When a hospital is so short-staffed that it cannot keep a children's ward open during the peak holiday season without putting patients at risk, there must be concern about overall levels of staffing.
The children's ward at St John's Hospital in Livingston will close for three weeks next month because the number of paediatricians has been cut. The decision also reveals that the hospital is dependent on locums for the children's ward and they cannot provide enough cover during the holiday season for the 20-30 patients a week normally treated.
The problem stems from a reduction in the number of training posts for junior doctors.
In April, NHS Education for Scotland, the body responsible for doctors' training, removed all four trainee paediatricians from St John's to fill gaps elsewhere in South-east Scotland, leaving six consultants to run the ward which requires one consultant and one junior to be resident in the hospital every night. This means that the potential problem must have been known in April, raising the question of why the hospital and Lothian Health Board could not implement a means of ensuring sufficient staff were available.
There have been considerable job reductions in the NHS in Scotland and the pressure would seem to be made worse by a reduction in training places for junior doctors. However the situation at St John's follows the failure by Lothian Health Board to meet the Scottish Government's 18-week target for treatment last year. That raised questions about management of staff and resources at the health board when it was discovered patients were being suspended from waiting lists if they refused to travel to England for treatment.
Given the scale of staff cuts among both nurses and administrative staff across the NHS in Scotland and against a background of rising demand and a standstill budget, something has to give and a vital service has been compromised. It is the responsibility of health boards to ensure that essential cover is maintained.
Temporary closure of the children's ward may be the right decision to ensure safety, which must be the first priority, but it will make life more difficult for families with sick children, including babies who need special care, who must travel to Edinburgh. Training posts will be re-established in August but proper workforce planning is urgently required to restore public confidence.
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