MEDICS from three major hospitals have raised grave concerns with the Scottish Government that resources are being spread too thinly, describing a system "fast approaching crisis".
Doctors working in Hairmyres, Monklands and Wishaw hospitals wrote to NHS Lanarkshire chairwoman Neena Mahal months ago saying their efforts to deliver quality care were being undermined daily because services had not kept up with rising demand.
The health board has confirmed the letters were shared with the health department, but one hospital insider said that although meetings had taken place, no "tangible progress" has been made.
With the NHS a key referendum battleground, Health Secretary Alex Neil was last night accused of appearing to do nothing even though Monklands is in his Airdrie constituency.
The letters were leaked to The Herald as it emerged frontline staffing is so fragile in Lanarkshire that plans have been agreed to temporarily divert patients away from one emergency department in the event it cannot be staffed properly.
The board tried to reduce the number of A&Es in the region from three to two in 2006, but when the SNP came to power the following year they reversed this decision, saving Monklands A&E.
High mortality rates in Lanarkshire hospitals sparked an investigation into patient care last summer and the Medical Staff Association at Hairmyres in East Kilbride wrote to Ms Mahal in December last year expressing their anxiety.
The letter said: "The decision makers at the Scottish Government appear incapable of providing adequate resource to fund all current services to the levels required or to sanction the tough and hard choices required in an age of austerity to ensure a sustainable quality health service for the people of Lanarkshire."
The consultants add that Lanarkshire is the only health board sustaining three acute emergency centres, continuing: "the lack of economies of scale resulting from sharing clinical staff and resources over three hospitals has stretched the provision of services below acceptable and recommended levels."
Bed numbers and the configuration of Hairmyres "are not adequate to cope" with demand, according to the authors.
The medical staff associations from Monklands and Wishaw General Hospital wrote their own letters shortly afterwards endorsing the comments.
The Monklands letter said: "The body of opinion amongst the medical staff is that the current Lanarkshire model of working is not sustainable - and as time passes this is becoming increasingly apparent."
It adds that while the mortality rates review saw a "change management team being brought in ... there has been no mention of additional resources or staffing to address the problems of over-worked medical staff, who are stretched to the breaking point."
An NHS Lanarkshire spokesman said: "We are obviously keen to support our clinical staff to continue to provide the high quality of care our patients expect and we are working with them to develop a clinical strategy to ensure we go on providing safe, sustainable services across Lanarkshire".
Scottish Labour's health spokesman Neil Findlay MSP said: "These serious concerns were raised in January ... this is in the Cabinet Secretary Alex Neil's own backyard yet it appears he has done nothing. This is an astonishing situation."
A Scottish Government spokesman said: "The decision to maintain three A&Es was the right one for the people of Lanarkshire. We have backed that up with considerable increased resources.
"Since Monklands A&E was retained in July 2007 there have been over 450,000 attendances, and under the current Government staff numbers have increased by 9.9 per cent - an increase of over 900 staff, to the highest staffing levels there have ever been in NHS Lanarkshire. By 2015/16, NHS Lanarkshire's budget will have increased by 9.2 per cent in real terms since 2006/07."
"The letters were shared with Scottish Government and the Chief Executive of NHS Scotland met with the medical staff associations and noted their enthusiasm for developing a new clinical strategy, which would both assist in recruitment and retention of staff, and optimising patient care."
He added that the government was happy to "support and engage" in the process, which was for NHS Lanarkshire to take forward.
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