and unplanned staffing gaps.”
FINANCE Secretary John Swinney has asserted in regard to the reduction of the UK’s triple-A rating that an independent Scotland would do much better. It has to be said that ultimately the independence vote will be won or lost on the economic arguments, national and personal.
I am one of the 50% of employed Scots who are state employees, and whose salary is paid by the state from tax receipts. If one assumes that all tax receipts up until the date of independence pass to the Westminster Treasury, from where will a new independent Scottish Treasury get the money to pay my first monthly salary after Independence Day (ID)? If ID falls in March as the SNP hopes, and the present tax payment days continue to be July 31 and January 31, the new Scottish Government will have little income for three to six months, and will have to seek credit from before ID just to pay the salaries of 50% of the working population, together with the welfare payments to another 25%.
Given the expectation that a residual UK Government will pass £11bn of the present UK national debt on to the new Scotland, that is likely to mean an initial independent Scottish debt of perhaps £13-£14billion, perhaps 40% of Scottish GDP. No fire sale of legacy UK assets in Scotland will match that.
What would an independent Scottish Government credit rating be; AAA or CCC, or junk?
Finally, would I be paid at the end of March 2016? These are the real questions the SNP needs to answer. Gavin R Tait, 37 Fairlie, East Kilbride. GOVERNMENT borrowing is to rise and Britain’s credit rating has been downgraded. I would say the last of the Tory credibility was gone if I thought it had any left before this happened. The point of austerity was supposedly to “sort out the nation’s finances”. Yet this downgrade combined with the announcement that borrowing is to rise proves this is a failure. Perhaps supporters of austerity should come clean about what they really want and admit that this is just a cover for removing social protection.
The Government has demonstrated that it is not competent and has no ability to improve the economy. Its policies do not work, yet it is refusing to change them. It is time for it to go. Iain Paterson, 2F Killermont View, Glasgow. ROSS Martin’s article (“Putting the public back at heart of public services” , The Herald, February 23) carried the highlighted phrase “gone are the days of centralised command and control”. That may be the case where Mr Martin lives, but it’s not a general truth in SNP-controlled Scotland where we have an unheralded centralised police force and fire service answerable to Holyrood Ministers and, in the council tax freeze, the centralisation of economic control over local government budgets in the hands of the Scottish Government.
Furthermore, the Scottish Government’s emphasis on Community Planning Partnerships (CPP), which are designed to bring more efficient management to the delivery of public services, does so at the cost of local democratic control and accountability.
Far from centralised control melting away, the Scottish Government controls the budgets of all 33 local authorities and the management structures of our police force, including the numbers of policemen on our streets. It also, fearful that the wrong decisions may be taken locally, dictates the numbers of teachers in our schools. Thanks to the policies of the Nationalists, local authorities across Scotland have just completed budgets with cuts to vital social, housing and education services with no ability to vary their income in compensation.
The return of a few village halls to the control of local committees may be desirable in cementing an appearance, and perhaps even the reality, of a type of localism. But it is no substitute for real local democracy delivering the vital services the public needs with the support of central government. The extreme centralising tendencies of the SNP at Holyrood are a hindrance, not a help, to the realisation of active and effective local democracy and they do not, whatever the opinion of Ross Martin, deliver the death of centralised command and control: quite the opposite. Alex Gallagher, Labour councillor, North Ayrshire Council, 12 Phillips Avenue, Largs.