Forth Valley (New Hospital)

– in the Scottish Parliament at 12:30 pm on 19 February 2003.

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Photo of George Reid George Reid Scottish National Party 12:30, 19 February 2003

The next item of business is a members' business debate on motion S1M-3864, in the name of Mr Brian Monteith, on the location of a new hospital for the Forth valley. Because of running times on the Criminal Justice (Scotland) Bill, the clocks will be stuck, but I will keep members right.

Motion debated,

That the Parliament notes the announcement by the Forth Valley NHS Board that its favoured location for a new single-site hospital for Forth Valley is the Royal Scottish National hospital site at Larbert; further notes that the board is to undertake further work including a feasibility study and transport impact assessment before submitting its outline business case to the Scottish Executive this summer; recognises that the Scottish Executive and the Minister for Health and Community Care retain the ultimate say over the location of the proposed new hospital for the area, and believes that the Executive should consider any case for a new hospital in the context of the accessibility of the hospital to the public and the consequential arrangements for community health care throughout the Forth Valley NHS Board area.

Photo of Brian Monteith Brian Monteith Conservative 12:35, 19 February 2003

I am grateful to those who have given me time to raise this matter in the chamber today.

My motives for lodging the motion and seeking the debate are not partisan. I would have written an entirely different motion if I had sought to score party-political points. In fact, I seek to raise issues that many members want to have discussed between several ministers.

I am fully aware of the strong local feelings between Falkirk and Stirling—or should I say between Falkirk bairns and the sons of the rock. Not only has this issue divided communities, it has divided political parties as they try to prove their own local loyalties. While recognising those feelings, I hope that we can address the issues in a broad and objective way, considering—as the Forth Valley NHS Board must—what is best for all Forth valley residents. It is also important that we have a debate with the Deputy Minister for Health and Community Care today so that she may respond to it.

I welcome the motion by Dr Richard Simpson that is to be discussed next week. The terms of his motion bring roads into discussion. In my estimation, that fact and the amendment by Dennis Canavan determine that the minister to respond should be the transport minister. It is important that we should hear both ministers respond to the debate because, although the transport element is important, the final decision rests with the Minister for Health and Community Care.

The question of having two general hospitals, one in Falkirk and one in Stirling, has troubled Forth Valley NHS Board for a long time—at least as far back as 1985 and possibly longer. Once the management structure for the two hospitals was merged, it was inevitable that the two hospitals themselves would merge. As an Edinburgh lad, I was not bound by tribal loyalties, and I have always supported a single site where accessibility would make travel from west Perthshire, west Stirlingshire and Clackmannanshire, as well as from Stirling and Falkirk, as simple and timely as possible. Balanced by the large proportion of people in Stirling and Falkirk themselves, Crianlarich, Killin, Balfron, Aberfoyle, Dollar and Alloa must have their needs considered, and we all understand that. I met a mother from Killin who had had four children, all of whom were delivered in Stirling royal infirmary. However, she said that, had the location of that hospital been in the centre of Falkirk, two of them would have been born in the car.

I pay tribute to the health board chairman, Ian Mullen, who has expedited the issue since the first consultation two years ago. By considering and then rejecting the proposal that either the Stirling or the Falkirk hospital should be the new site for a single hospital, he has ensured that the final decision is made on the merits of the location, rather than on the local loyalties generated in previous years by the debate on which of the two existing hospitals should be chosen.

Larbert is not Falkirk, and the second choice that was being considered, Pirnhall, is not Stirling. Forth Valley NHS Board has now chosen Larbert, and that site has many advantages. It is available and can be developed without planning delays and there is room to expand. However, its links to local roads, and to the M9 in particular, are poor. To correct that will require considerable road construction work, at great cost. Pirnhall, on the other hand, offers space for development and offers far better access to local roads, and particularly to the M9. However, the difficulty is that the planning surrounding Pirnhall could delay progress for far too long.

Forth Valley NHS Board decided to go ahead with recommending Larbert, but showed that it had some doubts by deciding to commission traffic impact studies. It is important that members are able to raise the relative merits of the sites and are able to question ministers and bring to the chamber the concerns of residents.

I ask the minister to consider the whole package, including the costs and the length of time that it might take to build the necessary roads. She should ensure that roads are part of the package and that she considers the matter holistically.

I hope that the minister takes the opportunity to discuss the matter with her transport colleague, so that there is no possibility of the roads part of the Larbert project falling between two stools. We cannot have Larbert being chosen because Forth Valley NHS Board does not have to pay for the roads and the Minister for Health and Community Care approving the project without ensuring that the roads will become part of the plan. In the long run, we could find not only that the Pirnhall option would have been easier to travel to, but that it would have been cheaper and could have been delivered before the Larbert option, with construction added in. We must get to the bottom of such questions through the two departments.

Photo of Brian Monteith Brian Monteith Conservative

I am just closing. All I ask is that ministers treat the project with an open mind.

Photo of Sylvia Jackson Sylvia Jackson Labour 12:41, 19 February 2003

Some members who have indicated that they will speak today, including Brian Monteith, represent a wider Mid Scotland and Fife regional perspective, but I will focus on the Stirling constituency, as that is the constituency that I represent. I want to discuss concerns and progress since the recent Forth Valley NHS Board decisions relating to the future Forth valley health strategy.

Locally, the decision by Forth Valley NHS Board to make the Royal Scottish national hospital site at Larbert the favoured site for the new acute hospital was a blow, given the accessibility of the proposed Stirling sites, which lie adjacent to the M9 and M80 interchange. Stirling Council has to be congratulated on the hard work that has been undertaken to have those sites considered.

The Stirling sites were seen by the board as problematic in respect of the time scale. Unfortunately, it was thought that sites such as the one at Pirnhall, which is within the proposed new growth area, would, through the local plan process, take up to two years before being available to the health board. The situation at the Corbiewood site is the reverse—business interests there wanted a quick decision by April this year, or alternative proposals would be considered. The independent report that was compiled by Ryden for the health board stated that both issues raised questions about the viability of the two sites. Therefore, time factors became critical in the discussions, and that was reinforced by clinicians on the health board, who maintained that acute services would not be maintained in the Forth valley without speedy action.

Brian Monteith mentioned that accessibility continues to be a key concern. Although the Larbert site became the favoured option, it was agreed that there would be an investigation into transport infrastructure there. The issue is important, particularly for the Stirling and Ochil constituencies and the whole Forth valley.

Although the transport study is to take place as soon as possible, I bitterly regret that, in moving to a favoured site option, the board acted in a way that failed to address the shortcomings of all the sites. I suspect that when the transport costs are assessed, the board may live to regret its haste in reaching a preferred option in advance of knowing all the cost factors in developing each site.

However, the battle is not over and we must use the time that is available to us while the transport study takes place to explore whether there are any mechanisms by which Stirling Council's local plan process can be shortened, or whether an agreement can be reached with developers in the new growth area to release a site in less than two years. I have already met Keith Yates, the chief executive of Stirling Council, and Corrie McChord, the leader of the council, to start discussions. I hope that we will move forward on the issue in a meeting that will take place soon with developers. Certainly, we are trying hard to decouple the site that could be used for the hospital from the local plan process. It should also be remembered that planning for a new hospital will take considerable time. I suspect that, if there is a one or two-year delay in knowing exactly where the hospital site will be located, that will not materially affect the building time to any great degree, especially if a public-private partnership option is to be pursued.

The siting of the new acute hospital is critical, but it is clear that the development of community health provision is also important, particularly for our rural areas—in particular, I am thinking of Aberfoyle, Balfron, Callander and Killin.

I have spoken and written to Fiona Mackenzie, who is the chief executive of Forth Valley NHS Board, to ask her to start discussions about the developments as soon as possible. She has assured me that that will happen.

Finally, I assure members that I will fight Stirling's corner, both for the residents of the city and for those who live in its rural communities. I firmly believe that that will prove to be in the interests of all residents of the Forth valley area.

Photo of Michael Matheson Michael Matheson Scottish National Party 12:45, 19 February 2003

I congratulate Brian Monteith on securing time for this afternoon's important debate.

As Brian Monteith mentioned in his opening remarks, this consultation exercise is not the first to have been carried out into how the health service should be configured within the local communities that are served by Forth Valley NHS Board. However, no one can be in any doubt that the consultation exercise on the new single-site option has proven to be effective and fair. We need only look at the figures for those who participated in the consultation exercise. Some 5,626 responses were received from across the whole of the Forth valley. If we compare that against the number of people who were involved in the previous consultation exercise, we can see that the most recent consultation was fair and that it was effective in engaging and involving people.

The consultation exercise was also fair because it was extended to allow Stirling Council time to propose other sites that it wished to be considered in the consultation process. Those sites were also measured against criteria that were fair and that were established by the health board. No one disputes how the health board should have evaluated the individual sites. The RSNH site is the only one that meets all the criteria that the health board laid down.

At more than 82 hectares, the RSNH site is of sufficient size to allow the hospital to be configured in the way that is most appropriate for offices, labs and parking. I believe that the site offers the greatest flexibility for building a new hospital within the Forth valley. I understand the many concerns that people have—in particular, those in west Stirlingshire and in some parts of Clackmannanshire—about the possibility that there may be problems in accessing any new hospital that might be built on the RSNH site. However, the site is closest to the majority of people within the Forth valley, given the fact that 63 per cent of the residents of the Forth valley are within a 15-minute drive of the site. As transport links improve, that proportion is likely to increase yet further.

In addition, the accessibility analysis that was undertaken by Forth Valley NHS Board last August highlighted that 93.43 per cent of the population are within a 30-minute drive of the site. The RSNH site also addresses the socioeconomic aspects of accessing a hospital. A major rail link is within 10 minutes' walk of the hospital site. That will allow those who do not have a car to gain access. There are also plans to improve access within the area.

I believe that now is the time to make the business case to ministers to ensure that the new hospital is built on the RSNH site. If additional factors must be taken into consideration in addressing transport links, I am sure that ministers will be prepared to work alongside the health board to ensure that those are addressed. We need to ensure that the people of Forth valley get the state-of-the-art hospital that they require as part of the best possible health service.

Photo of Lyndsay McIntosh Lyndsay McIntosh Conservative 12:49, 19 February 2003

I intend to make only a small contribution to today's debate on the motion in the name of Brian Monteith, whom I congratulate on securing time in the chamber for today's discussion.

Obviously, we all have our own viewpoint as to where the new hospital should be. I fully understand the concerns that have been expressed by Brian Monteith, whom we should perhaps not single out as the only person to harbour doubts. It will never be easy to make a decision of this magnitude that satisfies everyone. As politicians, we are only too well aware that tough choices must be made from time to time.

For my part, I welcome the announcement that a single-site hospital at Larbert is the board's favoured option. A whole host of considerations were taken into account and I do not intend to rehearse them all. Among the comments made to me was one about the growing unsuitability of the present site at Falkirk. I have been in Falkirk at peak traffic times on many occasions and I believe that it can readily be understood why a move is necessary. For no other reason than base self-interest, I think that it is perfectly understandable why the residents of Falkirk and its environs should have their fears addressed.

In the interests of balance, I point out that I am aware that people furth of Falkirk will see the decision in a different light. Brian Monteith is right to highlight the issues of accessibility, timing and cost. However, no site is ideal; if it were, we would not be having the debate.

We should note the terms of the motion: we are rightly asked to note that the matter should be considered on accessibility and community health care grounds. I sincerely hope that, when the decision is made, those factors are taken into account and that the people of Falkirk get the decision that they want.

Photo of Richard Simpson Richard Simpson Labour 12:51, 19 February 2003

I congratulate Brian Monteith on securing the debate and I thank him for his kind comments about my motion on the subject. Next week, we will talk about the accessibility issues in greater detail with the transport minister.

All members welcome the fact that, after more than 30 years, the Forth Valley NHS Board, under the chairmanship of Ian Mullen, has at long last grasped the nettle and decided to have a single- site hospital. He will not find division in the chamber on that issue. It is 30 years since I was involved in the group that proposed a single site to Sir John Brotherston. That was before the motorway from Stirling to Edinburgh was built, which meant that Bellsdyke hospital could have been provided with the links that we wanted at that point.

Constant delays have damaged the case in successive years, not least because the substantial, necessary developments at Falkirk and Stirling in the 1980s will largely be put to rest as a result of the new single-site hospital. That has been a waste of public money.

We must consider the infrastructure. All the reports that have been produced show that we must put the infrastructure for the acute hospitals on the correct basis. The board has stated that part of that should involve the new Clackmannanshire community hospital and resource centre, which is vital because it will provide not only primary services, but intermediate care, diagnostic services, rehabilitation, out-patient services and, I hope, minor accident and emergency services.

We do not need an acute services review; we need nothing less than a total review of the health service. That applies to every area in Scotland, not only to the Forth valley. I urge the Executive to use the Forth Valley NHS Board proposals as a model for examining the need for integrated care that, as far as possible, brings services closer to the patient and which leaves only acute in-patient short-term stays in hospital.

Given that the board has problems with recruitment and retention that will only get worse in the interim, early decisions are necessary. It will be important for the minister, in considering the problem, to ensure that any temporary movement of services does not endanger my constituents, particularly those in Clackmannanshire.

I will discuss accessibility in greater detail during next week's debate, but if the RSNH site is chosen, the board and the minister must balance the absence of a new Forth bridge crossing until 2007 and the probable subsequent closure of the old Kincardine bridge until 2008 with the planning disadvantages at Pirnhall. That will be a difficult decision for the minister.

I return to a theme that I wanted to develop earlier in my short speech. A modernised, integrated national health service must be addressed nationally. A strategic view must be taken in making the decision on the new district general hospital. There are problems in Livingston because of its distance from a new hospital, problems with the change in services at Perth, and problems with Dunfermline's Queen Margaret hospital's relationship to Kirkcaldy.

Without a strategic Scottish view, we—not me, I am glad to say, but our successors—might in 20 years say once again that the health service does not meet the needs of modern Scotland. A strategic view must be taken. I hope that the minister will tackle that difficult problem.

Photo of Dennis Canavan Dennis Canavan Independent 12:54, 19 February 2003

I welcome the opportunity to debate the review of acute services in the Forth valley, which has been dragging on for well over a decade. I am pleased that the Forth Valley NHS Board, at its meeting on 28 January, at last took a decision, which was unanimous, that there should be a new single-site hospital and that the favoured location is the Royal Scottish national hospital site at Larbert. I welcome that decision not simply because the RSNH site is in my constituency, but because I believe that it is in the best interests of the majority of people in the Forth valley.

When a new single-site hospital was first suggested, I expressed the view that the RSNH site was the best location and that it should emerge as the favourite. However, some politicians in the Stirling area, perhaps understandably, suggested two other sites—one at Corbiewood and the other at Pirnhall.

The health board sought to be fair to all concerned by commissioning Ryden consultants to assess the other two options, but the health board made it clear that any alternative site to RSNH must satisfy four criteria. First, any alternative site must be of sufficient size. Secondly, it must be within half an hour's car journey for at least 90 per cent of the Forth valley population. Thirdly, there must be no significant increase in costs. Fourthly, there must be no significant delay. It was obvious from the consultants' report that the RSNH site was the only one that met all four criteria. It has huge advantages over the other two options. It both belongs to the national health service, and is designated as a hospital site. Costs and planning delays would therefore be minimised.

Photo of Sylvia Jackson Sylvia Jackson Labour

How does the member think possible transport costs will be taken into account when the transport study is completed?

Photo of Dennis Canavan Dennis Canavan Independent

I am coming to that.

There were proposals to have better access to and egress from the motorway system at Larbert long before the RSNH site was suggested as a possibility for a new hospital. Proposals were required, for example, for better access to the business park on the Bellsdyke road. Brian Monteith's point about the roads department having to meet any improved infrastructure for roads has therefore been on the agenda for many years. It is clear from the Ryden consultants' report that the sites at Pirnhall and Corbiewood do not satisfy the criterion of no significant delay, and the Corbiewood site does not satisfy the criterion of no significant additional costs. The RSNH site, on the other hand, satisfies all four criteria and is therefore the best location for the new hospital.

I accept that much work has to be done, including a transport impact assessment. The new Kincardine bridge will mean better access to the hospital for people coming from Clackmannanshire, and access will also be improved if there are better links to the motorway system at Larbert, which will benefit the nearby business park.

In conclusion, I urge the Executive to take appropriate action to ensure that the new motorway links and the Kincardine bridge are constructed as soon as possible. I also urge the Executive to respond positively and quickly to the health board's case for the new hospital when it is submitted in a few months time. As I said earlier, the matter has been dragging on for well over a decade, and we have a great opportunity—the opportunity of a lifetime—to ensure that the people of the Forth valley get a new state-of-the-art hospital that will serve them well into the 21st century. It is an opportunity that must be grasped now.

Photo of Donald Gorrie Donald Gorrie Liberal Democrat 12:58, 19 February 2003

We would all sign up for Richard Simpson's concept of integrated care by having good, appropriate local facilities in Stirling, Falkirk and Clackmannanshire and having a central hospital for acute services.

The health board has conducted a good consultation—perhaps it is not perfect, but it seems better than most—and it has come to a conclusion. I think that the Larbert site is good—I have been there and know it well. I do not know the other sites, so I am not in a position to say whether they are better. However, the health board clearly preferred the Larbert site.

The most important thing that I have stressed in discussions with the health board has been the access question, especially relating to public transport. Michael Matheson mentioned the railway. It is also essential that there is a really good bus service from the train station and from other communities. After all, that is a major failing of some new hospitals in other areas. Furthermore, given the very large housing and business developments that are proposed for the Bellsdyke area, there will be a big demand for public transport. Obviously, roads will have to be improved. Presumably, the costs for such improvements can be shared out between the hospital and other beneficiaries in the community.

As other members have said, I hope that the Executive will ensure that the matter is concluded soon. If better arguments can be made for the other sites and if they can be assessed as quickly as the Bellsdyke site was, we should consider them. However, at the moment, a good proposition is on the table, and the Executive should reach a rapid conclusion on it.

Photo of Cathy Peattie Cathy Peattie Labour 1:01, 19 February 2003

I will not cover all the points that have already been covered. However, as a Grangemouth resident, I am pleased that a decision has been reached. Like Dennis Canavan, I have campaigned for a long time for a decision to be made on acute services in the area.

Good transport links are essential for any hospital, and decisions are obviously easier if there is a single concentration of population that already has such links. Where that is not the case, any decision will have more profound effects and we must consider carefully how people will be disadvantaged.

In particular, we must consider the effects of any decision on people who are socially disadvantaged and might therefore have poorer health. The population of the Falkirk Council area is greater than that of the other two council areas in Forth valley combined. Although the breakdown of health information is limited, the information that is available shows clearly that the Falkirk area has higher rates of lung cancer, heart disease and strokes than the rest of the Forth valley.

Photo of Cathy Peattie Cathy Peattie Labour

No. I am sorry, but I must continue.

The average household income varies from about £18,000 in Falkirk to £20,500 in Stirling. By constituency, unemployment is highest in Falkirk East and Ochil; long-term illness is highest in Falkirk West; and, although almost 40 per cent of school leavers in Stirling and Ochil go on to higher education, little more than a quarter of school leavers in Falkirk do so.

Because of the high level of need in Falkirk, there was enormous concern about the proposals. Almost 800 people attended the Falkirk area consultation meetings. There were 4,811 written submissions from the Falkirk area, 99 per cent of which were clear that the hospital should be located on the RSNH site. Almost 2,000 people signed petitions that supported the choice of that site; more than three quarters of the questionnaires that were returned came from the Falkirk area; and of the 5,345 letters and questionnaires that were received, 5,193 supported the choice. As a result, I believe that the RSNH site is the natural choice for a new hospital.

The site might not be convenient for people who favour private health care interests. However, it is large enough, it is already owned by the health board and it is near enough to the motorway. On that last point, I look forward to next week's debate and other discussions on the transport infrastructure.

As long as community hospitals are maintained to sufficiently high standards, I believe that the site represents the best solution for Forth valley. It is important that the health board begins real consultation and perhaps does some lateral thinking on the delivery of primary care services. It is time to stop going over the same old ground; instead, we must look forward and find out how we can achieve the best for all the residents of the Forth valley.

Photo of Bruce Crawford Bruce Crawford Scottish National Party 1:04, 19 February 2003

Members have pointed out that the issue has a long history: some have mentioned 30 years, others have mentioned 10 years. Whatever the length of time, the issue has been too long in the melting pot. Earlier consultations have ended in confusion, failure, disappointment and disengagement and no final decisions have been reached. As a result, I am glad that on this occasion a decision has actually been made.

At the beginning of the consultation, I was worried that the process would fall into disrepute. However, I have been greatly heartened by Forth Valley NHS Board's consultation exercise, which was better than others that I have witnessed in Fife and in the Tayside area. The consultation was comprehensive and effective. I think that we all agree that the decision to have a single-site hospital is right.

Questions still need to be asked. I say to Dennis Canavan that it is our job as politicians not to do down other potential sites, but to ensure that we get the best option for all the central Scotland area that the Larbert hospital will serve. I understand why Forth Valley NHS Board decided that Larbert is the preferred site. However, I am concerned that irrevocable decisions will be taken without the necessary long-term strategic perspective that would consider all the sites and, as others have said, the primary care aspect. Perhaps that aspect should have been central to the consultation.

Photo of Bruce Crawford Bruce Crawford Scottish National Party

No. I do not have much time.

It is obvious that if primary care had been at the centre of the consultation process, and the transport study issues had been considered beforehand, the process could have been greatly strengthened.

Larbert might be the correct site and the sites that Stirling Council identified at Corbiewood and Pirnhall might have associated challenges, but any site has those. I believe that Stirling Council must be given every opportunity to ascertain whether the problems of the Corbiewood and Pirnhall sites could be overcome, because the sites deserve the opportunity, as do the people of Stirling and of Falkirk. If those sites were given a further opportunity, they might end up being better options. However, after further investigations, Larbert might still come out at the top of the list.

Whatever happens—whether the preferred site is Larbert, Corbiewood or Pirnhall—we must have a real examination, as others have said, of the impact on the rural communities of Aberfoyle, Callander, Balfron and the Strathendrick area, particularly in relation to community health facilities. There is a black hole in those communities that must be filled, whatever the circumstances. The Deputy Presiding Officer has been involved in the campaign for, and has a long-standing commitment to, a hospital in the Clackmannan resource centre area. Something like that should be considered for the Strathendrick area and the Callander and Aberfoyle area for the future.

The public transport issue must be investigated further to ensure that we get the links right between whichever town the hospital is eventually sited in and the towns that are furthest away. That must be a prerequisite for the future.

Let us take a wee bit longer to get the decision dead right so that we have the right option for the whole Forth valley area, which deserves such a chance.

Photo of David Davidson David Davidson Conservative 1:08, 19 February 2003

I wanted to speak in the debate because it is important. I used to be involved in consultation processes as a former resident and councillor in Stirling. I was the councillor for the Trossachs ward, which is a rural area, and I felt that the biggest issue—which has only just begun to be addressed and which was referred to fleetingly by Sylvia Jackson and Bruce Crawford—was the rural hinterland of north-west Stirling. I defy anyone to make the journey from that area to the proposed site by car in 30 minutes during the summer tourist months; it cannot be done. During the tourist season, it used to take me more than half an hour just to get from the back of Aberfoyle into Stirling. What I am concerned about is not the routine, high-quality medical care that the existing hospitals currently supply—I am sure that any new hospital would do the same—

Photo of David Davidson David Davidson Conservative

May I just finish my point?

I am concerned about emergency access rather than primary care facilities that could take some of the load away from the rural areas. There is no public transport from such areas, anyway. What about provision for accident and emergency, maternity services and cardiac arrest? Wherever the hospital is sited, accessible emergency service care for the whole of the Forth valley area must be built into the planning. The issue is about patients' needs, not just about convenience because there is a nearby bus route. People can make a journey for routine medical attention and it does not matter whether that takes 30 or 45 minutes. However, emergency treatment is important.

Photo of Dennis Canavan Dennis Canavan Independent

If there were an accident or emergency in the Aberfoyle area, someone would probably be quicker going to a hospital in Glasgow than to one in Stirling. Indeed, some people in the Aberfoyle area use national health services in Glasgow rather than those in Stirling.

Photo of David Davidson David Davidson Conservative

The medical practices have an option about where to send patients, but that would work only in routine circumstances. I would not recommend trying to get into Glasgow from the rural hinterland of Stirling in a hurry in the tourist season, with all its associated problems.

The minister should pay attention to the fact that the issue is not just one of ease for the majority. The same level of care must be available to everyone. By having outreach units to supply some of the consultants' care, or by using the model that operates in Aberdeen and Grampian, where community hospitals are serviced from the centre, a lot of the problems of movement and transportation could be dealt with. It is vital that the rural hinterland of Stirling is considered in relation to emergency care on the basis of the worst transport conditions that might arise. I have no doubt that parts of Clackmannanshire fall into the category that we are talking about, although the situation is a little better in the Falkirk area.

Photo of Bruce Crawford Bruce Crawford Scottish National Party

Crieff community hospital does some emergency work, such as cardiac treatment, and allows other services to be delivered. Does Mr Davidson agree that that model would work in the Stirling area?

Photo of David Davidson David Davidson Conservative

I agree. I am asking the minister to consider those options and to try to find a way in which such services can be delivered in that area. When I was a councillor in the area, people were desperately worried about the removal of a hospital facility from Stirling. That fear was based not on the usual turf wars between Stirling and Falkirk, but on the need for access at times of emergency.

Photo of Mary Mulligan Mary Mulligan Labour 1:11, 19 February 2003

I listened with interest to Brian Monteith's remarks and to the positive speeches by other members, all of whom have an interest in modernising and improving the health services for all the people of the Forth Valley NHS Board area.

It has been evident from today's lively debate that there is broad support for Forth Valley NHS Board's initiative to develop a new hospital for its area on a single site. That support comes from the public, their representatives, national health service staff and other stakeholders.

The shape of hospital services in the area has been under discussion for some time, as many members have said. In the past couple of years, the NHS board and trusts have been concerned with identifying a way to ensure that safe, sustainable and accessible services can be enjoyed by all. There was a real possibility that, otherwise, hospital-based services for residents in the area would end up being provided from outside the region.

I think that the NHS board would agree that some difficult points were encountered along the way. However, the board has succeeded in developing options for clinically sustainable and affordable models of care. The recent consultation exercise has been thorough and wide-ranging, as many members noted. It went beyond public consultation to embrace engagement and involvement. All local people and organisations had the opportunity to have their say.

Photo of Bruce Crawford Bruce Crawford Scottish National Party

Does the minister agree that the consultation process would have been strengthened if it had wrapped in primary care issues with the acute care issues that were dealt with?

Photo of Mary Mulligan Mary Mulligan Labour

It is important that primary care issues continue to be considered in the on-going discussions. We have not reached the end of the process by any means. There is still a lot of work to be done.

The board specifically sought views on the development of a single acute hospital to serve the population of the area; proposals for community-based health services, including a community hospital in Clackmannanshire, which would incorporate a new health centre for Alloa; the best location for a new acute hospital; what factors should be taken into account in choosing a site; and, importantly, what immediate changes needed to be made to ensure that safe, high-quality services could be maintained until the long-term vision was realised.

The public's feedback from the consultation has been encouraging, with more than 5,500 responses. The board, the public and other stakeholders are to be commended for their active involvement and for ensuring that the exercise was conducted openly. One of the key outcomes of the consultation was the increasing level of public involvement in the shaping of NHS services. I want the board to continue in that way, and I know that the chair, the board members and Fiona Mackenzie, the chief executive, share my view.

Ultimately, it is for the board to decide on the organisation and location of health services in its area, but it must ensure that those services represent best value for all the people of the Forth valley. The board must also demonstrate that effective linkages will be made between primary and secondary care to create the fully integrated services for which Richard Simpson asked. Those services must deliver for the patient in the right place at the right time.

It is evident from this afternoon's debate that there are areas of concern to members. Those areas include accessibility and the further development of health services in the community. As part of the consultation exercise, the board proposed key access criteria, including

"accessibility to a minimum of 90% of the population within 30 minutes by car, and with the potential for appropriate public transport links to all main population centres within Forth Valley".

That recognises that it will not be possible for 100 per cent of the population to realise that 30-minute access. However, I say to Mr Davidson in particular that discussions must also take place with the Scottish Ambulance Service, particularly on accidents and emergencies, in which the service is called on to stabilise a patient wherever it picks them up and ensure their safe delivery to the hospital. There is, therefore, less of an issue about how long it might take for even an emergency ambulance to access a hospital. Those are the kind of developments that we want in the Ambulance Service and which will allow safe transport in future.

The board has been able to take account of the impact of the proposed Alloa rail link and the planned new Forth crossing at Kincardine. That investment in the transport infrastructure will make a significant impact on accessibility, especially for the 80,000 residents of the wee county. I am sure that we will return to that subject in the transport debate next week.

I understand that the board's chair and chief executive are to meet the three local authorities shortly to discuss how the development of community health services might be taken forward. The board is considering using the same successful model of involving local people, staff and key stakeholders as was used previously.

The overriding issue is that the future configuration of health services in the Forth valley, as in the rest of Scotland, must be clinically safe, achievable and financially sustainable. The board is approaching the task of identifying options and reaching decisions openly and even-handedly. It is very important that the public are engaged and involved in the process. I believe that Forth Valley NHS Board is doing its best to achieve that. For example, the board has placed all the relevant consultation documents on the worldwide web and made them available to anybody who wants them. That is the kind of involvement that we want.

I expect Forth Valley NHS Board to be able to demonstrate that it has listened and taken into account local opinion, as well as all the representations made and data provided to it. It is easier for the board to demonstrate that since the restructuring of health boards 18 months ago.

It is evident from the debate that there is consensus that what is required for the people of the Forth valley is one centre with well-developed, modern, local services. The board will take further independent advice on location issues before a final decision is made. We expect the transport impact study to be thorough and to have been consulted on when we receive it. We will look to Forth Valley NHS Board to develop its ideas on future patterns of primary and community care in partnership with the local community.

Of course, any proposals for major changes, such as those that we have discussed, will require the approval of my colleague Malcolm Chisholm, the Minister for Health and Community Care. That will give the Executive an opportunity to ensure that the proper processes have been followed and that all relevant information has been taken into account. It is inevitable that not everyone will agree with the board's decision on the location, but it is clear that there can be only one new hospital in the Forth valley and that it can be in only one place.

I have listened to the points that have been raised today, and members can be sure that Forth Valley NHS Board will be made aware of the debate. However, the development of a new hospital, important as it is, is only a part of a wider, continuing review of NHS services in the Forth valley. I am sure that the public, their representatives and staff will support the NHS board to make whatever decision is eventually taken work—and work well—for all the people of the Forth valley.

Meeting suspended until 14:00.

On resuming—