This petition is based on a widespread concern about the provision of Community and Cottage hospitals as well as Council Care homes throughout Scotland.
The closure or threatened closure of such healthcare facilities has been widely opposed by local communities both in rural and urban areas. Indeed, the opposition to such closures has in some cases led to the retention of such services as evidenced by the decision to retain six Community and Cottage hospitals in the Dumfries and Galloway area.
However, in other areas, closures or radical changes of use have gone ahead despite considerable local opposition to such steps being taken. To cite one example, the popular Lockhart Hospital in Lanark was closed as a residential hospital in 2016. This resulted in over three hundred people attending a public meeting in Lanark, the largest for thirty years.
The background to the general closure of Community and Cottage hospitals is grounded in Scottish Government and NHS policies dating back to 2012. I attended a meeting organised by the Clydesdale Public Health Partnership. There, the new Integrated Public Healthcare Partnership was showcased. One of the salient features of this was to replace Community and Cottage hospitals with Care at Home.
The closures began not long afterwards across Scotland, but the pace of closures or moves away from residential care picked up pace in 2016 - 2017 after financial packages had been provided for the implementation of Government policy.
Public reaction has not been positive, as there is still a need for residential care. In Lanarkshire, for example, residential care is provided in more rural areas such as Biggar and Douglas. There is no similar provision in larger areas such as Carluke and Lanark. This can be a serious problem, especially for people without their own transport, who may not be able to get to Biggar or Douglas to visit friends or relatives. This problem has also been found to be true in other areas such as dementia units and facilities for older people in Peterhead where similar service cuts have taken place.
Another example of the threat to services for older people is the recent proposal to do away with 89 beds at Crosshouse Hospital in Ayrshire to reduce debt to the Scottish Government from the Ayrshire and Arran Health Board.
Care at Home has been a central plank of the changes in care for those who are either elderly or with long term conditions. This has posed significant problems for hospital to home transitions. The major hospitals have had spates of bed blocking as the necessary Care Packages are sometimes quite difficult to provide both in terms of care staff or mechanical devices to assist the patients.
It is not only the NHS that faces problems but also Local Authorities. During my time as a Councillor on South Lanarkshire, I noticed that the amount of money given towards the implementation of social care integration was small. Indeed, the figure for the Clydesdale district was only £1 million. The net result, not only in Clydesdale, but in South Lanarkshire as a whole, was a considerable shortfall in funding resulting in the need to transfer extra funding to implement the Integrated Care package.
This problem however is not just limited to just South Lanarkshire. Apart from the need to look at extra funding, there have been suggestions that the number of residential care homes should be cut down. This process has already taken place in North Lanarkshire. The majority of these have now been closed or had their function altered into being temporary care homes until a home package can be worked out. Now South Lanarkshire is poised to follow suit in the reduction of Council run Care Homes in its area.
In terms of patient treatment, the Integrated Social Care package cannot cover all the needs of both older people and those with long term conditions. In the first instance, some conditions are so bad that Home Care is impossible.
This was recognised several years ago when it was decided by NHS Lanarkshire to make forty beds available at Udston Hospital near Hamilton. In addition, the very fact that both the Kello hospital in Biggar and the Lady Home hospital in Douglas still provide the traditional Community Hospital care is an indication of the need for this type of care.
Social Integration Packages do not work for everybody. For isolated older people the visits by both healthcare professionals and social care staff is insufficient in terms of those with major problems, especially appertaining to bowels and bladder. Then there are those properties which are completely unsuited to provision of mechanical devices such as chair lifts.
Finally, I would urge serious consideration to be taken of this petition. Whilst recognising that in some cases provision can be made for some people to return home, there are a substantial number of people that require residential care. A fact that has been noticed in other countries such as Germany which is actually building more Community Hospitals and Care Homes to manage the problems facing their older citizens.