NHS purchase of HCI could have negative effect

IF HCI hospital is bought over for the NHS and turned into a centre of excellence it could drain the west of Scotland of medical staff and ruin Glasgow's future hospital plans, experts have warned.

NHS Greater Glasgow has just completed its hospital plans for the next few decades based around three major hospitals in the city. Doctors have warned that these could be jeopardised if staff are robbed to run a centre of excellence at HCI in Clydebank.

HCI has been proposed as a centre of excellence for the NHS in either cancer or heart disease but as a new cancer centre is already under construction at Gartnavel Hospital in the north of Glasgow, it is believed a heart centre is more likely.

But if the centre is used for emergency as well as routine heart treatment experts warn that patient care would suffer. Dr Barry Vallance, associate medical director at Lanarkshire Acute Hospitals NHS Trust, which refers patients to Glasgow for heart surgery, said: "If patients present with a heart attack at Glasgow Royal Infirmary or the Southern General Hospital then HCI in Clydebank is quite far away. We have looked at this carefully and do not think services should be any more than 25 minutes away.

"For major planned procedures this would work but I do not know how they would handle emergencies."

He added: "One of the proposals I have heard is having a team at HCI for the day - there would be a pool available and the team would be based there. But this would create an issue about taking expertise away from the local hospital's coronary care unit."

A centre of excellence in heart disease would be better located at one of the existing hospitals in the city, says Dr Frank Dunn, consultant cardiologist at Stobhill Hospital in Glasgow. "A stand- alone cardiac centre would need major support services. For this reason it may be better to have the centre located within a hospital in the city.

"There is also an issue of the staffing of it. With the cutting of junior doctors' hours there is already a staffing shortage and there would be major issues about the opening of another site when one of the planks of the health board's plans was to reduce the number of sites."

Dr David Murdoch, consultant cardiologist at the Southern General Hospital in Glasgow, also believes HCI is too remote to deal with emergencies.

"There is a problem of getting equity of access. HCI is stuck out a bit to the west. If this is just for non-urgent cardiac surgery it could work. The biggest problem is the emergency situation for heart attacks and severe angina and carrying out immediate angioplasties - that is my main concern at the moment. There would need to be a special ambulance service set up to get patients to HCI in time."

But Ken Davidson, head of cardiac services at HCI, last night pointed out that the private hospital has the advantage of numerous theatres and intensive care beds.

"My view is that there is an opportunity to help the NHS, whether that is through outright purchase or not. A cardiac centre does not need to be in the city centre.

"It has been built with a huge number of intensive care beds and a huge number of theatres. It is built with the provision of services that the NHS wouldn't try to match but if we look at the problems of MRSA, a contributory factor is not being able to isolate patients. At HCI there are individual rooms."

Argyll and Clyde Acute Hospitals NHS Trust has expressed an interest in HCI as a replacement for the ageing Vale of Leven hospital in Alexandria. A spokesman for Argyll and Clyde Acute Hospitals NHS Trust said the Scottish Executive is dealing with the negotiations.

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