PLANS to send hundreds more patients from across Scotland to the Golden Jubilee National Hospital for routine operations have sparked concern among surgeons.
The Scottish Government has announced it is spending an extra £1.5 million on doctors and nurses at the Clydebank hospital to perform more hip and knee replacements and cataract operations.
Health Secretary Alex Neil said the move would help health boards achieve promises on waiting times and cut the number of patients they refer to private hospitals for timely treatment.
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The announcement follows questioning of NHS managers by Holyrood's audit committee about patients missing out on the Scottish Government's supposedly legally-binding waiting times guarantee.
Leading surgeons said they welcomed efforts to cut treatment delays, but they expressed concern about sending hundreds more patients away from their local hospital for routine treatment.
Mr Colin Howie, vice-president of the British Orthopaedic Association and an orthopaedic surgeon in Scotland, said: "Reducing waiting lists is important and we, as a profession, support reducing waiting lists. Our concern is about how it is being done.
"While the profession supports the centralisation of complex surgery, it is disappointing that in Scotland we appear to be centralising routine care.
"This will lead to de-skilling due to lack of practise at a local level.
"Patients will no longer be able to see the consultant who will do their operation locally."
The Golden Jubilee was bought for the NHS from the private sector to carry out planned operations and reduce waiting lists in 2002 and has expanded since.
Last summer almost 40% of hip and knee replacements on patients from the NHS Forth Valley area were carried out at Golden Jubilee.
In the Lothians more than a quarter of patients were sent across for these procedures in the first half of last year and in the first quarter of 2013 the figure for Lanarkshire was just below 20%.
Some surgeons have described increasing use of Golden Jubilee as "centralisation by stealth".
They talk about performing routine hip and knee replacements being important for maintaining surgeon's skills and say staff in regional hospitals need a balance of this planned work and emergency trauma care.
The extra money announced yesterday is creating capacity at Golden Jubilee for an extra 300 joint replacements and up to 1200 cataract operations a year.
Mr Ian Ritchie, president of the Royal College Of Surgeons Of Edinburgh, said: "Overall, this is good news for patients in Scotland but, like Colin Howie, I would be concerned about the effect this is going to have on the morale of clinicians around Scotland who have seen other routine work diverted away from them."
He questioned where the new Golden Jubilee staff would come from and how it would affect the appeal of jobs in regional hospitals - where staff are needed to provide emergency cover.
Mr Ritchie added: "The patients will have good operations done by well-trained staff in an excellent environment at Golden Jubilee, but I would like to see that replicated throughout Scotland."
Mr Neil said the concerns were "unfounded". He said the aging population meant more patients would need operations and the money would help the NHS meet demand without reducing through-put elsewhere.
He added: "We are not forcing anyone to the Golden Jubilee, but people who have been through the hospital very often want to go back if they need further treatment because of the standard of the service."