It is time to ask a few searching questions about the political oversight of the Scottish healthcare system.
In the recent past there has been the major furore over the planned closure of A&E services at Ayr and Monklands. These were cancelled by the incoming SNP administration, which then set up an independent review which concluded that, in the case of Ayrshire and Arran, the board had misled the public during the consultation period, had been selective in their use of statistics and did not have patient care and safety as their prime concern.
This has been followed by the manipulated waiting list issue at Edinburgh Royal Infirmary, and then by the issue of critical incident recording failures at – again – Ayrshire and Arran. These failures, with potentially fatal consequences to patients, were investigated and strongly condemned by an independent review. Only this week, Ayrshire and Arran was strongly criticised by the Information Commissioner's office for failing to take ownership of the issue of records.
With the exception of the Edinburgh case, nobody has been brought to account over these issues. In Ayrshire specifically there have been repeated questions as to why the entire board, executive and non-executive, have retained their posts in circumstances where much lower down the chain of authority automatic suspension would be the norm.
On a day-to-day basis healthcare is key to many people as highlighted in the editorial "A&E waiting times are unacceptable" (August 10). There has been a failure of political action to deal with what appear to be deep-seated failures of healthcare management repeatedly identified by independent watchdogs – it doesn't get much worse than "not having patient care and safety as their prime concern".
This shows either seriously flawed advice at the highest level, or a failure of political courage. The key issue is that the electorate is being failed.
Patrick McNally,
Kennoch House,
St Quivox, Ayr.
The obsolete language of The Herald's leader comment on unacceptable A&E waiting times makes the front door of the hospital sound like a dressing station behind the frontline of the Somme. The word "casualty" says it all. This expression was dumped by North America, Australia and New Zealand 25 years ago in favour of the proper title "emergency department".
The fact is that emergency medicine in the UK is a Cinderella speciality. The tragedy of British medicine is that the emergency medicine fraternity never really took on the combined might of the Royal Colleges to secure a higher profile and a bigger slice of the budgetary cake.
The team of doctors running the emergency department of Middlemore Hospital in South Auckland, New Zealand, are led by more than 20 consultant emergency physicians who specialise in emergency medicine and work exclusively in the emergency department. Nothing like that exists in the UK.
Dr Hamish Maclaren,
1 Grays Loan
Thornhill, Stirling.
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