Concerns for patient safety if out-of-hours surgery is lost
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IF out-of-hours surgery at Caithness General Hospital is removed at any time in the future it could “lead to unnecessary deaths and a huge cost to the public purse”.
That is the personal view of local community first responder Willie Marshall who is “strongly opposed” to any move to cut the round-the-clock surgical cover at Wick. He is worried about the impact such a scenario could have on local people.
“Lives would be lost because of the need to transfer critically ill or injured patients to Raigmore but there is another worrying aspect to this scenario. Given that the ambulance cover in Caithness is already inadequate with occasions when patients have to wait for an hour or more for a response to a 999 call, any increase in the number of patient transfers to Raigmore will mean that critically ill or injured patients will be at increased risk of dying in their homes before help is available,” said Mr Marshall.
“I have some sympathy with the health authority in its desire to reduce the reliance on locum cover which is hugely expensive. But that is largely a result of previous NHS and Scottish Government policies in failing to provide adequate funding packages to attract doctors into full-time posts.
“This must be changed so that full-time posts become more attractive.”
Mr Marshall thinks more funding should be made available to attract consultants here.
“The Scottish Government and the UK Government should agree a joint initiative given that the problems in England and Wales are just as great as they are in Scotland. This could result in more funding coming our way from the UK Government. Having said that, money is not the only consideration,” said Mr Marshall, who was speaking prior to the Scottish Government providing an extra £9.4 million for the health authority.
He would like to see the quality of life in the north being stressed to attract staff and a reduction in the number of managers within the health service. “The NHS needs doctors not managers, most of whose competence could, it seems to me, be rightly questioned,” said Mr Marshall.
Asked what should be done if the health authority can’t attract people to the posts, despite the incentives, he replied: “I do not believe it will be impossible to provide sufficient incentive. If, however, that situation did arise, only a radical shake-up of the contract arrangements within the NHS could create a requirement for doctors to serve in remote or rural situations,” stated Mr Marshall.
He has no personal experience of out-of-hours surgery at Caithness General.
“But my involvement with the Scottish Ambulance Service gives me an enhanced awareness of the likelihood of a significant increase in patient waiting times for a response to a 999 call. I think few people will realise that it is already possible to wait more than an hour for an ambulance to respond to a 999 call in Thurso and this can only get worse. Should 24-hour surgical cover ever be removed in the future it is likely to lead to unnecessary deaths and a huge cost to the public purse,” he added.
NHS Highland insists it is trying to recruit consultant surgeons to fill the vacancies caused by the retirement of one member of staff and the resignation of another, which left only one surgeon in post.
It announced it was going to introduce a contingency plan at Caithness General on December 15. That would have resulted in no operations being carried out at the hospital at weekends and after 6pm on weekdays. But it did not implement the policy as it managed to find locum cover. The health authority says it wants to see more use made of the Wick hospital, not less. It has also set up a pan-Highland review of surgical cover in a bid to try and address the issue.
