Health Secretary Neil Gray makes a statement in the Scottish Parliament on NHS Lothian's plan to close Edinburgh's Eye Pavilion for six months for urgent plumbing work. He also talks about the future of eyecare and refused to confirm whether the promised replacement eye hospital would go ahead. 26-09-24.
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00:00in Edinburgh. Last week, NHS Lothian announced that, from late October, the eye pavilion
00:06will be vacated for a period of around six months. That is to allow critical maintenance
00:11to be carried out and subsequent recommissioning of the site. It is clear that that will cause
00:16disruption to patients and staff. I understand that both groups are concerned about the impact
00:21that that will have on arrangements for providing care and on waiting times. I am sorry for
00:27the worry that I know that that will cause for many. Let me start by being clear that
00:31my priority and that of NHS Lothian is ensuring safety and, to the fullest extent possible,
00:37minimising disruption.
00:38In my statement today, I will provide further information on the critical maintenance that
00:42will be carried out at the eye pavilion and on the planning for those patients' appointments
00:46that need to be rearranged as a consequence. I hope that that will provide assurance to
00:50all concerned that the matter is being addressed with due care and speed. I will also speak
00:55to the need for service and financial sustainability and reform in the future. We know that change
01:01is needed and we must do things differently.
01:05Let me briefly explain the issue that has led to the temporary closure of the eye pavilion.
01:10Two copper waste pipe stacks require to be replaced. It is critical that that is done
01:14quickly to prevent damage that would require more significant remedial works and cause
01:19greater disruption. That is why vacating the hospital is being done at pace. With NHS Lothian
01:25planning to hand the building over to contractors on 25 October.
01:29With regard to the expected duration of the closure, the current estimate from NHS Lothian
01:34is six months. That is an estimate and the timeframe and programme of works is being
01:39developed. It will be kept under review ahead of and during the works and recommissioning.
01:46In terms of what will happen during the period of closure and why that takes time, the site
01:51requires to be decanted before remedial works can be undertaken and recommissioning is required
01:56before reopening. Decanting the site is a complex process and includes the removing
02:01of equipment as well as the relocation of clinics. Unfortunately, during surveys to
02:06assess the work required, it has been identified that one of the waste pipes is located within
02:10a cavity that contains asbestos. That adds to the complexity and timeline of the remedial
02:16works.
02:17Brief removal of the asbestos material is essential ahead of the pipework replacement
02:21for the safety of those carrying out the work and for those who use the site. Once the remedial
02:27works are complete, the process of recommissioning is required to provide assurance that the
02:31site is fully operational and to ensure safety ahead of reopening.
02:36During the coming weeks and months, my officials and I will stay in close contact with NHS
02:40Lothian to seek the necessary assurances around progress. As I have said, patient safety is
02:47paramount. Following my visit to the eye pavilion this morning, along with Miles Briggs,
02:51Sarah Boyack and Daniel Johnson, I am assured that the board is doing everything possible
02:56to minimise disruption and any potential harm to patients. NHS Lothian is looking at all
03:03possible options across its estate to maximise capacity for ophthalmology patients. After
03:09hearing directly from patients at a previous meeting on the issue, I have also sought assurance
03:15that there will be minimal travel for those patients with the most profound needs, which is a
03:20critical issue that patients have raised with me. The vast majority of patients who are scheduled
03:25before Friday 25 October will be unaffected, and the small number of patients who are affected
03:31will be contacted by NHS Lothian at least two weeks prior to their appointment. Patients who
03:36are booked for appointments from Monday 28 October will be contacted with changes to
03:41their appointments, and new patients will be given an alternative location in their booking letter.
03:46Although NHS Lothian is still finalising all the details of its plans, I have heard
03:51from it that communication with patients, MSPs, local partners and Government is and will be
03:58on-going. I know that it will also have a planned meeting on 4 October with all
04:04Lothian MSPs, where it will share more detail following the conclusion of its final plan.
04:09The board is also working closely with staff and unions for staff who will be
04:13displaced to manage their concerns.
04:16I turn to the future of eye care services. It is important to recognise that the replacement of the
04:21eye pavilion was included as part of the national treatment centre programme, which is intended to
04:25provide capacity for all of Scotland. As we look ahead, we must continue to plan on the basis of
04:30need and available resources across the whole of Scotland. The landscape has changed significantly
04:35since the national treatment centre programme started, not least as a result of Covid,
04:41Brexit and soaring construction costs. As we have made clear repeatedly,
04:47the financial climate is extremely challenging across the revenue and capital budgets.
04:52We have also made clear that health service reform is essential for operational and
04:57financial sustainability. Our actions must enable NHS Scotland to maximise capacity,
05:02build greater resilience and deliver reductions in the number of patients who have waited too long
05:07for treatment. In that context, all spending, even that previously committed, must be carefully
05:12considered so that it is directed where it will have the greatest impact.
05:16We know that the NHS estate is ageing and that it is not affordable to replace everything as
05:20quickly as we might like—a position that is not unique to Scotland. We must make better use of
05:25our existing resources to support reform and improvement, and we must consider where strategic
05:30investment across our existing estate will provide better value than replacement.
05:35We must also consider how we can improve through service redesign to ensure that we have a
05:39resilient service for the future. We are working with all health boards, including NHS Lothian,
05:45to develop a whole-system infrastructure plan. That will consider health infrastructure needs
05:50for the whole of Scotland to support continued safe operation of existing facilities and inform
05:55longer-term investment priorities. As I have made clear, a key part of our consideration
06:01must be how existing resources can be better utilised to provide the required capacity.
06:08We must also retain focus on preventing the need for hospital treatment in the first place.
06:13That means investing in our existing estate and reducing pressure on that estate by delivering
06:18services in a different way. For eye care services, that includes consideration of how
06:23we better utilise capacity at existing treatment centres. A key part of that is ensuring that more
06:29people are treated in a community setting where that is clinically appropriate. We know that
06:34treatment closer to home is of benefit to patients, with the potential to improve patient experience
06:39and overall health outcomes. Making better use of community services frees up acute capacity
06:44for more complex cases. The community optometry sector already provides a first port of call
06:50service to patients with eye problems. That is enabled by Scotland being the only nation
06:55in the UK to provide free universal NHS eye examinations, a policy that the Government
06:59is committed to maintaining. That has been successful in supporting many patients to
07:03be managed in the community, closer to home, instead of needing to be referred to hospital
07:08or to be seen by a GP. However, the community optometry sector has the capacity and capability
07:13to do much more. An example of that is the new community glaucoma service,
07:19which moves lower-risk patients who are traditionally seen in a hospital setting
07:22to available capacity in the community optometry sector, freeing up hospital capacity for patients
07:28with the most sight-threatening conditions. That service has been rolled out nationally and will
07:33deliver the capacity and technology for an estimated 20,000 patients to receive their
07:37care closer to home. We are also investing in our future optometry workforce through Scotland's new
07:43UK-leading master's optometry undergraduate degree. That, among other things, will enable
07:49students to graduate as independent prescribing optometrists, and it will help to build additional
07:54capacity to support more patients being managed in the community instead of being referred to
07:58hospital. The course has just been launched at Glasgow Caledonian University, and the
08:02public health and higher education minister visited the university on Tuesday to meet the
08:07new students and teaching staff. The Government looks forward to the University of the Highlands
08:11and Islands launching a similar course next year.
08:16I understand that members and their constituents are extremely concerned about the announcement
08:21that the eye pavilion will close for a period of time. I share that concern. Let me reaffirm
08:27that my priority, along with that of NHS Lothian, is to limit disruption and avoid harm, as well as
08:34ensuring that eye care appointments that would have taken place at the eye pavilion go ahead,
08:38despite the temporary closure. I also know that many are concerned about the future of
08:42the eye pavilion and will be disappointed that I have not been able to confirm today
08:46its replacement in my statement. I give my commitment that we will continue to look ahead
08:51to how eye care services can be delivered most effectively, with a clear focus on improved
08:56services and reduced waiting times. We must be open to all possibilities on how that can be
09:01achieved, including how we make better use of existing services.