Tuesday, 27 March 2007
STV - Not a TV Station
A friend of mine asked me the other day, how the single transferable vote works, or STV. It's the voting system that is going to be used for the council elections and is a form of proportional representation. It's going to lead to a major shake up in councils across Scotland. Anyway, I promised my friend that I would post a full explanation of STV and the Additional Member system on my blog. Which is probably why I haven't written here for some days. It will appear in due course.
Wednesday, 21 March 2007
Bonnie Jean
Lets start with a wee test. How many of you have heard of John Crofton? Rachel Carson? Tim Berners Lee, anyone? If you haven't heard of them, don't feel bad. These people all did something useful, and the curse of being useful, is that you generally don't get attention. No good news is news.
Which brings me to another useful person who gets very little attention; Jean Turner. I was at a Stobhill meeting with her in Kirkintilloch the other night and it was a reminder to me, of just how much I have to learn, before I'm upsides with Jean on the health brief. Jean could tell you what an ACAD is, standing on one leg. She could explain how all the different areas of health care connect; what step down beds are; what the implications of merging health visitors with district nurses are; what can go wrong in the most routine of operations which would require emergency attention and so on. For the past four years, Jean has been sharing that expertise with anyone who would listen in the Scottish Parliament and because of her things are much better up here than they are down in England. But most of the people I speak to say 'Who's Jean Turner?' Well, it's time you knew.
( By the way, John Crofton came up with the definitive cure for TB in the 'fiftes, Rachel Carson was a microbiologist who wrote 'The Silent Spring' and stopped the indiscriminate use of pesticides and Tim Berners Lee was the inventor of the Internet. So now you know.)
Which brings me to another useful person who gets very little attention; Jean Turner. I was at a Stobhill meeting with her in Kirkintilloch the other night and it was a reminder to me, of just how much I have to learn, before I'm upsides with Jean on the health brief. Jean could tell you what an ACAD is, standing on one leg. She could explain how all the different areas of health care connect; what step down beds are; what the implications of merging health visitors with district nurses are; what can go wrong in the most routine of operations which would require emergency attention and so on. For the past four years, Jean has been sharing that expertise with anyone who would listen in the Scottish Parliament and because of her things are much better up here than they are down in England. But most of the people I speak to say 'Who's Jean Turner?' Well, it's time you knew.
( By the way, John Crofton came up with the definitive cure for TB in the 'fiftes, Rachel Carson was a microbiologist who wrote 'The Silent Spring' and stopped the indiscriminate use of pesticides and Tim Berners Lee was the inventor of the Internet. So now you know.)
Saturday, 17 March 2007
We Need Helicopters
The newsletter of the NHS Consultants' Association just came out today. In it was an article by Evan Lloyd, who is a Consultant Anaesthetist(hurray, spelt it right) in Edinburgh. He talked about the principles that were used in treating the wounded in Korea by American teams, where the injured were evacuated by helicopter with on board paramedics.
Minor injuries were treated on site, major ones which could wait were sent on, while others were stabilised and then sent to the major unit. He comments,
'If this was found to be the best management system when helicopter transport could be virtually guaranteed, how much more important is it for land based travel in an ambulance? For example, though the Lanarkshire health board state that the ambulance transit time between Monklands and Wishaw is only 20 minutes, ambulance drivers state that this is the best possible time, and that in rush hours it could be twice or three times as long.'
He continues,
'On purely medical grounds it would surely be better to maintain Monklands A&E in the middle of an area which has one of the highest rates of MI (heart attack) in the world. It is obviously unfair on ambulance paramedics and unsafe for severely ill patients whether trauma or medical, for the medical responsibility for a case during long transport times,to be left to a paramedic.' Give this man a medal for speaking out.
Now do you think that NHS Lanarkshire will a) reprieve the hospital; b)provide helicopters to Wishaw;or c)run a Wee Happy Bus service for heart attack victims, to Wishaw? We'll c..
Minor injuries were treated on site, major ones which could wait were sent on, while others were stabilised and then sent to the major unit. He comments,
'If this was found to be the best management system when helicopter transport could be virtually guaranteed, how much more important is it for land based travel in an ambulance? For example, though the Lanarkshire health board state that the ambulance transit time between Monklands and Wishaw is only 20 minutes, ambulance drivers state that this is the best possible time, and that in rush hours it could be twice or three times as long.'
He continues,
'On purely medical grounds it would surely be better to maintain Monklands A&E in the middle of an area which has one of the highest rates of MI (heart attack) in the world. It is obviously unfair on ambulance paramedics and unsafe for severely ill patients whether trauma or medical, for the medical responsibility for a case during long transport times,to be left to a paramedic.' Give this man a medal for speaking out.
Now do you think that NHS Lanarkshire will a) reprieve the hospital; b)provide helicopters to Wishaw;or c)run a Wee Happy Bus service for heart attack victims, to Wishaw? We'll c..
Coatbridge College Cool Dudes
Vanity has its price.
On Thursday, I was going to hand out leaflets outside Coatbridge College. It was an absolutely miserable day, and normally I would have opted for my anorak, but knowing the cool dude company that I would be moving in and not wanting to look like-well, an anorak, I went for my Matrix style leather coat. I hope I looked cool. I can tell you I was absolutely frozen. I am now sitting at home with a very uncool cold and a nose like Rudolph. So I hope you're all grateful and that you'll all vote for me. Cool running,guys..
On Thursday, I was going to hand out leaflets outside Coatbridge College. It was an absolutely miserable day, and normally I would have opted for my anorak, but knowing the cool dude company that I would be moving in and not wanting to look like-well, an anorak, I went for my Matrix style leather coat. I hope I looked cool. I can tell you I was absolutely frozen. I am now sitting at home with a very uncool cold and a nose like Rudolph. So I hope you're all grateful and that you'll all vote for me. Cool running,guys..
Thursday, 15 March 2007
Does Anyone Care About Mental Health?
Just before I launch into this post, I'm going to place a rant alert here. You have been warned.
Right; does anyone care about mental health? Does anyone care about people with brain injury, dementia, Downs, bi polar disorder, depression or do you just wish that they would all go away and be swept under a carpet somewhere where we can't see them? Do you think they are a drain on resources that we could be spending on such vital things as tax breaks, or shoring up unpayable debts from private sector consortia? Do you think that these people are a waste of space and do not have a right to exist?
What's brought this on, I hear you ask? Let me tell you. Our Health board have just announced that the learning disabilities suite that was planned for Strathclyde Hospital, is going to go to Kirklands hospital instead. Not much wrong with that you might think. It's just that Kirklands has been going through a phased process of closure for the past three years, where the patients from it are being placed into the community. So not only is there now doubt about whether Strathclyde hospital will stay open; there is also doubt over whether the learning disabilites suite is going to be built at all. Why would you build a new facility at a hospital that is already closing?
We in Lanarkshire have learned to live with the foibles of the Health board over mental health and elderly care. Just recently they were proposing two new build 112 bed mental health wards, one at Monklands and one at Hairmyres. Now the one at Monklands has been dropped; they are going to refurbish some wards in the existing building, while the build at Hairmyres is going ahead. Again, the people of East Kilbride saved up money to build a new hospice on the Hairmyres site. The Health board said they would give them land for it. Then the Health board reneged on the deal and tried to take the money that was saved up for the hospice, saying that people preferred to stay at home when they were dying.
And we are still trying to work out how a cancer centre that is any use, is going to be run at Monklands, when they have no MRI scanner and the lab services are going to Wishaw. Watch this space after the election to see where that goes.
The argument that is constantly used against people like myself, is that we prefer an institutional model of care. People should live in the community, not in institutions,and any concerns about housing allocation, adequate funding, special treatments such as brain injury units and occupational therapy, the provision of properly trained carers; all this is brushed aside with the sweep of a hand. When the larger institutions were shut in the eighties and care in the community became the buzzword, these concerns were ignored. The result was that many of these people ended up in jail on a regular basis for petty offences such as shoplifting and vagrancy, because they were not properly supported. When a review of the policy was done, the one place that was left out of the review, was prisons. Others just slipped through the cracks; a house fire here, someone choking to death on their food there, goes largely unnoticed by the papers.
So what's going on? well, when someone is tranferred to the community in this fashion, they become the charge of the local authority. The health board will pay a dowry on the patient (in our area it's 39k per year) but the local authority has to look after such things as day to day care, housing and so on. It's a way of tranferring fiscal responibility from the NHS to the local social work budget. This then frees up the NHS to sell the day hospital, which is no longer in use. This has become increasingly common practice because of PFI and the debts incurred; also because of what is known as 'capital charge'. This is an annual charge the NHS has to pay to the Treasury on the value of their land and and equipment, and has been a major driver in day hospitals shutting and general hospitals being shifted to out of town sites, where the charges are lower. The closure of the Western, Queen Mum and Yorkhill in favour of a shift to the Southern General is a case in point. Bye bye maternity units and mental health wards; hello housing developers.
One last point; in November I asked if the £300 million that had been set aside for primary care in our area, was ringfenced. It's not, so if the Health board decides that it's going to use the money to service its debt, it can do it. NHS Lanarkshire, we are watching you..
Right; does anyone care about mental health? Does anyone care about people with brain injury, dementia, Downs, bi polar disorder, depression or do you just wish that they would all go away and be swept under a carpet somewhere where we can't see them? Do you think they are a drain on resources that we could be spending on such vital things as tax breaks, or shoring up unpayable debts from private sector consortia? Do you think that these people are a waste of space and do not have a right to exist?
What's brought this on, I hear you ask? Let me tell you. Our Health board have just announced that the learning disabilities suite that was planned for Strathclyde Hospital, is going to go to Kirklands hospital instead. Not much wrong with that you might think. It's just that Kirklands has been going through a phased process of closure for the past three years, where the patients from it are being placed into the community. So not only is there now doubt about whether Strathclyde hospital will stay open; there is also doubt over whether the learning disabilites suite is going to be built at all. Why would you build a new facility at a hospital that is already closing?
We in Lanarkshire have learned to live with the foibles of the Health board over mental health and elderly care. Just recently they were proposing two new build 112 bed mental health wards, one at Monklands and one at Hairmyres. Now the one at Monklands has been dropped; they are going to refurbish some wards in the existing building, while the build at Hairmyres is going ahead. Again, the people of East Kilbride saved up money to build a new hospice on the Hairmyres site. The Health board said they would give them land for it. Then the Health board reneged on the deal and tried to take the money that was saved up for the hospice, saying that people preferred to stay at home when they were dying.
And we are still trying to work out how a cancer centre that is any use, is going to be run at Monklands, when they have no MRI scanner and the lab services are going to Wishaw. Watch this space after the election to see where that goes.
The argument that is constantly used against people like myself, is that we prefer an institutional model of care. People should live in the community, not in institutions,and any concerns about housing allocation, adequate funding, special treatments such as brain injury units and occupational therapy, the provision of properly trained carers; all this is brushed aside with the sweep of a hand. When the larger institutions were shut in the eighties and care in the community became the buzzword, these concerns were ignored. The result was that many of these people ended up in jail on a regular basis for petty offences such as shoplifting and vagrancy, because they were not properly supported. When a review of the policy was done, the one place that was left out of the review, was prisons. Others just slipped through the cracks; a house fire here, someone choking to death on their food there, goes largely unnoticed by the papers.
So what's going on? well, when someone is tranferred to the community in this fashion, they become the charge of the local authority. The health board will pay a dowry on the patient (in our area it's 39k per year) but the local authority has to look after such things as day to day care, housing and so on. It's a way of tranferring fiscal responibility from the NHS to the local social work budget. This then frees up the NHS to sell the day hospital, which is no longer in use. This has become increasingly common practice because of PFI and the debts incurred; also because of what is known as 'capital charge'. This is an annual charge the NHS has to pay to the Treasury on the value of their land and and equipment, and has been a major driver in day hospitals shutting and general hospitals being shifted to out of town sites, where the charges are lower. The closure of the Western, Queen Mum and Yorkhill in favour of a shift to the Southern General is a case in point. Bye bye maternity units and mental health wards; hello housing developers.
One last point; in November I asked if the £300 million that had been set aside for primary care in our area, was ringfenced. It's not, so if the Health board decides that it's going to use the money to service its debt, it can do it. NHS Lanarkshire, we are watching you..
Tuesday, 13 March 2007
No Synergy in Sight (Allyson Pollock lectures part 2)
After the heady heights of fame, back to sober reality, and it doesn't come much more sober than the current state of the NHS. As I already informed you, I was at the Allyson Pollock lectures up at Edinburgh University yesterday. It is so pleasant to listen to a lecture that is clear, informed and totally bumff free. A complete lack of annoying buzz words like 'rationalisation' 'fit for the 21st century' and my pet hate 'synergy'. Who in the name of the wee man thought that one up, I'll never know.
Joking apart, it was also a very alarming lecture. I left rather green about the gills at the end; the reason being that Prof Pollock had been talking about the new GP contract and what it was going to allow private health firms to do.
To give a very brief summary, GPs used to have a direct contract with the NHS. The contract would be between the NHS and the GP and that was it. Simple. The new agreement means that the NHS can have a contract with a provider of healthcare; that can be anything from a single GP, to a multinational company. This nearly happened up at Harthill GP practice, where SERCO were trying to move in. After an almighty fuss, letters to the Herald and protests from the locals, it was agreed that one of the GPs who was already in the practice, should be allowed to take over.
Now you might ask; what does it matter if a multinational takes over, so long as they provide the care? Well, here's why it matters; primary care is about 80-90% of all healthcare and it is the area that pharmaceutical companies are particularly interested in. They pay out big sums of money to companies like SERCO to promote their drugs, and the healthcare company in turn, helps them to meet their sales targets. But it gets worse still. Up in Stracathro, a new ACAD has been built (Ambulatory Care and Diagnostics Unit). It's really a kind of glorified outpatient unit and will do minor operations. Netcare, a South African company, have been brought in to run it. Now, the ACAD has been given money to do 15 000 operations per year, for three years. But what happens if there aren't 15 000 patients to go there? Well, Netcare get paid exactly the same. So in order to maximise the usefulness of the ACAD, NHS Lothian is going to have to scrabble about to find enough patients to send there, so that it doesn't lose money.Now you might think that it would be easy enough to find 15 000 patients, but here's the rub; Netcare will only take them if they're minumum risk patients that are pretty healthly. They won't take patients that really are sick. So the NHS absorbs all the risk and the private company takes all the profit. I don't think even Maggie Thather would agree with a private company that wouldn't take normal marketing risks. There'll be more on this subject, when I can face thinking about it. In the meantime, the third and final lecture is this Monday coming, the McEwan lecture hall, 10-12. GO!!
Joking apart, it was also a very alarming lecture. I left rather green about the gills at the end; the reason being that Prof Pollock had been talking about the new GP contract and what it was going to allow private health firms to do.
To give a very brief summary, GPs used to have a direct contract with the NHS. The contract would be between the NHS and the GP and that was it. Simple. The new agreement means that the NHS can have a contract with a provider of healthcare; that can be anything from a single GP, to a multinational company. This nearly happened up at Harthill GP practice, where SERCO were trying to move in. After an almighty fuss, letters to the Herald and protests from the locals, it was agreed that one of the GPs who was already in the practice, should be allowed to take over.
Now you might ask; what does it matter if a multinational takes over, so long as they provide the care? Well, here's why it matters; primary care is about 80-90% of all healthcare and it is the area that pharmaceutical companies are particularly interested in. They pay out big sums of money to companies like SERCO to promote their drugs, and the healthcare company in turn, helps them to meet their sales targets. But it gets worse still. Up in Stracathro, a new ACAD has been built (Ambulatory Care and Diagnostics Unit). It's really a kind of glorified outpatient unit and will do minor operations. Netcare, a South African company, have been brought in to run it. Now, the ACAD has been given money to do 15 000 operations per year, for three years. But what happens if there aren't 15 000 patients to go there? Well, Netcare get paid exactly the same. So in order to maximise the usefulness of the ACAD, NHS Lothian is going to have to scrabble about to find enough patients to send there, so that it doesn't lose money.Now you might think that it would be easy enough to find 15 000 patients, but here's the rub; Netcare will only take them if they're minumum risk patients that are pretty healthly. They won't take patients that really are sick. So the NHS absorbs all the risk and the private company takes all the profit. I don't think even Maggie Thather would agree with a private company that wouldn't take normal marketing risks. There'll be more on this subject, when I can face thinking about it. In the meantime, the third and final lecture is this Monday coming, the McEwan lecture hall, 10-12. GO!!
Monday, 12 March 2007
Fame! Fortune! Men! (well, two out of three ain't bad..)
Whoa! Your humble blogger has just found out that this blog (yes, this one) has been featured in today's Herald Diary. The gorgeous Ken Smith has printed a section from the post on 'How to Run a Conference on Hospital Closures' and thinks that this blog is funny! We are not worthy. For those who want a look, the Diary page is here. For those of you who are blogger virgins,click on the link that says February and just keep scrolling down to have a look at the hospital closure post. There's lots to see.
Thanks Ken, I'll dance at your wedding..
Thanks Ken, I'll dance at your wedding..
Allyson Pollock Lectures (part 1)
The sun is shining, the birds are singing, there's a castle on a hill and I have just finished listening to one of the most informed speeches on the NHS I have heard. So where are you all? Why are you not here? There's one more lecture to go on the 19th March and it's free (unlike the NHS which is going to hell in a handcart). Come and listen to someone who knows what they're talking about. Mon 19th March, 10 -12. And it's FREE!
Thursday, 8 March 2007
Heart Attack Friendly Times for Glasgow - A Study
As our health boards are compiling studies of this and that, we thought that we would compile a wee study of our own, on when you can have a heart attack in Glasgow, if you have to travel to the Southern General. Here are our intrepid traffic academics' results.
Good heart attack times; any time before 7am and after 12 midnight, when roads are clear.
Bad heart attack times; between 8 and 10 am; between 4 and 7pm most days; after 7pm when traffic in the Clyde tunnel is reduced to one lane; any time there is a match at Ibrox.
Heart Attack Avoidence; do not listen to football matches on your car radio,between 4 and 7pm, while driving through the Clyde tunnel, especially European fixtures. You'll be DOA.
Good heart attack times; any time before 7am and after 12 midnight, when roads are clear.
Bad heart attack times; between 8 and 10 am; between 4 and 7pm most days; after 7pm when traffic in the Clyde tunnel is reduced to one lane; any time there is a match at Ibrox.
Heart Attack Avoidence; do not listen to football matches on your car radio,between 4 and 7pm, while driving through the Clyde tunnel, especially European fixtures. You'll be DOA.
How Many Roads Must a Man Travel Down (Before He gets to Wishaw)
I was watching Panorama the other night; in it, their reporter had been challenged to reduce his 'carbon footprint' by 20%. At one point his wife had to go to hospital because she was about to give birth. Do you know how they got there? They walked. Yes, gentle reader, their hospital was within walking distance of their house. (there has been no word as yet of divorce proceedings from the wife.)
This made me ponder on how we have become more green conscious, but at the same time we are creating a society in which you can only exist if you possess a car. Because hospitals and schools are being centralised and local hospitals and schools are being shut, you can only get to them if you drive, or have a friend that drives. You can't walk there. In an area like mine where car accessibility is only 53%, this represents a real problem. Public transport in Lanarkshire is lamentable; you can only get anywhere quickly, if it's Glasgow you're going to. If you are going to Wishaw by the bus, you can get there, but you would be advised to take a sleeping bag, a thermos flask and a copy of War and Peace.
Of course, if we're all on the roads travelling to schools or hospitals, it's going to get more congested. And if it's more congested, it's more difficult for emergencies to get through. NHS Lanarkshire compiled a report on how long it took to travel to each hospital in Lanarkshire, from each town. There was just one wee snag. They left out the rush hours. They estimated that you could travel from Monklands to Wishaw in 22 minutes. I can tell you that you could only get from Monklands to Wishaw in 22 minutes if it was 2 in the morning and you were Michael Schumacher.
Centralisation of this type can also cause problems when there are major emergencies. When the 7/7 bombings happened in London, they had problems getting emergency personnel to the scene, because they lived so far away from the centre of London. Similarly, our hospitals are going to have problems if their staff has to travel several miles to get to it in a major incident. Look at the stretch of the M8 from Easterhouse to Edinburgh. If Monklands A&E shuts and if St John's A&E in Livingston shuts, then that means that in the event of a major incident, ambulances are either going to have to drive to the centre of Glasgow to the Royal Infirmary, or the centre of Edinburgh to the ERI. Add the rush hour to that and you have problems. Not to mention all the nasty pollution.
But hey, let's be cheerful. All we have to do is to make sure that we don't have accidents at the rush hour. We can all manage that, can't we?
This made me ponder on how we have become more green conscious, but at the same time we are creating a society in which you can only exist if you possess a car. Because hospitals and schools are being centralised and local hospitals and schools are being shut, you can only get to them if you drive, or have a friend that drives. You can't walk there. In an area like mine where car accessibility is only 53%, this represents a real problem. Public transport in Lanarkshire is lamentable; you can only get anywhere quickly, if it's Glasgow you're going to. If you are going to Wishaw by the bus, you can get there, but you would be advised to take a sleeping bag, a thermos flask and a copy of War and Peace.
Of course, if we're all on the roads travelling to schools or hospitals, it's going to get more congested. And if it's more congested, it's more difficult for emergencies to get through. NHS Lanarkshire compiled a report on how long it took to travel to each hospital in Lanarkshire, from each town. There was just one wee snag. They left out the rush hours. They estimated that you could travel from Monklands to Wishaw in 22 minutes. I can tell you that you could only get from Monklands to Wishaw in 22 minutes if it was 2 in the morning and you were Michael Schumacher.
Centralisation of this type can also cause problems when there are major emergencies. When the 7/7 bombings happened in London, they had problems getting emergency personnel to the scene, because they lived so far away from the centre of London. Similarly, our hospitals are going to have problems if their staff has to travel several miles to get to it in a major incident. Look at the stretch of the M8 from Easterhouse to Edinburgh. If Monklands A&E shuts and if St John's A&E in Livingston shuts, then that means that in the event of a major incident, ambulances are either going to have to drive to the centre of Glasgow to the Royal Infirmary, or the centre of Edinburgh to the ERI. Add the rush hour to that and you have problems. Not to mention all the nasty pollution.
But hey, let's be cheerful. All we have to do is to make sure that we don't have accidents at the rush hour. We can all manage that, can't we?
Saturday, 3 March 2007
And so to Beds..
(Picture from Wikipedia).Wishaw hospital, which is near Motherwell, is going through a torrid time just now. The Wishaw Press reported that the hospital racked up record waiting times for patients in the A&E unit, that they had had to divert patients on 83 occasions during 2006 and that one patient was seen by a doctor in a cupboard two weeks ago. In reply, NHS Lanarkshire said that it was a very modern cupboard fit for the 21st century, that the patient had now been discharged from the cupboard and that contrary to scurrilous rumours, there had not been a skeleton in it.
Seriously though, bed numbers (and cupboards) are declining fast. Across Lanarkshire, we lost 300 acute beds after the new builds at Hairmyres and Wishaw, and these hospitals have been struggling to cope ever since they opened. According to the Unison report 'The PFI Experience' Hairmyres has been running at 99% capacity ever since it opened. A hospital is meant to run at 85% daily, to avoid cross infection and to enable effective turnaround of beds. So just what is happening? Why don't we have beds? Yep folks, it's good old PFI again.
Because it is so expensive to build under PFI, the hospitals tend to get built smaller. This means they can't fit as many beds into them, so you get a reduction in bed numbers. It also impacts on the number of operations that you can do. If you do an operation on someone, you need a bed to put them in. If you don't have a bed, you can't do the operation. If you can't do the operation, the waiting list grows. And so on.
Jean Turner has been flagging up this issue in the Scottish Parliament. For those who want a wee look at the most recent debate it's at http://www.scottish.parliament.uk/business/officalReports?meetingsParliament/or-06/sor1116-02htm#Col29484 . The debate was on the 16th November (and yes, I must learn how to do a link on this site.)
But the big question in Lanarkshire is; what happens when Monklands A&E shuts? How are we all going to cope? Better get started on kitting out those cupboards..
Seriously though, bed numbers (and cupboards) are declining fast. Across Lanarkshire, we lost 300 acute beds after the new builds at Hairmyres and Wishaw, and these hospitals have been struggling to cope ever since they opened. According to the Unison report 'The PFI Experience' Hairmyres has been running at 99% capacity ever since it opened. A hospital is meant to run at 85% daily, to avoid cross infection and to enable effective turnaround of beds. So just what is happening? Why don't we have beds? Yep folks, it's good old PFI again.
Because it is so expensive to build under PFI, the hospitals tend to get built smaller. This means they can't fit as many beds into them, so you get a reduction in bed numbers. It also impacts on the number of operations that you can do. If you do an operation on someone, you need a bed to put them in. If you don't have a bed, you can't do the operation. If you can't do the operation, the waiting list grows. And so on.
Jean Turner has been flagging up this issue in the Scottish Parliament. For those who want a wee look at the most recent debate it's at http://www.scottish.parliament.uk/business/officalReports?meetingsParliament/or-06/sor1116-02htm#Col29484 . The debate was on the 16th November (and yes, I must learn how to do a link on this site.)
But the big question in Lanarkshire is; what happens when Monklands A&E shuts? How are we all going to cope? Better get started on kitting out those cupboards..
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