Report on the Scottish Regional Treatment Centre


See below the summary of the report by Ronald N Macdonald and John R Evans. For the full report, click here to download PDF.

Summary

The Scottish Regional Treatment Centre (SRTC) at Stracathro Hospital is the first Independent Sector Treatment Centre (ISTC) in Scotland. Between the 15 and 16 November 2006, Tayside NHS Board signed the SRTC contract with Amicus Healthcare (Scotland) Ltd, a subsidiary of Netcare (UK), an independent sector healthcare company. The SRTC contract is for elective procedures for NHS patients from Tayside, Grampian and Fife. An unused ward at Stracathro Hospital was refurbished for this purpose. £15million, over three years, was provided by the Scottish Executive to fund the contract.

Stracathro Hospital was the first National Health Service Ambulatory Diagnostic and Treatment Centre (NHS ADTC) operating in Scotland. This opened in March 2002. Since January 2007 the excellent facilities at Stracathro Hospital are shared by the NHS ADTC and the SRTC. The NHS ADTC operates during the day from Monday to Friday, while the SRTC operates evenings and weekends.

The BMA in Scotland has openly expressed reservations about the SRTC project at Stracathro Hospital, but, up to now, there has been little public comment by other trades union in Scotland.

The whole development was characterised by a lack of public debate. In our opinion NHS Tayside (supported by the Scottish Executive) have not followed the spirit of Scottish Executive guidelines on public consultation, and we believe that our request for a public consultation, based on the NHS Reform (Scotland) Act 2004, should have been granted.

Prior to 15 December 2004, the date that funding for arrangements with the independent healthcare sector for new diagnostic and treatment facilities was announced by the Scottish Executive, neither ISTCs, nor the SRTC, were debated in the Scottish Parliament or at the Scottish Parliament Health Committee. The SRTC Pilot Project at Stracathro Hospital was announced on 26 May 2005 as part of a Scottish Executive Health Department news release on waiting times.

There was no mention of ISTCs in the NHS in Scotland by the Scottish Labour Party, or their coalition partners, in the manifestos for the 2003 Scottish Parliament election and, hence, they did not have a mandate from the electorate in Scotland to introduce private healthcare into the clinical services of the NHS in Scotland in the form of the three-year SRTC contract at Stracathro Hospital.

Prior to the contract being signed, Tayside NHS Board refused to provide the financial data in the SRTC contract on the grounds of commercial confidentiality. After the contract was signed, in November 2006, the contract was published on the NHS Tayside website, but without any financial data. In October 2007, a formal Freedom of Information request for the financial data was denied by NHS Tayside on the grounds that such disclosure would be likely to prejudice substantially Netcare Healthcare UK Ltd.’s commercial interests. A review by NHS Tayside has confirmed that view, and the papers have been sent to the Scottish Information Commissioner for a decision. Without this financial data, the public and researchers have great difficulty in the assessment of value for money of this project. Currently, NHS Tayside is planning an internal first year review of the pilot project to assess its effectiveness.

In November 2007, we are assured that Nicola Sturgeon, Deputy Prime Minister and Cabinet Secretary for Health and Wellbeing in the Scottish Government, will organize a comprehensive evaluation of the SRTC project prior to the end of the three-year contract. It is the Secretary’s view that this will need to examine value for money, the benefits to patients and whether these benefits could have been, or could possibly in the future be, realized in different ways.

In England, the ISTC programme, which has been funded by a total of about £5.4billion, is highly controversial, and many of the issues in England apply to the SRTC project in Scotland.

We hope this report will help to inform any future debates and discussions on ISTCs or the SRTC project.

Ronald N Macdonald and John R Evans

 

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