Sunday 18 May 2014

Ambulance for Neil?

THE controversy over Health Secretary Alex Neil intervening in the shake-up of mental health services at his local health board has been a slow-burn one.
The Sunday Herald broke the story as far back as November 2012.
Since then, the First Minister and the Permament Secretary have said Neil did nothing wrong in upending his predecessor's decision to remove acute beds from Monklands Hospital in his Airdrie & Shotts seat.
But last week the story came back to bite Neil after new FoI material obtained by Labour proved he ordered the U-turn before stepping back from the issue to avoid a conflict of interest.
Compounding Neil's offence in Labour eyes is the way he later said he'd delegated the matter to a junior minister because Monklands was in his constituency, when he had already taken the crucial decision himself.
That, Johann Lamont claimed, was deceiving parliament.
The FM has refused to sack Neil, but Labour smell blood and won't let go.
The Sunday Herald has now obtained a new email suggesting Neil's primary motivation was his own political backyard, rather the wider health board concerns cited by Alex Salmond at FMQs.
Here's a longer version of today's story.



EXCLUSIVE
Tom Gordon
Scottish Political Editor
 
ALEX Neil was last night under growing pressure to resign after an email emerged showing his ferocious opposition to a health shake-up in his constituency that he controverisally reversed within days of becoming Health Secretary.  
 
The email, obtained by the Sunday Herald despite an attempt to censor its contents, shows Neil was vehemently against removing acute mental health services from Monklands Hospital because of the impact on his Airdrie & Shotts seat.
 
He later ordered NHS Lanarkshire to rewrite its plans and retain beds at Monklands, despite official warnings it would mean a “less than optimal service” in “inferior accommodation” at the hospital, where asbestos is officially described as “ubiquitous”.
 
Despite his critical intervention, Neil subsequently told the Scottish Parliament he had delegated decisions on Monklands to a deputy minister “because it lies in my constituency”.
 
The Ministerial Code says ministers must avoid conflicts of interests when taking decisions affecting their constituencies.
From NHS Lanarkshire Property Strategy April 2009 to March 2013
 
Labour claim Neil “deceived” the parliament and have urged Alex Salmond to sack him.
The First Minister, who previously cleared Neil of breaching the Ministerial Code over the affair, last week refused to dismiss him, and said the Monklands decision was part of wider changes affecting the whole health board.
“To define it purely as a constitutency issue ignores the fact that the health service affects and serves all of the population,” he said.
However an email written by Neil to NHS Lanarkshire on 9 August 2012 suggests that constituency issues were paramount to the future Health Secretary.
At the time, the then Health Secretary Nicola Sturgeon had just agreed to concentrate mental health beds at Wishaw and Hairmyres, outside Neil’s seat, and remove them from Monklands.
With NHS Lanarkshire due to finalise the plan on 23 August, Neil was asked if he would endorse the board’s decision in a press release.
Neil's unredacted email of 9-8-12
 Although NHS Lanarkshire blacked out Neil’s reply, the Sunday Herald has seen the contents.  After asking the board to delay a decision until after his holiday, Neil declined to contribute.
“While I support the overall strategic approach, I don’t agree with your recommendations in relation to not locating one of the new units in Monklands, which covers a much more deprived catchment area than East Kilbride,” he said.
“The proposals are not consistent with an anti-poverty strategy.
“My reading of the analysis of why Monkalnds shouldn’t retain a mental health unit is that it is essentially prejudiced on the economics of the PFIs [private finance initiatives] at both Wishaw and Hairmyres.”
He said it would be “extremely rash” to announce the change without laying on free hospital transport for patients’ friends and families.
“Given the level of poverty and deprivation in Airdrie this will just not be possible if people on low incomes have to pay to get to Wishaw or Hairmyres. I strongly suggest that this release includes the details of planned investment at Monklands Hospital, otherwise local people will be even further incensed yet again by the actions of NHS Lanarkshire.”
Neil's email after NHS Lanarkshire's redactions
To allow Neil to stay involved, the board agreed to delay its decision until 26 September.
However on 5 September, a reshuffle saw Neil promoted to the position of Health Secretary.
Within days he undertook a “review” of the mental health plans, and on 26 September his private secretary told fellow government officials Neil’s “clear view” was to keep beds at Monklands and NHS Lanarkshire was to be asked to “reconfigure their plans accordingly”.
It was not until later that day that Neil stepped aside because of “a perception of a conflict of interest” and passed responsibility for mental health services at Monklands to public health minister Michael Matheson.
Labour argue that by then Neil had already taken the key decision on Monklands, leaving Matheson to merely rubberstamp the board’s revised plan.
Labour health spokesman Neil Findlay said: “This is another deeply damaging revelation. It makes clear that Alex Neil was going to oppose the decision, approved by Nicola Sturgeon, to close mental health beds at Monklands, because of the impact it would have on his constituency. 
“Alex Neil said he wouldn’t handle the decision because it was a constituency matter.
“Alex Salmond this week said it wasn’t a constituency matter. The SNP’s defence is all over the place as they scrabble to defend a minister interfering in NHS decisions. Alex Neil’s position is untenable. He must resign.”
Neil campaigning about Monklands services before the 2011 election, when he took Airdrie & Shotts from Labour
A Scottish Government spokeswoman said: “On his appointment as Health Secretary, Mr Neil wished to review a number of key decisions, including the proposals about to be put forward by the board of NHS Lanarkshire on mental health services. With over 500,000 people resident in NHS Lanarkshire’s area, Mr Neil addressed his concerns on the service change to the region as a whole. He was clear in his view that acute mental health facilities would be best retained at Wishaw General Hospital, Monklands Hospital, and with a unit at Hairmyres Hospital.”
Regarding asbestos at Monklands, the government added: “Asbestos is only dangerous when disturbed. NHS boards have a responsibility to ensure asbestos is safely managed and contained. It should not be removed unnecessarily.”
 

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