Back from brink
Kenneth Roy tells the tale of how relentless investigation and campaigning became a lifeline to a local hospice
KEY POINTS
- Don’t accept defeat
- Find a good storyteller
- Get your story to the decision-makers
- Don’t take no for an answer
- Maintain a public profile
In the closing weeks of 2009, I was asked if the Scottish Review would become involved in the campaign to save St Margaret of Scotland Hospice. I knew nothing of the campaign and just the barest fragment of an anecdote about the hospice itself. I was about to learn a great deal more.
All I had ever heard of St Margaret's was a sad, amusing little story told by Murray Ritchie, former political editor of the Scottish Herald and contributor to the Scottish Review.
Bob, a former colleague of Ritchie’s, spent his last weeks in the hospice. Early one afternoon, a nurse came to his bed and asked if there was anything he would like. “Yes”, Bob replied, “I would like a glass of dry white wine”. Murray spoke well of the care our dying friend received there. He was not alone. The Care Commission has consistently rated St Margaret's as excellent in every department (see Figure 1 for more detail on St Margaret’s).
A lost cause?
When he first contacted me, the chairman of the hospice's board, Leo Martin, was disarmingly frank. He said he could use an inquiring journalist who would be in it, as he put it, “for the long haul”. He asked me to look at the history of the NHS's decision to withdraw funding for St Margaret's 30 continuing care beds – without which there would be a huge question over its viability. He said he could put many papers, reports and emails at my disposal. He duly did.
My heart sank as I studied the mass of material forwarded to me by Martin. It was a complex saga dating back ten years and was not going to be easy to present the material in a compelling way. Worse, it seemed that NHS Greater Glasgow and Clyde, the architect of the hospice's present misfortune, was quite immovable Having made up its mind, it betrayed no hint of being in any mood to budge. I concluded that if the Scottish Review did take on this cause, it would be fighting a lost one.
Yet the apparent injustice of the health board's policy surely demanded some last-ditch resistance. The board had embarked on a scheme to replace the continuing care beds at the hospice with a new build, financed by private capital, on the site of the crumbling Blawarthill Hospital nearby. There, the beds of the frail elderly would be rented out for profit, their care put in the hands of a commercial outfit called Southern Cross Healthcare. The scheme made no sense. It was inexplicable.
The more I thought about the Scottish Review’s approach to the story, the more convinced I became that there was no merit in joining an already substantial chorus singing the praises of St Margaret's. The Care Commission's glowing endorsements had made no difference. A petition signed by more than 100,000 people, the second largest ever to come before the Scottish Parliament, had made no difference. The support of influential politicians had made no difference. The only chink in the health board's formidable armour was the nature of the Blawarthill deal: this was the point of greatest weakness, yet it had never been properly exploited.
Flaws in the plan
There was no time to waste. The papers for the redevelopment of Blawarthill were due to be signed on 31 January 2010. We came to the story with five days to spare, heading our long expose: 'The land deal, the end of life, and the public interest'.1
We called it 'the most controversial land deal in the history of the NHS in Scotland' and, point by point, challenged its muddled thinking and the extraordinary cloudiness of the financial projections.
We made the most of our discovery that, when the plan for Blawarthill was approved by the health board and sent out for public consultation, there was no mention of the impact on the existing service being provided by St Margaret of Scotland Hospice. Indeed, there was no mention of the hospice at all. Had the members of the board been fully informed of the consequences of the scheme? Did they know what they were approving? If they had not been fully informed, if they did not know what they were approving, there seemed to us to be a strong case for challenging the legitimacy of the Blawarthill redevelopment.
Before we published these revelations, we alerted the first minister's office – we wanted Alex Salmond to know personally what we were doing – and received an appreciative message back.
Errors of judgement
Of course I did not know any of this until much later, but I had already planned our next move. The following day, bypassing the PR department, I contacted all the ministerial appointees on the board with personal emails routed through the office of the chairman, Andrew Robertson. The terms of each email were identical: I put seven questions about various aspects of the deal and asked them to reply individually.2 If part of the purpose of this strategy was to unsettle a complacent management – as I suppose it was – it certainly had the desired effect. The management promptly made its first error of judgement.
Instead of forwarding the emails to their intended recipients, it sat on them, allowing an enterprising journalist from the Daily Record, who had spotted the seven questions in the Scottish Review, to put them to the board himself. The board could safely ignore the tiny Scottish Review, but it would have been folly to ignore the Daily Record. The head of PR promptly answered the questions – but without consulting the board members. This failure of consultation was the second error of judgement, and it was to have serious repercussions.
Unknown to me when I started digging into the health board's affairs, a senior member of the board, John Bannon, who had been awarded the MBE for his services to the NHS, had become increasingly concerned by the Blawarthill scheme and he wrote a long letter to the cabinet secretary for health, Nicola Sturgeon and gave permission for the Scottish Review to quote from it.3 The letter, headed 'Scottish Review investigation', said “[I] requested all facts, figures, tendering documentation...but I have been frustrated, indeed would go as far as to say that I was obstructed in my endeavour to get to the truth”. Nicola Sturgeon at once sought a report from the health board on these serious allegations.
The Holyrood debate and its aftermath
A spark had been lit. All-party support for the hospice, always there but recently dormant, was reignited. During a debate in the Scottish Parliament on 11 March, Nicola Sturgeon, in her closing statement, said she expected the health board to engage in constructive discussions with the hospice about “a range of options” for its future.
At first these discussions seemed to be progressing well. But as soon as they ceased to be chairman to chairman, in other words between Martin and Robinson and began to involve senior officers of the board, they ran into the sand. The 'range of options' was effectively reduced to one: the conversion of a significant wing of the hospice into a bog-standard care home – an option consistently rejected by St Margaret's because it would have represented the destruction of the hospice movement's ethos. Martin felt he was getting nowhere. Contact between the parties became infrequent.
Meanwhile , the Scottish Review had seized on another weakness in the health board's plan for Blawarthill: the choice of Southern Cross to provide the care. Although the company looked buoyant at first glance, its underlying position was far from secure and it had been in financial difficulty. A debt of £33m, a share price in freefall,4 and a care record which had made some worrying headlines5, did not strike me as the record of a company with which a major public body should necessarily be doing important new business.
These doubts were confirmed when, by a piece of good luck, I discovered that Southern Cross had hired the services of a Glasgow-based crisis management consultant. If Southern Cross was officially in 'crisis', why was it still the preferred bidder for the Blawarthill contract?
The hospice is saved
The Scottish Review put these questions in a long piece headed 'Intensive Care'.
I emailed Dr Kevin Woods, the then head of the NHS in Scotland, informing him of all we had discovered about Blawarthill, including the state of Southern Cross. The letter was never acknowledged.
After a delay of some months, the papers were signed: despite all the warnings, the health board committed itself to its foolish scheme. But the Southern Cross share price kept tumbling. Had no one noticed?
In the weeks running up to Christmas, rumours began to emerge from the health board that Blawarthill was in deep trouble. By the end of the year, the scheme was dead. As Martin and Robertson met on 18 March, the PR department was preparing a press statement: the notice to end the contract for St Margaret's continuing care beds had been lifted (see Figure 2).
That evening Martin emailed John Bannon and myself: “I wanted to place on record my utmost thanks to both of you for all the public and selfless help you have given to the hospice and for the strength it has afforded us”. The hospice has been saved, although if I were Martin I would be insisting on a watertight, long-term contract.
Note: This article has been adapted from a version first published in The Scottish Review on 21 March 2011.
1. The Scottish Review, 26 January 2010
2. Set out in The Scottish Review, 27 January 2010
3. An extract of this letter appears in The Scottish Review, 2 February 2010
4. See ‘Southern Cross shares plunge’ by Maggie Urry and John O’Doherty, Financial Times, 30 June 2008
5. See ‘Hospice faces axe as scandal-hit care home chain strike deal for new hospital’ , by Annie Brown in The Daily Record, 2 December 2009
Author: Kenneth Roy
Kenneth Roy is editor of the Scottish Review and director of the Institute of Contemporary Scotland, and founder of the Young UK and Ireland Programme.
There are no comments on this article. Be the first to comment.